Frequently Asked Questions

SmartCoding.ai is built for healthcare organizations of all sizes, including:

• Solo practitioners and small practices
• Multi-specialty medical groups
• Hospitals and health systems
• Billing companies and RCM service providers
• Ambulatory surgery centers

Our AI engine analyzes clinical documentation using natural language processing (NLP) to understand the context, diagnoses, and procedures documented. It then suggests the most appropriate ICD-10, CPT, and HCPCS codes based on the clinical content, payer rules, and coding guidelines.

Each suggestion includes a confidence score and reasoning, allowing coders to quickly review and accept or modify the recommendations.

SmartCoding.ai supports all major medical code sets:

• ICD-10-CM (diagnosis codes)
• CPT (procedure codes)
• HCPCS Level II (supplies, equipment, services)
• ICD-10-PCS (inpatient procedures)
• Modifiers

Our code database is updated quarterly to reflect the latest code additions, deletions, and revisions.

SmartCoding.ai currently integrates with Claim.MD for clearinghouse connectivity, supporting:

• 837P claim submission
• 835 remittance import with auto-posting
• 276/277 claim status inquiry
• 270/271 eligibility verification

Direct EMR integrations are on our roadmap. Currently, clinical documentation can be imported via file upload or copy/paste. Contact us to discuss your integration needs.

SmartCoding.ai supports all medical specialties, including but not limited to:

• Primary Care / Family Medicine
• Cardiology
• Orthopedics
• Dermatology
• Gastroenterology
• OB/GYN
• Behavioral Health
• Emergency Medicine

Our AI models are trained on specialty-specific documentation patterns and coding guidelines.

Our claim scrubbing engine validates every claim against thousands of rules before submission, including:

• CCI (Correct Coding Initiative) edits
• LCD/NCD requirements
• Payer-specific rules
• Gender and age-specific edits
• Modifier validation
• Missing or invalid data detection

Issues are flagged with clear explanations and suggested fixes before claims are submitted.

We offer flexible pricing options to fit organizations of all sizes:

• Healthcare Practices: Per-claim or per-provider pricing based on volume
• Billing Services / RCM: Volume-based pricing for multi-client management

Contact us for a custom quote based on your specific needs, or visit our pricing page for more details.

We offer demos and pilot programs to help you evaluate the platform. Schedule a demo to see SmartCoding.ai in action with your own workflow, and ask about pilot options for your organization.

A claim is defined as a single 837P transaction submitted to a payer. Multiple service lines on the same claim count as one claim. Resubmissions and corrected claims are counted as new claims.

No hidden fees. Implementation and training are included with all subscriptions. Custom integration work may have additional costs depending on complexity, but these are always discussed upfront before signing.

Most practices are up and running within 2 weeks. This includes:

• Account setup and configuration
• EMR/PM integration (if applicable)
• User training sessions
• Data migration assistance

Enterprise implementations with complex custom integrations may take 4-6 weeks.

All plans include comprehensive training:

• Live onboarding sessions with your team
• On-demand video tutorials
• Interactive help documentation
• Role-specific training tracks (coders, billers, managers)

Enterprise customers receive dedicated training specialists and can request on-site training sessions.

Yes. Our implementation team will help you migrate historical data from your existing system. We support imports from standard data formats like CSV and X12. HL7 integration is coming soon.

Yes, absolutely. SmartCoding.ai is fully HIPAA compliant. We:

• Sign Business Associate Agreements (BAAs) with all customers
• Encrypt all data in transit and at rest
• Maintain strict access controls and audit logs
• Conduct regular security assessments
• Train all employees on HIPAA requirements

SmartCoding.ai implements enterprise-grade security measures:

• AES-256-GCM encryption for data at rest
• TLS 1.3 encryption for data in transit
• PHI sanitization before AI processing
• Role-based access control (8 user roles)
• Comprehensive HIPAA audit logging

Learn more about our security practices.

All data is stored in secure data centers located in the United States. We use Microsoft Azure cloud infrastructure with redundant storage, automatic backups, and disaster recovery capabilities.

We offer multiple support channels:

• Email support
• Phone support
• In-app help documentation

Support response times and dedicated account management vary by plan. Contact us for details on support options.

You can reach our support team through:

• Email: support@smartcoding.ai
• Phone: (404) 282-1085
• Contact form: Contact Us