Solutions / Healthcare AI & RCM
05 / Healthcare AIHealthcare revenue cycle management, powered by AI and run by specialists.
ESN combines AI with specialist revenue cycle teams. Intelligent document processing reads charts, an ICD-10 coding assistant proposes codes, and audit agents check each claim before submission. Coders and specialists review every AI suggestion, under HIPAA-compliant processes.
1 · Documentation
ESN team
Clinical documents, charts and encounter details are collected and organized for coding.
AI assist
Intelligent document processing reads charts and pulls out diagnoses, procedures and provider details.
A claim moves through five stages, left to right. Select a stage to see what ESN's team handles and where AI assists; people review every AI suggestion before a claim moves on.
Revenue cycle services
Specialist teams across the revenue cycle, with AI at each stage.
Each service can run on its own or as part of an end-to-end engagement, and each uses AI where it helps.
Medical coding and coding audit
Certified coders assign ICD-10 and CPT codes, starting from AI-suggested codes, and audit coding accuracy.
Charge entry and claim submission
Charges are entered and claims prepared to each payer's requirements, then checked by AI audit agents before submission.
AR follow-up and denial management
Unpaid and denied claims are followed up and worked to resolution, with denial reasons grouped by AI so recurring causes get fixed.
Payment posting and reporting
Payments are posted and reconciled, with reporting on denials and turnaround.
AI in the revenue cycle
Automation that keeps coders and specialists in control.
Intelligent document processing
Charts and clinical notes are read automatically, and the details needed for coding are extracted.
ICD-10 coding assistant
Suggested codes come with a confidence score and the phrase they came from, and a coder confirms each one.
Claim audit before submission
Audit agents check each claim against coding and payer rules, built on our Agentic AI & Workflows practice.
- Diagnosis codes validICD-10-CM E11.9 and I10 match the chart
- Visit level supported by documentationCPT 99214 matches the note
- Modifier checkMissing modifier on a same-day procedure, sent to a coder
- Payer rulesEligibility and authorization on file
Each claim is checked against coding and payer rules before it is submitted. Anything that fails goes back to a coder instead of to the payer, so it isn't denied later.
FAQ
Healthcare and revenue cycle questions.
Does AI replace your coders?
No. The coding assistant proposes ICD-10 codes with a confidence score, and a certified coder reviews every suggestion before the claim moves on.
How is patient data protected?
All work follows HIPAA-compliant processes, and access to patient data is limited to the people and systems that need it.
Can AI be added to our existing revenue cycle?
Yes. Each capability can start on its own, for example coding assistance or pre-submission claim audits, and connect to your existing billing systems.
Talk to us about your revenue cycle.
Tell us where claims slow down or get denied. We'll show you which services and automation fit, stage by stage.