What if autonomous coding had the power to ensure enterprise healthcare companies were paid every dollar earned for services provided?

An Uphill Battle for Revenue

The reimbursement battle between healthcare providers and insurance companies is growing exponentially more complex and convoluted.

The reality is that this complexity favors insurers, who have invested in new technologies that can automatically limit or deny claims. Health systems have caught on and begun leveraging technologies to try to balance the field, while also managing limited staffing and tight budgets across the revenue cycle.

But, as the complexity has evolved, autonomous coding solutions have started to struggle with limitations on its potential impact on the revenue cycle. Many solutions help automate coding with a high level of accuracy, and many vendors make similar claims of speed, increased revenue, hours saved, etc.

The problem is that these solutions focus only on automating coding based on available documentation, which is often not the best approach for optimal, compliant reimbursement. Because coding is limited by the quality of documentation, money is being left on the table.

Arintra is taking a fresh look at how healthcare organizations manage their entire revenue cycle. Our platform goes beyond traditional approaches, offering an advanced solution for autonomous coding, clinical documentation, and denials prevention.

Arintra, now armed with a $21 million Series A investment, is not merely leveling that playing field, but giving healthcare providers a distinct advantage.

Taking the Lead in GenAI Powered Autonomous Medical Coding

Our mission is simple, yet transformative: become the most comprehensive Revenue Assurance platform for hospitals and health systems. Revenue Assurance means that we take autonomous coding a step beyond simply translating from one source (documentation) to another (medical codes for insurance claims).

By leveraging cutting-edge GenAI and deep domain expertise, we analyze documentation to identify any potential gaps and ensure that all aspects of the service are captured. We dive deeper, asking questions of providers, such as “When the practitioner completed X procedure, did she also conduct Y and Z?”, based on our universal knowledge of what practitioners typically do in such procedures. Our AI reasoning agent analyzes mountains of claims data from health systems and insurance firms to get the insights we need to ensure customers see a sharp increase in revenue.

The platform provides granular feedback for physicians and coders to capture all possible codes related to that service, and to improve terminology in existing documentation to support the highest level of compliant coding. The better that documentation reflects the services provided, the more optimal the code level, and the more revenue improves. Combining this with payer-aware denials insights, we lessen the impact of delays and the back-and-forth between providers and insurers.

In this way, we're helping hospitals and health systems optimize their financial performance through compliant reimbursement with fewer delays and significantly less manual effort.

That is why Mercyhealth – with over seven hospitals and hundreds of clinics, urgent care and medical center locations – used our platform and realized a more than 5% increase in revenue. They also slashed their work queue in half while actually cutting costs by one-third.

It’s also why Indiana’s Reid Health used our systems to accelerate accounts receivables cycles and sharply improve coding accuracy across all specialties.

Arintra’s relentless focus on getting health systems paid accurately and efficiently for every service provided is what we call Revenue Assurance.

A Step Apart from Current Healthcare Coding

What sets us apart? First is our background. Although many startups tout their deep history with healthcare, our founders understood that a fresh analytical approach from two computer science PhDs could be the key to fixing a system where technology can make many of the decisions.

We combined deep clinical knowledge with the newest advancements in GenAI to rapidly develop cutting edge approaches that handle complex medical specialties and continuously adapt to support evolving requirements. We're building a platform that doesn't just solve today's challenges, but anticipates tomorrow's healthcare financial landscape.

The reason this new investment is so critical is that it will allow us to accelerate our move to more complex specialties, strengthen CDI and enhance denial analysis. It will also enable us to support more EHRs, as well as establishing a physical foothold in our new headquarters in the Bay Area so that we can better tap into an amazing ocean of talent.

Mastering Coding is a Never Ending Process

Medical coding is a constantly evolving system, with new rules, regulations and codes being added. Different health systems, practices and specialties have constantly shifting needs. A narrow specialty practice, such as radiology, will have to deal with comparatively fewer codes than internal medicine or an emergency room physician.

The sad truth is that the number of codes for all practitioners is likely to soar over the next couple of years, as the industry starts to implement the WHO’s ICD-11. That will give additional cover for insurers who want to deny legitimate payments.

Because of this, any solution of value needs to be able to adapt at the same pace. Being a GenAI-native platform (i.e., not retrofitted or an add on) Arintra can not only adapt faster, but we have built the technology to analyze the reasons insurers give for denial and to anticipate and negate such denials. The speed that insurers use today to deny claims mandates that we top their speed. Only a GenAI-native approach can enable that.

An Approach for Tomorrow

Our approach is explicitly designed to stay ahead of the changes and to understand the nuances of all codes that your practice has to deal with now, and rapidly support requirements as they evolve.

We’re using technology to get reimbursement for the actual services hospitals and health systems are providing, not just assigning codes based on existing documentation. We’re building on the basics of autonomous coding to deliver true Revenue Assurance that brings an outsized impact for health systems’ financial bottom line.

This is why Arintra is uniquely qualified to deliver Revenue Assurance to its partners.

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