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Revenue · RCM & Prior Authorization

Charge Capture from Unstructured Clinical Notes

Surface likely missed charges from notes for coder review, not autonomous coding theater.

Primary search: charge capture AI medical billing

The problem

Missed charges are silent revenue loss. Full autonomous coding is a liability landmine.

Ops-only RCM AI: denials, packets, policy RAG. No diagnostic claims. Faster ROI, lower liability surface.

Buyer: VP RCM or Billing Director at a DSO, specialty group, or medical billing company

How we ship it

  1. 01Suggest candidate charges with evidence spans
  2. 02Require coder confirmation
  3. 03Log overrides for continuous improvement
  4. 04Stay clear of diagnostic claims

Outcome

Recover missed charges with human accountability.

KPI: Revenue

How to engage

Start bounded on this workflow. Expand only after the KPI moves.

Denial / prior-auth diagnostic

From $7,500

Baseline first-pass yield and packet cycle time; pick the first mandate.

Scoped production mandate

From $15k

Denial scoring or prior-auth packets live in 6–10 weeks.

Embedded partnership

From $25k/mo

Expand payers and specialties with your RCM team.

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Frequently asked questions

How long does it take to ship charge capture assist?

Most charge capture assist mandates target a 6–10 week production deploy after a short diagnostic. Week one locks the KPI (revenue) and data sources; we redirect if a simpler path wins.

Do we have to replace our existing systems?

No. We orchestrate against the systems you already run. The first mandate is charge capture AI medical billing in your stack, not a platform rip-and-replace.

How is this different from buying another SaaS tool for RCM & Prior Authorization?

You own the code, evals, and models in your cloud. SaaS adds another login; we ship a production workflow your team operates with the Production Standard contracted in writing.

Is this clinical AI?

No. We do not diagnose. We automate billing ops: denials, packets, and policy retrieval. Lower regulatory surface, faster ROI.

How do you scope AI for our industry?

Week-one discovery locks business KPIs (revenue, cost, risk, or cycle time), not model vanity metrics. We map your data sources, compliance constraints, and existing stack, then propose a fixed-scope mandate with acceptance criteria or redirect you to a simpler path.

Do you have experience in our sector?

Proven depth sectors (financial services, federal, real estate, telecom, higher education) reflect production systems we've shipped. Growth and operator verticals (MGAs, credit unions, property management, 3PL, RCM, staffing, licensed iGaming, FFL) are selective mandates where those patterns transfer with industry-specific tuning. Biotech, insurance, and regulated work often runs under NDA.

The Production Standard

The Production Standard

Six commitments contracted in writing on every engagement.

01

Deploy or redirect

If AI isn't the right tool, we say so in week one and redirect budget to what will ship. No POC theater.

02

Metrics before models

Business KPIs locked in discovery. Model selection follows the metric, not the hype cycle.

03

Governance from day one

Model cards, access controls, evaluation harnesses, and audit trails, not a compliance bolt-on at go-live.

04

Production artifacts

Deployed code, monitoring dashboards, CI/CD pipelines, and incident runbooks. Not recommendations for someone else to implement.

05

6-week production target

Scoped projects designed for production in 6–10 weeks. Boutiques move; global programs wait for steering committees.

06

Capability transfer

Your team can operate, extend, and maintain what we build. IP and documentation transfer is included, not upsold.

Every scoped project includes a production deliverable checklist signed off before close. If we can't commit to deployable output, we won't take the engagement.

Selective intake · 2026

Your next system shouldship to production.

Agentic development from architecture through deployment, with the Production Standard contracted in writing.

(801) 508-4734contact@prismbase.aiAtlanta · Serving select clients nationwide