You deliver the care. We make sure you get paid for it. Assured Health AI brings together people who actually understand healthcare billing with smart automation that catches what humans miss — so your revenue flows the way it should.
Here's what we keep hearing from providers: the care is excellent, but the money isn't following. Claims get denied for avoidable reasons. Prior auths sit in limbo. Coding gaps quietly drain revenue. Staff are burned out and the rules change every quarter. Sound familiar?
Our coders and billing specialists have been doing this for years. The difference? They now have AI watching their backs — flagging likely denials, verifying eligibility in real time, and catching the stuff that's easy to miss at 4pm on a Friday.
Cardiology billing is a completely different animal from home health. We don't pretend otherwise. We've built separate teams for 30+ specialties, staffed by people who think in the CPT codes and payer quirks specific to your world.
No black boxes, no monthly PDF reports that tell you nothing. You get real-time dashboards showing every claim, every denial, every dollar — benchmarked against national averages so you know exactly where you stand.
From the moment a patient books an appointment to the day the last dollar lands in your account — there are a hundred places where revenue can leak. We plug every one of them.
Most denied claims can be traced back to something that went wrong before the patient even sat down. A wrong insurance ID. A missed prior auth. We fix that.
Our team handles scheduling, demographics, real-time eligibility checks (EDI 270/271), benefits validation, prior auths, and financial counseling. The AI part? It predicts which services will need authorization before your front desk even picks up the phone, and our bots confirm coverage in under a minute.
Registration Accuracy ≥ 98% · Eligibility Verification within 24 hours · Prior Auth Turnaround ≤ 48 hours · POS Collections ≥ 80% of estimates
This is where the clinical work becomes billable revenue — and honestly, where most money gets left behind. If the documentation isn't tight, or the code doesn't match the encounter, you're losing before you even submit.
Our CDI specialists work directly with your providers on queries. Our coders hold CPC, CCS, CPC-H, and COC certifications and know their way around ICD-10, CPT, and HCPCS cold. They use AI-assisted tools to work faster, but every code gets a human set of eyes before it goes out the door.
Coding Accuracy ≥ 95% · Charge Lag ≤ 48 hours · CDI Query Response ≥ 90% within 48 hours
After the claim is built, that's when our team really earns its keep. We scrub every claim against payer-specific rules, submit electronically via EDI 837, track every acknowledgment, and jump on rejections before they turn into denials.
Denial management is probably what we're best known for. Our AI flags risky claims before they go out. When denials do happen, we dig into the CARC/RARC codes, figure out why, draft the appeal, resubmit — and then feed those lessons back to the front end so the same mistake doesn't happen twice.
Clean Claim Rate ≥ 95% · Denial Rate ≤ 5% · First-Pass Resolution ≥ 90% · AR Days ≤ 40 · CEI ≥ 98%
Here's one that catches a lot of practices off guard: you can code a claim perfectly, but if the provider's credentials lapsed or the payer enrollment fell through the cracks, that claim is dead on arrival.
We handle the entire credentialing lifecycle — CAQH ProView, PECOS, every major commercial payer portal. Our systems track license renewals, attestation deadlines, OIG exclusion checks, and DEA renewals automatically. For larger organizations, we do delegated credentialing under NCQA standards and can cut turnaround from 90 days to 30.
Credentialing Turnaround ≤ 90 days · Re-Credentialing Completion ≥ 98% · Inactive Provider Claim Rate ≤ 1%
This isn't just about finding mistakes after the fact — it's about building a system where those mistakes are harder to make in the first place.
We run pre-bill and post-bill audits, reconcile charge capture, review your payer contracts for compliance gaps, and hunt down underpayments. We follow OIG guidance, audit 5–10% of coded claims every quarter, and keep complete documentation trails. When CMS or RAC auditors show up, you won't be scrambling.
We're not slapping "AI" on a brochure. These tools are baked into our daily workflows and they make a measurable difference.
Our RPA bots cut manual work by 60–80% on things like eligibility checks and ERA posting. The denial prediction engine catches at-risk claims before they go out, boosting first-pass rates by 10%+. Our NLP tools read clinical notes and suggest codes, making coders 25–40% more productive. And our contract intelligence software finds the underpayments your team doesn't have time to chase.
Every tool we use has a human checking its work. That's not a tagline — it's how we actually operate.
A billing team that can't tell a global surgical period from an infusion sequence will cost you money, not save it. That's why we've built dedicated teams for each specialty — staffed by coders who hold the certifications and live in the nuances of your specific discipline.
We didn't build AI to replace your team — we built it so they can stop doing the tedious stuff and focus on the work that actually requires a brain. Our platform chews through eligibility data, clinical notes, claim files, and denial patterns in real time, surfacing the stuff that matters.
Flag services likely to require auth, identify coverage gaps, estimate out-of-pocket costs
Read clinical docs, suggest ICD-10/CPT codes, catch missed charges before they become lost revenue
Score every claim for rejection risk, route high-risk claims for pre-submission correction. 90%+ first-pass rate
Auto-post remittances, detect underpayments, categorize denials by root cause, prioritize AR by collectability
We're serious about this: every model we deploy is explainable, auditable, and monitored for bias. PHI never leaves HIPAA-compliant, BAA-covered environments. And no AI suggestion — whether it's a code recommendation or a prioritization score — goes into production without a human reviewing it first. AI earns trust the same way any new team member does: by being transparent, accurate, and accountable.
Assured Health AI started with a frustration most healthcare people know well: the revenue cycle is broken, but not because anyone's lazy or incompetent. The systems just haven't kept pace. Regulations shift every quarter. Payer rules change by plan, state, and specialty. The gap between what a doctor documents and what actually gets reimbursed keeps getting wider.
We're the healthcare arm of Assured Outcome, a company that's built a reputation for structured delivery and measurable results across industries. We took that same operational discipline and pointed it squarely at revenue cycle — then layered on the clinical knowledge, payer intelligence, and AI tooling that this space actually needs.
Today we work with everyone from five-provider family medicine clinics to 200-bed hospital systems. The model flexes. What doesn't flex is our standard of work.
Behind each CPT code is a real person who received care and a provider who showed up to deliver it. Our job is to make sure that story gets told right — so the organizations that provide care can keep providing it.
We use AI and automation for the repetitive stuff — the rules-based, high-volume work that burns people out. That frees our human experts for the judgment calls, the tricky appeals, the conversations with payers that actually require a brain.
HIPAA, the No Surprises Act, OIG guidelines, payer-specific edits — these aren't afterthoughts. They're baked into every workflow from day one. It's cheaper and less stressful to build it right than to fix it later.
In healthcare, getting compliance wrong doesn't just cost you a denied claim — it can cost you your practice. We've built compliance into the foundation of everything we do, not as an afterthought or a marketing line.
HIPAA, HITECH, the ACA, MACRA/MIPS, the Cures Act, No Surprises Act, Stark Law, Anti-Kickback — the list keeps growing. Our team tracks CMS MLN updates, OIG Work Plan changes, and state-specific laws (CCPA, NY SHIELD, Texas HB 300) so regulatory surprises don't become your problem.
All PHI is protected with AES-256 encryption at rest and TLS 1.2+ in transit. Access requires multi-factor authentication and follows least-privilege principles. We run 24/7 SIEM monitoring, continuous vulnerability scanning, and maintain incident response plans aligned to NIST SP 800-61. BAAs are signed before any data moves. Period.
We keep complete audit trails linking every billed service to its clinical documentation. We run internal coding audits using OIG sampling methods and do annual mock audits simulating RAC, ZPIC/UPIC, and OIG scenarios. When auditors come — internal or external — the paperwork is already organized, timestamped, and ready to defend.
Look, denial rates are up 20% since 2020. Patient responsibility is creeping toward 25% of revenue. Hospital margins are razor-thin. And finding good coders is getting harder every year. You need a partner that's built for this reality — not one that's still pitching a 2015 playbook.
We inherited this from Assured Outcome: if your AR days aren't dropping, your denials aren't shrinking, and your collections aren't climbing — we haven't done our job. We tie our success to your KPIs, not to hours billed or headcount deployed.
We don't just assign whoever's available. Each specialty we support has its own team — coders who hold the relevant certifications, denial analysts who know the top rejection patterns for that specialty and payer, and managers who've worked in those clinical settings.
Our bots handle eligibility, claim status, ERA posting, license tracking — the high-volume, rules-based stuff that eats up hours. Our people handle the judgment calls: tricky coding decisions, appeal strategy, payer negotiations. It's a better use of everyone's time.
We run a hybrid U.S. and offshore model — you get stateside client management with certified teams in SOC 2-audited, HIPAA-compliant delivery centers. Need 5 people? 50? We scale without cutting corners on quality or security.
We share what we learn — partly because it makes the industry better, and partly because if you read these, you'll understand why we do things the way we do.
Forget the jargon. Here's a plain-English breakdown of the new documentation requirements, time-based billing updates, and modifier rules you need to know.
We pulled apart the most common CARC/RARC codes, traced what triggers them, and mapped out practical steps to prevent them upstream.
NLP-assisted coding is genuinely useful in some areas and overpromised in others. Here's an honest take on where the technology stands today.
Maybe you're a solo doc drowning in denials. Maybe you're running billing for a 50-provider group and it's not scaling. Maybe you're a hospital CFO who keeps hearing about AI and wants to see if it's real. Whatever the situation, we're happy to just talk.
We'll ask about your challenges, look at your numbers, and tell you honestly whether we can help. If there's a fit, we'll put together a proposal tailored to your situation. If there isn't, we'll tell you that too — and probably point you in a better direction.