Built for independent specialty practices

Agentic Billing for Independent Practices

Clairdoc checks claims before submission, flags payer and documentation issues, and routes only high-risk cases to human reviewers.

Starting with LegendEHR workflows. Built for solo practitioners, small practices, and growing specialty groups.
Supported By
Google for Startups
NYU
What Clairdoc Does

Clairdoc catches billing issues before claims are submitted.

Instead of waiting for denials, Clairdoc reviews claims early, flags preventable billing problems, and surfaces only the cases that need human judgment.

Today’s Workflow
  • Reviews claims before submission.
  • Checks CPT, modifiers, documentation, and payer rules.
  • Surfaces risky claims for follow-up.
  • Learns from denials, corrections, and approvals.
What Clairdoc Checks Before Submission

Concrete billing checks that practices already understand.

Clairdoc is built around the actual places claims break before submission and reimbursement.

CPT and modifier conflicts

Flags coding combinations that can trigger rework or denials.

Payer-specific edits

Validates claims against payer logic before they leave the queue.

Documentation gaps

Surfaces missing or inconsistent support for the billed claim.

Prior auth risks

Highlights claims that may need follow-up before submission.

Medical necessity mismatches

Detects cases where the note and billed claim may not align.

Claims needing human review

Routes uncertain or high-risk claims to reviewers with context.

The System

Software-first on the surface, workflow-aware underneath.

Clairdoc combines AI agents, structured billing logic, and escalation workflows so teams can automate routine review without losing control.

Layer 01

Claim Intake Layer

Claims and encounter data enter Clairdoc without a heavy implementation project.

Layer 02

Billing Logic Layer

Structured billing rules, payer edits, and AI reasoning keep decisions grounded and explainable.

Layer 03

Review and Routing Layer

Clairdoc flags denial risk, coding mismatches, and prior auth issues, then routes edge cases to humans.

Layer 04

Learning Layer

Corrections, denials, and approvals strengthen the system over time.

See Clairdoc in Action

A product demo that shows workflow intelligence, not just UI.

Clairdoc surfaces throughput, claim readiness, review pressure, and preventable revenue risk at the queue level.

Claim queue visibility See what is ready, what is blocked, and where review is building.
Operational prioritization Rank denial drivers and focus teams on the highest-leverage fixes first.
Billing-native review Surface CPT mismatches, modifier issues, documentation gaps, and prior auth follow-up in one queue.
Human escalation only where needed Keep routine claims in automation and surface context-rich edge cases to people.
Clairdoc
Upload Claims Dashboard Manual Console

Analysis Dashboard

Queue-level visibility into throughput, review pressure, and denial drivers.

Processing Complete
API Key
••••••••••••••••••••
Practice ID
pilot-console
Load Dashboard
20
Claims Processed
In current queue
4
Ready for Submission
20% straight-through
12
Claims Triaged Automatically
Routine review completed
8
Claims Routed for Review
High-risk follow-up surfaced
1:00
AI Processing Time
Pilot display
1 hrs
Estimated Reviewer Hours Saved
Queue review deflected
3
Primary Queue Bottlenecks
Detected before submission

Financial Impact

Total Claim Value$19,920
Claims with Preventable Risk$17,430
Claims Requiring Follow-Up8 claims
$17,430

Top Denial Drivers

  • Documentation mismatch with billed CPT14 claims
  • Prior auth follow-up needed14 claims
  • Site of service mismatch14 claims
Workflow Grounding

Built around real billing operations.

Clairdoc is shaped by live workflow inputs from billing operators, physicians, and specialty-practice teams.

50+
Billing Workflow Inputs
300+
Claims Reviewed Daily
25+
Physicians & Billing Experts
Live
Pilot Workflows
Proof

Operational proof from live workflows.

Built with live billing feedback loops, real claims, and human accountability.

Operator feedback loops

Billing teams contribute edge cases and rejection patterns that sharpen the system over time.

Live claim evaluation

Clairdoc is tested against real claims and payer-policy friction.

Human judgment where it matters

Routine throughput stays automated while high-risk decisions stay reviewable.

Request Pilot

Bring agentic billing into your practice.

Clairdoc is offering pilots for independent specialty practices ready to move beyond reactive billing cleanup.