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Step 7 of 14 · AI & Coding

AI Claim Intelligence

CLM-2026-0088431 · Sarah Johnson · $528.00 in charges

9-point scrub

NetRev AI Claim Review

Ready to scan

0%
0/9 checks
1Eligibility & benefits
2Diagnosis coding
3CPT selection
4Modifier logic
5Documentation support
6Medical necessity (LCD/NCD)
7Prior authorization
8Duplicate claim scan
9Payer coding rules

Rule Engine Detail

Payer-specific edits · UnitedHealthcare Choice Plus

Eligibility & benefits

Active coverage, $30 co-pay applied

Queued

Diagnosis coding

M17.11 valid, specificity satisfied

Queued

CPT selection

99204 supported by MDM & time

Queued

Modifier logic

Evaluating NCCI edits

Queued

Prior authorization

Checking payer auth registry

Queued

Duplicate claim scan

No match in prior 90 days

Queued