Educational claim review engine

🧠 ClaimIQ™

Review your claim like an expert before you submit it. ClaimIQ™ is designed for physicians, APPs, residents, and medical coders who want a clearer educational review of claim construction before final coding review.

Build a case and review with ClaimIQ™ Review sources

ClaimIQ™ is an educational decision-support tool. It does not replace professional coding judgment, payer policy, or claim adjudication and does not guarantee reimbursement.

What ClaimIQ™ Reviews

CPT coding ICD-10 diagnosis selection Diagnosis pointers Modifier usage NCCI edits MPPR calculations Documentation completeness Medical necessity considerations Payer-specific considerations Final claim construction

For Physicians and APPs

ClaimIQ™ helps surface documentation, diagnosis linkage, modifier, and claim construction issues that may need review before submission.

For Coders

Each finding includes what was detected, evidence used, why it matters, potential consequences, references, score impact, and review actions.

For Education

The review explains coding relationships and documentation logic without predicting payment or replacing payer-specific policy review.

How It Works

1. Build the caseAdd CPT lines, diagnoses, pointers, and modifiers in the Case Builder.

2. Review with ClaimIQ™ClaimIQ™ checks coding, documentation, payer, compliance, and construction signals.

3. Improve the claimUse prioritized actions to review missing diagnoses, pointers, laterality, modifier documentation, and policy concerns.

4. Export the reviewAudit report and JSON export preserve findings, evidence, score impact, and final ClaimIQ™ summary.