For Your Practice · How It Works

From the visit
to the payment.

Follow one encounter through Althais: the note, the codes, your review, the claim, the checks, and the money coming back.

One encounter · example
NoteSigned
Codes99285 · R07.9 · R06.00
ReviewApproved by provider
ClaimCMS-1500 assembled
StatusPaid
Eight steps
NoteCodesReviewClaimChecksSubmitTrackPaid
Eight steps

One encounter,
start to finish.

01 · Provider note

It starts with
the note.

Clinical documentation is captured as-is: SOAP notes, dictation, or text from your EHR.

Write a note
app.althais.com
The SOAP note entry screen in Althais, with chief complaint, HPI, vitals and assessment and plan
02 · AI coding

Codes come from
the documentation.

Diagnoses and procedures are pulled from the note as ICD-10 and CPT codes, with the right specificity and modifiers, and a confidence score on each.

Suggested codes
app.althais.com
AI-suggested ICD-10 and CPT codes generated from the clinical note, with confidence scores
03 · Provider review

A person decides
on every code.

The rendering provider accepts, edits or rejects each suggested code. Nothing moves forward without that decision.

Review codes
app.althais.com
A provider accepting AI-suggested codes in Althais
04 · Claim assembly

The claim
builds itself.

Approved codes, modifiers and encounter details are assembled into a CMS-1500 claim, ready to read once before it goes.

Claim form
app.althais.com
A CMS-1500 claim form assembled from the approved codes
05 · Payer checks

Checked before
it leaves the building.

Each claim is checked against CMS edits and payer-specific rules, so problems are fixed before a denial instead of after.

Payer intelligence
app.althais.com
Payer intelligence showing tracked payers, approval rates and payer-specific billing rules
06 · Submission

Sent through
your clearinghouse.

The clean claim is transmitted electronically through the clearinghouse you already use.

Submitted
app.althais.com
Claim transmission confirmation with the EDI transaction details and status
07 · Tracking

Every status,
as it changes.

Accepted, pending, denied: updates flow back as they happen. Denials arrive with the reason and an appeal letter ready to draft.

Claims overview
app.althais.com
Claims overview with live status: paid, submitted, denied and pending review
08 · Payment

The loop closes
when it's paid.

Payments are reconciled and posted against each claim, so you can see what came in and what still needs attention.

Payments
app.althais.com
Claims filtered to paid, showing posted payment amounts
Going live

Live in 30 to 60 days,
with a pilot first.

  1. Week 1

    Connect

    Your EHR and clearinghouse are connected, and practice, provider and payer details are set up.

  2. Weeks 2 to 3

    Tune

    Coding is tuned to your specialty mix, roles are set, and your team is invited and trained.

  3. Pilot

    Prove it

    A small group of providers uses Althais on real documentation while you check the results.

  4. Rollout

    Go live

    Everyone moves over, with support included as you grow.

Who does what

Everyone keeps their job. The busywork goes.

Providers
Record the visit, review the drafted note, sign it, and approve or change the codes
Coders
Review suggested codes with their confidence and reasons, and run the code check
Billers
Work the claims queue, fix held claims, send appeals and post payments
Front desk
Schedule and register patients so visits start with the right details
Managers
Invite staff, set role access, and see the whole practice's claims
Althais
Drafts notes, suggests codes, runs the checks, assembles claims and tracks them
Questions

Asked and answered.

How long does implementation take?

Most organizations are live within 30 to 60 days: integrations first, then tuning, then a provider pilot before full rollout.

Who approves the codes?

The rendering provider approves every code before it reaches a claim.

Do we need a new clearinghouse?

No. Althais works with the clearinghouse you already use.