AI Claim Scrubber
Deterministic rules + an LLM risk pass catch denial-prone claims before they leave your office.
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AI-native revenue cycle
Get paid faster.
Deny fewer claims.
MedIQ pairs a deterministic rule engine with your choice of LLM to scrub every claim, route every denial, and draft every appeal — across one secure, multi-tenant workspace.
HIPAA-aligned AES-256-GCM secrets BAA available SOC 2 in progress
app.mediq.ai / claims / CLM-001 274
LiveClaim
CLM-001274 · $642.00
Payer
Aetna Commercial
First-pass accept
98.4%
Mean A/R
11d
Denial rate
-42%
Cost / claim
$0.18
AI risk score
42
/ 100 likely to pay first pass
- ✓Eligibility verified · plan active
- ✓CPT 99214 ↔ ICD E11.9 crosswalk passes
- ✓Modifier 25 valid given E/M + procedure
- !Prior auth recommended within 24h
Appeal draft (if denied)
Per ACA §2719 and plan SPD, the rendered service is medically necessary documentation
Designed to interoperate with the payers and clearinghouses you already use
Change Healthcare
Availity
Waystar
Aetna
United Health
Anthem
Cigna
Humana
Blue Shield
Kaiser
Medicare
Medicaid
Change Healthcare
Availity
Waystar
Aetna
United Health
Anthem
Cigna
Humana
Blue Shield
Kaiser
Medicare
Medicaid
Demo workspace · illustrative
Numbers that move when you actually fix the pipeline.
0.0%
First-pass acceptance
vs. 89% industry baseline
−0%
Denial rate
after first 90 days
0d
Mean days in A/R
down from 31d baseline
$0.00
Cost per scrubbed claim
amortized LLM + rules
One workspace
A complete revenue cycle, not a stack of tabs.
Encounters, claims, scrubber, denials, payments, work queues, reports, admin — all stitched together with the same multi-tenant data model and the same security guarantees.
Denials & Appeals
Track every CARC/RARC, prioritize by recoverable dollars, and auto-draft appeal letters.
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Encounters & Charge Capture
Capture CPT, ICD, modifiers, and POS at the point of service with crosswalk validation.
Payments & ERA
Post payer EFT/ERA and patient payments to the right claim line with auto-reconciliation.
Reports & A/R
Aging buckets, payer mix, denial trend, days-in-A/R — drillable, exportable CSV.
Work Queues
Tasks routed by queue, priority, and assignee — claim review, denials, missing info, payment posting.
AI architecture
Deterministic rules plus the model you trust.
We never gamble compliance on a black box. Every claim goes through a deterministic rule engine first — CPT/ICD crosswalks, modifier checks, payer rules, duplicate detection. The LLM only adds risk scoring and human-quality appeal drafting on top.
- Bring your own modelClaude, GPT, Gemini, or Llama — per workspace.
- Bring your own keyYour OpenRouter key, AES-256-GCM encrypted at rest.
- De-identified promptsPHI never leaves your tenant in plaintext.
- Auditable decisionsEvery AI call logged with input hash and model version.
Appeal letter · auto-drafted
streamingSecurity-first
The same workspace your auditor will love.
MedIQ was designed for HIPAA-conscious operations from day one. Per-tenant row-level security, encryption at rest and in transit, granular roles, and a full audit log of every change.
Tenant-isolated by default
Every row carries a tenant_id; Postgres RLS enforces who can see what.
AES-256-GCM secrets
Per-tenant OpenRouter keys encrypted with per-record IVs.
Role-based access
Super admin, tenant admin, biller, provider, front desk, auditor.
Audit log of every change
Status transitions, role grants, secret rotations — all logged.
BAA available
Signed Business Associate Agreement for HIPAA-covered customers.
No PHI in AI prompts
De-identification before any model call; logged input hash.
Built for the way you bill
Whether you're a clinic, a billing company, or a system — MedIQ scales with you.
PCP · Specialty · DSO
Independent practices
Replace the spreadsheets and patchwork EHR add-ons with one billing surface your front desk and biller actually share.
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Service bureaus · MSOsBilling companies
Onboard a new client in hours, not weeks. Multi-tenant by design, with per-tenant AI keys and reporting.
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Hospitals · IDNsHealth systems
Standardize denials and appeals across sites, then plug into your data warehouse via FHIR + CSV exports.
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We cut denials almost in half in our first quarter on MedIQ. The scrubber catches what our seniors used to catch — and the appeal drafts are the difference between an overtime weekend and a 30-minute review.
Director of Billing, multi-site PCP group
Illustrative — replace with real customer once pilot completes.
Pilot in 14 days
Plug in a clearinghouse and a payer; we'll seed the workspace and run scrubber side-by-side.
BAA on request
Standard BAA available before any PHI flows.
Implementation engineer
Growth + Enterprise plans ship with a named implementation engineer.
Pricing
Per-provider, per-month. Cancel anytime.
Start with the deterministic scrubber and add AI capacity as you go. Bring your own model key on Growth and above — no surprise inference bills.
Starter
$249/ provider / mo
- Up to 3 providers
- Deterministic scrubber
- 100 AI scrubs / mo
Growth
$549/ provider / mo
- Unlimited providers
- BYO LLM key
- Appeal drafts
Enterprise
Custom
- White-label & SSO
- Custom connectors
- BAA + SLA
Spin up the demo workspace in 60 seconds.
Click 'Set up demo' on the sign-in page. You'll land in a fully-seeded MedIQ workspace with patients, encounters, claims, denials, payments — and a live scrubber.