AI-Powered • Rule-Based • Fully Integrated

Two engines. One flawless revenue cycle.

MediVatrix combines machine-intelligence with deterministic payer-rule engines to automate, assist and audit every step of your revenue cycle — from clinical documentation to final payment — with an integrated EHR/EMR and a purpose-built NICU module.

HIPAA-Compliant FHIR & HL7 Native Human-in-the-Loop Governance SOC 2 Ready

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Healthcare professionals analyzing revenue performance on a data display

98.6% Clean Claim RateFirst-pass acceptance, pre-submission

48 hrs Encounter → Clean ClaimFrom charge capture to payer submission

0%Uplift in realized revenue
0%Reduction in RCM operating cost
0%Fewer denials at the payer
0hEncounter to clean claim

Works with the systems you already run — no rip-and-replace

Epic
Oracle Health (Cerner)
MEDITECH
athenahealth
NextGen
eClinicalWorks
Allscripts
Greenway

The MediVatrix RCM Engine

AI where it counts. Rules where it must.

Most platforms choose one approach. MediVatrix runs both in parallel: predictive AI models that learn from every claim, and a deterministic rule engine that never bends on compliance — with every output explainable and auditable.

Engine 01

AI-Powered Intelligence

Purpose-trained clinical and billing models read the chart the way a coder would — surfacing gaps, suggesting codes with linked evidence, and scoring denial risk before submission.

Documentation gap detection & auto-generated physician queries
Evidence-linked CPT / ICD-10 / HCPCS / modifier suggestions
Predictive denial & underpayment scoring on every claim
Continuous learning — every adjudication feeds the model back

Engine 02

Rule-Based Determinism

A configurable, payer-specific rules layer enforces what cannot be approximate. Edit logic, medical policy and custom payer contracts apply identically to claim number one and claim number one million.

NCCI, MUE, LCD/NCD and payer contract rules at pre-bill
Custom rule sets per payer, plan, specialty and site of service
Compliance guardrails — modifiers, units, split/shared, global periods
Every rule firing logged, versioned and audit-ready

Core Capabilities

Comprehensive RCM, end to end

Six linked capabilities cover the full cycle — each one automated where it should be, human-controlled where it must be.

Clinical Documentation Improvement

Finds documentation gaps before coding happens and drafts physician queries at the source — MDM and specificity flags, HCC/RAF gap detection, copy-paste and clone awareness.

3–5% RVU uplift captured

Autonomous & Assisted Coding

AI models propose evidence-linked codes across CPT, ICD-10, HCPCS and modifiers. Route simple charts to straight-through coding and complex ones to your human coders.

98%+ coding accuracy

Pre-Bill Claim Validation

Every claim is scrubbed before it leaves the building: payer rules, medical policy, edit logic and denial-probability scoring stop rejections at the door — not after.

~30% denials prevented pre-submission

Denials & Appeals Automation

Root-cause classification, appeal letter drafting and payer follow-up driven by AI — with workflow bots handling outreach so your team only touches what needs judgment.

Appeals filed automatically

RPA Status Checks & AR Follow-up

Software bots monitor claim status around the clock across payer portals and EDI, surfacing aging AR automatically — zero manual status calls, day or night.

24/7 autonomous AR worklist

Clean Submission, Posting & Patient Billing

Validated claims go out same-day; ERAs auto-post payments, refunds and patient balances flow to statements and text-to-pay — cash lands without keying.

3–7 day reduction in DNFB

How It Runs

One continuous cycle, five automated checkpoints

MediVatrix embeds into your existing workflow and moves with the claim — capturing, correcting, validating, submitting and recovering without hand-offs between disconnected tools.

Register & Verify

Eligibility, benefits and prior-authorisation checks fire at scheduling and again before the visit.

Document & Code

CDI gaps and AI-assisted coding work in parallel on the chart, with human sign-off you control.

Scrub & Validate

Rules engine applies NCCI/MUE/LCD/NCD and payer contract logic; AI scores denial probability.

Submit & Track

Clean claims go the same day; RPA bots watch payer status and aging AR automatically.

Recover & Learn

Denials are root-caused, appealed and fed back into CDI and rules — the cycle tightens monthly.

Data network visualisation over clinical billing documents

Integrated Suite • EHR / EMR

An EHR/EMR built to feed the revenue engine

Clinical excellence and clean revenue are the same data problem. MediVatrix's EHR/EMR layer captures care in structured, billable, query-ready form — so nothing is lost between the bedside and the payer.

Smart charting — specialty templates, flowsheets & problem-oriented notes
CPOE & e-prescribing — orders, med rec, formulary and EPCS-ready
Results & documentation — labs, imaging, vitals and scanned records in one chart
Encounter-to-charge sync — every note flows straight into the RCM engine
Patient portal & scheduling — appointments, messages, forms and bill pay
Interoperability — FHIR R4 and HL7 v2 interfaces, CCDA import/export
Quality & risk capture — HCC/RAF recapture, registry and MIPS/Qualified-Clinician reporting
Mobile rounds — role-based access with full audit trails

45%faster chart closure

2xcoder throughput

99.9%uptime SLA

See EHR/EMR in a Demo NICU Configuration →

Physician reviewing patient data on a tablet in a modern exam room

Specialty Module • Neonatal Intensive Care

Purpose-built for the NICU

Neonatal intensive care is the hardest revenue cycle in medicine: two patients, shifting custody, severity-based payment, per-diem vs. service logic, and documentation that must survive audit. MediVatrix handles it natively — not as a workaround.

Maternal–infant record linking — dual charts, delivery stays and transferred-custody billing done right
Risk-adjusted reimbursement — RST-IR / GRN II severity scoring captured at the point of care
Respiratory support tracking — vent & CPAP hours auto-compiled for prolonged-service and RT charges
Per-diem & service hybrids — payer-specific NICU billing rules enforced per plan, level and day
Growth, feeding & BPD/IVH documentation — structured flowsheets that feed coding specificity
Charge capture at the bedside — lines, imaging, breast-milk processing and consumables never missed
Compliance bundles — hearing screening, CLP, immunisation and discharge-checklist records
Family-centred care — parent portal, messaging and rooming (MRS) support

99%+NICU charge capture

30%fewer level-of-care denials

+3.5%RVS recovery on reviewed charts

Request a NICU Walkthrough

Neonatal nurse adjusting equipment beside an incubator in a NICU

Who It's For

Built for every setting that bills for care

Hospitals & Health Systems

High-volume automation, cross-service-line analytics and enterprise controls that scale with volume — not headcount.

Physician Groups & MSOs

One standardised revenue engine across every practice under management — with specialty-aware rules per entity.

Surgical & Specialty Clinics

Ortho, cardiology, oncology and multi-procedure ASC claims with the payer logic each specialty demands.

Children's & Neonatal Units

The dedicated NICU module plus paediatric rulesets — maternal–infant billing, severity scoring and compliance bundles.

Behavioural Health & Rehab

Complex payer requirements, longer stays and carve-out plan logic handled end-to-end.

FQHCs & Community Health

Mission-driven care backed by sustainable operations — PPS wrap, encounter accuracy and grant-ready reporting.

Why MediVatrix

What leading providers choose us for

One integrated platform that prevents denials before they happen — and proves it with an audit trail.

Pre-Submission, Not Post-Denial

We intervene while the claim is still yours to fix — catching documentation gaps, coding errors and payer-rule violations before submission.

Dual-Engine Confidence

AI proposes; rules enforce. Where they disagree, the claim goes to a human — every exception is logged and used to improve both engines.

Continuously Learning

A built-in data lake captures billing data, adjudication outcomes and payer rule changes. Every denial feeds root cause back into CDI and coding.

RCM + EHR + NICU in One Stack

No stitched-together point solutions. Clinical documentation, revenue intelligence and specialty workflows share one source of truth.

Deep EHR Integration

FHIR/HL7 APIs, native integrations and batch/SFTP pipelines meet your practice where its data already lives.

Enterprise-Grade Compliance

HIPAA-aligned operations, HITRUST-mapped controls and SOC 2 Type II posture satisfy clinical and compliance leadership alike.

Security HIPAA HITRUST Aligned SOC 2 Type II 256-bit Encryption at Rest & in Transit Role-Based Access & Full Audit Trails

Results

Outcomes you can take to the board

“

Our clean claim rate moved from 92% to 99% in a single quarter. The rules engine caught payer edits our old scrubber never saw, and first-pass yield hit 96%.

“

NICU denials used to eat weeks of appeal work. Now vent hours, severity scores and maternal–infant linkage are documented at the bedside — level-of-care denials dropped 30%.

“

We cut AR days by 35% within two quarters and recovered $2.4M in aged claims — while spending less on back-office staffing, not more.

FAQ

Frequently asked questions

MediVatrix runs two engines in parallel: predictive AI models and a deterministic, payer-specific rules layer. AI handles judgment work — documentation gaps, coding suggestions, denial prediction — while rules enforce what must never be approximate, such as NCCI edits and contract logic. Everything is auditable, and disagreements between the engines escalate to your human reviewers.

Traditional RCM software applies static rules and needs constant manual intervention. AI-based RCM learns from adjudication outcomes and surfaces issues rules alone can't see. MediVatrix deliberately combines both, so you get the reach of machine learning with the predictability and compliance of explicit rules.

Yes. We connect natively with major systems (Epic, Oracle Health/Cerner, MEDITECH, athenahealth, NextGen and more) through FHIR R4, HL7 v2, and batch/SFTP pipelines. There is no rip-and-replace — although if you want one, the integrated MediVatrix EHR/EMR is available too.

By stopping them before submission: CDI fixes documentation at the source, coding suggestions arrive with linked evidence, and the rules engine applies payer, medical-policy and edit logic at pre-bill with denial-probability scoring. Post-submission, denials are root-caused and appealed automatically, then fed back into the engine.

MediVatrix NICU covers maternal–infant record linkage and transferred-custody billing, RST-IR/GRN II severity capture, ventilator and CPAP hour compilation, per-diem versus service-based payer logic, growth/feeding and BPD/IVH documentation flowsheets, bedside charge capture, compliance screening bundles and a family-centred parent portal.

Typical programmes see measurable impact within 6–9 months: a 1–5% lift in realised revenue, double-digit denial reduction, and lower administrative cost per claim. Clean-claim cycle time commonly falls to 48 hours or less per encounter within the first two months after go-live.

Low-confidence and unfamiliar cases are flagged for human review instead of being decided automatically. Your reviewer's decision then trains both engines — so the platform widens its automated coverage over time without ever guessing on compliance.

HIPAA-aligned operations, HITRUST-mapped controls, a SOC 2 Type II posture, 256-bit encryption at rest and in transit, role-based access with full audit trails, and regional data-residency options. Every AI and rules decision is logged for payer audit and internal review.

Ready to capture every dollar of earned revenue?

See the dual-engine RCM platform, the EHR/EMR and the NICU module in one 30-minute walkthrough.

Book Your Free Consultation Estimate Your ROI

Get Started

Talk to a MediVatrix specialist

Tell us where your revenue cycle leaks — denials, coding turnaround, aging AR or NICU complexity — and we'll map the fix to your environment in a live session.

Office 2nd floor, Suchi Mansion, 33, Chikkathogur Main Rd,
Pragathi Nagar, Electronic City,

Bengaluru, Karnataka 560100

Email hello@medivatrix.com

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