A Predictive Approach to Diagnostic Discovery
We apply hundreds of predictive models to identify the conditions most likely for each patient encounter—even when nothing is done or documented. ROI is guaranteed and payments are contingent on achieving net new revenue targets.
- I10Essential hypertension
- N18.3Chronic kidney disease, stage 3
- E11.9Type 2 diabetes mellitus
- Z79.4Long-term insulin use
- 2024-08Cardiac catheterization
- 2023-04Total hip arthroplasty, right
- 2025-09ED visit · acute dyspnea
- 2024-12Inpatient · CHF exacerbation, 5 days
- 2024-06Inpatient · UTI with sepsis, 3 days
validated models
Automated Extraction and Interpretation with Frontier LLMs
We use advanced AI to identify full or partial documentation and evidence across every note in the chart—for every patient. Each extracted finding is tied back to the baseline prediction it confirms.
68-year-old male with PMHx of hypertension and CKD stage 3 admitted from the emergency department with three days of progressive dyspnea, orthopnea, and lower extremity edema. Reports unintentional weight gain of 12 lbs over the past week and has been unable to lie flat for sleep.
Patient appears in moderate respiratory distress with O2 saturation 89% on room air. Bibasilar crackles noted to mid-lung fields. Jugular venous distention to 12 cm. Lower extremity 3+ pitting edema bilaterally. Blood pressure 158/96 mmHg confirming poorly controlled hypertension. Heart rate irregular at 112 bpm.
ECG shows atrial fibrillation, persistent with rate 112. BNP elevated at 1,840 pg/mL with bilateral pleural effusions and suspected decompensated CHF on echo (EF 35% with global hypokinesis). Sodium 128 mEq/L. Creatinine 2.1 mg/dL, up from baseline 1.0, consistent with acute kidney injury on CKD. HbA1c 9.2% on admission labs with random glucose 287 mg/dL. CXR also notable for right lower lobe pneumonia, likely community-acquired. WBC 13.4 with neutrophilic predominance.
Streamlining CDI and Coding Workflows
We integrate directly with your EHR and billing data to generate suggested queries and codes from the day of admission through the final pre-bill review, improving accuracy and capture rates while reducing review time.
Dear Dr. *** and Team,
Please provide further specificity for the type and acuity of documented CHF. Clinical indicators include:
- •Type: Systolic / Diastolic / Combined Systolic-Diastolic
- •Acuity: Acute / Chronic / Acute on Chronic
A Clear Plan from Immediate Wins to Operational Transformation
Beginning with an initial release of revenue from recent missed codes, we help health systems realize value within weeks while beginning the transition to deeper AI-enabled diagnostic discovery.
Retrospective
Past claims · 3–6 month audit
Post-Bill Audit
Audit of 3–6 months of claims to identify missed acuity capture, train coding and CDI teams, and release revenue for a full implementation.
Concurrent
Pre-bill · Before claims submitted
Pre-Bill
Identify missed codes before claim submission, with clinical support tied to predicted risk and clear documentation in physician notes.
Prospective
Real-time · From admission
Concurrent Diagnostic Discovery
Full transformation of CDI and coding, with identification of likely conditions from point of admission to improve acuity capture and patient outcomes.
A Granular Look at Your Organization’s Opportunities
We leverage the nation’s largest longitudinal data set to assess your health system’s opportunities by hospital, service line, DRG, and diagnoses. You’ll know where to focus before you start.
Illustrative Report
All Facilities
Memorial Health System · 8 hospitals · Trailing 12 months
Want to see your numbers?
A 3-month retrospective audit will quantify the acuity capture gap in your own claims data — service line by service line — at no upfront cost.
Stop Leaving Revenue on the Table
See how Diagnostic Discovery can improve coding accuracy and revenue integrity at your organization.
Request a Demo