AI Medical Coding · Automated Claim Submission

AI Medical Coding · Automated Claim Submission

Claims coded and validated against payer rules before submission

Claims coded and validated against payer rules before submission

Noxus retrieves the encounter, applies payer-specific billing rules and submits a clean claim, escalating any failures to the relevant team.

Noxus retrieves the encounter, applies payer-specific billing rules and submits a clean claim, escalating any failures to the relevant team.

95%+

Clean claim rate

<5%

Denial rate

0

Manual touches per clean claim

The Status Quo

Claims Triage & Prioritization · AI Insurance Operations

Claims leave the practice with errors that payer validation would have caught

Today

Operations team

Coded encounter retrieved and reviewed manually

Payer rules located and checked by hand per claim

Claims submitted without systematic pre-submission validation

Rule changes discovered through denials after submission

Denials returned as reason codes to interpret and investigate

With Noxus

Co-worker

Encounter retrieved automatically from PMS and EHR

Configured payer ruleset applied deterministically to every claim

All claims meet payer requirements before submission

Ruleset updated centrally, applied to every claim after

Failures escalated with validation issue identified

How Noxus Works

Three layers powering AI medical coding, from coded encounter to clean claim submission

Noxus connects to the practice management system and EHR, retrieves the coded encounter, applies the configured ruleset for the identified payer, and runs pre-submission validation before the claim reaches the payer system.

01

Retrieval & Payer Identification

The coded encounter is retrieved from the practice management system, cross-referenced against the EHR, and the payer identified from the encounter data before the rules layer runs.

RETRIEVE

IDENTIFY

CONFIRM

02

Payer Ruleset

Identified ruleset is applied to extracted codes, modifier and bundling rules matched per payer rather than from a generic standard.

MATCH

APPLY

03

Validation & Submission

Assembled claim pre-submission validation against current payer requirements. Clean claims submitted; Failures escalate to a reviewer with the specific validation failure already identified.

VALIDATE

SUBMIT

ESCALATE

PROCESS IMPLEMENTATION

Book a working session with our experts designed around one of your processes

Bring a process you want to improve. Our experts show how it runs on Noxus, on your systems and data, and quantify the return, so you leave with a business case, not a demo.

Half a day · With our experts · Based in London & Lisbon

What you'll leave with

01

Prioritized business case

The highest-value processes in your operation, identified and ranked by impact.

02

Functional proof of concept

A working configuration of Noxus running on your real systems and data.

03

IT roadblock analysis

A structured assessment of integrations, security, and dependencies for IT approval.

Capabilities

What happens across each layer of the AI medical coding workflow

Retrieval & Matching

Retrieval & Matching

Coded encounter is retrieved from the management system and cross-referenced with the EHR before payer identification

Coded encounter is retrieved from the management system and cross-referenced with the EHR before payer identification

Coded encounter is retrieved from the management system and cross-referenced with the EHR before payer identification

The coded encounter is retrieved from the practice management system and cross-referenced against the EHR. Procedure and diagnosis codes are verified against the clinical record. Payer identification runs from the encounter data directly, not from a manual selection.

Rules Application

Rules Application

The payer's configured ruleset is applied to the coded procedures before the claim is assembled, catching mismatches before they become denials

The payer's configured ruleset is applied to the coded procedures before the claim is assembled, catching mismatches before they become denials

The payer's configured ruleset is applied to the coded procedures before the claim is assembled, catching mismatches before they become denials

Identified payer ruleset loads against the retrieved encounter. Modifier requirements, bundling rules, and documentation thresholds are applied on every claim. Coded procedures meeting payer's requirements are assembled; Mismatches are flagged before the claim goes further.

Validation & Submission

Validation & Submission

Every claim runs through pre-submission validation before it reaches the payer system, with failures routed to reviewers with the problem already identified

Every claim runs through pre-submission validation before it reaches the payer system, with failures routed to reviewers with the problem already identified

Every claim runs through pre-submission validation before it reaches the payer system, with failures routed to reviewers with the problem already identified

The assembled claim runs through pre-submission validation against the payer's current requirements. Clean claims submit directly without billing team involvement. Failed claims route to a reviewer with the specific validation failure and the relevant claim data already assembled.

agentic operations

Submitting a claim is not the same as submitting a clean claim

A claims submission workflow that applies payer rules per payer and validates against current requirements before the claim leaves the practice is a different operation from one that assembles a claim and waits for the payer to return a denial.

Generic Automations

Submits whatever the coder produces. Waits for the payer to deny it.

Noxus Co-workers

Extracts codes, matches payer rules, validates the claim, submits clean.

Built for Every Team

Built for every role in the workflow

Revenue Cycle Operations

Denials shrink as failures are caught pre-submission, not after. Reviewers handle exceptions with issues pre-identified; billing shifts from rework to volume.

Compliance & Audit

Every step from extraction to submission produces a complete audit record. Coding decisions are traceable to the source documentation, payer rule applications logged and replayable on demand.

IT & Architecture

The workflow runs on the EHR, practice management system, and payer portal already in the environment. No API layer required, no middleware project precedes deployment.

Measured results

Numbers from live deployments

Measured outcomes from healthcare deployments - live billing data, real volume.

95%+

Clean claim rate on automated submissions

95%+

Clean claim rate on automated submissions

<5%

Denial rate across payer submissions

0

Manual touches per clean claim submission

45

days to first production deployment

85%

FNOL intake workflows completed without manual intervention

95%

Reduction in time from notification to assessment-ready file

60%

Reduction in cost per claim at intake

6-8w

Reduction in cost per claim at intake

What Customers Say

Trusted by teams running the operations

“Noxus allows us to save 1,000s of hours per month in repetitive work across our operations”

Django L'OR

CEO @ Paybyrd

“Noxus allows us to save 1,000s of hours per month in repetitive work across our operations”

Django L'OR

CEO @ Paybyrd

"We gained a partner that removes technical complexity and accelerates ideas into scalable AI solutions.”

Head Of Applications

Jerónimo Martins

"We gained a partner that removes technical complexity and accelerates ideas into scalable AI solutions.”

Head Of Applications

Jerónimo Martins

"We tested solutions head-to-head and this was the clear winner."

Nuno Loureiro

Partner @ PWC

"We tested solutions head-to-head and this was the clear winner."

Nuno Loureiro

Partner @ PWC

Keep Learning

Go deeper on AI medical coding

How a UK Hotel Group Automated 70% of Reservations Across Email and Chat

A UK-based hotel group operating 10+ properties, with a centralised reservations and guest operations team responsible for handling reservations and guest enquiries across the portfolio.

António Calçada

How a UK Hotel Group Automated 70% of Reservations Across Email and Chat

A UK-based hotel group operating 10+ properties, with a centralised reservations and guest operations team responsible for handling reservations and guest enquiries across the portfolio.

António Calçada

How a UK Hotel Group Automated 70% of Reservations Across Email and Chat

A UK-based hotel group operating 10+ properties, with a centralised reservations and guest operations team responsible for handling reservations and guest enquiries across the portfolio.

António Calçada

Automating Post-Purchase Customer Operations for a European Retailer

A major European omnichannel retailer with a high volume of online orders across multiple product categories, with a centralised

António Calçada

Automating Post-Purchase Customer Operations for a European Retailer

A major European omnichannel retailer with a high volume of online orders across multiple product categories, with a centralised

António Calçada

Automating Post-Purchase Customer Operations for a European Retailer

A major European omnichannel retailer with a high volume of online orders across multiple product categories, with a centralised

António Calçada

Frequently Asked

Questions about AI medical coding and clean claim submission

How quickly can an AI medical coding workflow be live on our systems?

The first billing workflow reaches production on the existing clinical and administrative system environment in approximately 45 days from contract signature. That timeline covers integration setup, payer ruleset configuration, and validation logic tuned to the specific billing environment. No system replacement or infrastructure modernisation is required as a prerequisite. Noxus Forward Deployment Engineering handles the integration setup; the first deployment is typically the highest-volume payer and procedure mix.

What internal systems does Noxus connect to?

The workflow connects to the electronic health record, the practice management system, and the payer portal or clearinghouse used for claim submission. It operates on the systems already running in the environment through existing interfaces, including legacy platforms without modern API access. There is no API prerequisite and no dependency on the core system vendor's integration roadmap. If your team uses it today, Noxus can operate inside it.

What happens when clinical documentation is incomplete or ambiguous?

Where documentation does not support a specific procedure or diagnosis code at the required level of specificity, the record is flagged at the extraction layer rather than passed forward with a code that will produce a denial. The flagged record escalates to a reviewer with the documentation gap identified, so the reviewer addresses a defined problem rather than re-examining the full record. The threshold for acceptable specificity is configured at deployment.

Can it handle different billing rules across multiple payers?

Yes. Payer identification runs from the encounter data, and the ruleset applied to each claim reflects the requirements of that specific payer. A single deployment handles multiple payers, with modifier rules, bundling requirements, documentation thresholds, and filing deadline constraints applied per payer rather than from a single generic billing standard. Adding a new payer to the same deployment runs at substantially lower incremental cost because the integration infrastructure is already in place.

What does the billing team actually receive from this workflow?

Clean claims are submitted directly to the payer system without billing team involvement. Claims that fail pre-submission validation reach a reviewer with the specific validation failure identified, the relevant claim data assembled, and the payer requirement that was not met surfaced alongside it. The reviewer acts on a defined problem, not a denial reason code to interpret after the fact. Billing time shifts from rework to volume.

Does Noxus make any decisions in the governed part of the billing process?

No AI system makes a coverage determination, a reimbursement decision, or a clinical coding judgment outside the configured rule parameters. Where pre-submission validation identifies a failure that requires clinical or billing judgment, the case escalates to a human reviewer with full context already assembled. The AI extracts and matches; the rules determine what is submitted; humans resolve what falls outside those rules.

What does the IT security review process look like?

The platform is certified against SOC 2 Type II, ISO 27001, GDPR Article 28, and HIPAA. Deployment options include fully managed SaaS, private cloud on the client's own infrastructure, and air-gapped on-premises for environments with strict data residency requirements. Clinical data does not leave the client's environment unless the deployment architecture requires it. Every action produces a complete, tamper-evident audit record. RBAC integrates with Azure AD or the client's existing identity system.

How is Noxus priced for an AI medical coding deployment?

Pricing is a monthly platform license that scales with operational volume, not with headcount or per-claim consumption. The first engagement includes Deployment Engineering alongside the platform license to get the billing workflow into production. Subsequent payer rulesets and additional workflows added to the same environment run predominantly as platform spend, with the integration infrastructure already in place. The economics improve structurally with each new payer or service line deployed.

Why do healthcare providers need dedicated AI medical coding software?

Traditional billing systems were built to assemble and submit claims, not to extract codes from clinical documentation, apply payer-specific rules in real time, and validate claims before submission. AI medical coding sits in front of the billing system and runs the work that determines whether the claim arrives clean. Automated medical coding eliminates the manual lookup loop between coder and payer rule. Autonomous medical coding takes that further: the AI assigns codes within configured rule parameters and humans review only the exceptions surfaced at validation, rather than every claim before it leaves the queue.

How does Noxus compare to other AI medical coding and clinical coding solutions?

Most AI medical coding tools cover one slice of the workflow - code suggestion, claim scrubbing, or denial management - and leave the billing team to bridge the rest. Computer-assisted coding tools assist a human coder; modern clinical coding tools generate codes but stop before payer rules are applied. Noxus runs the full sequence on the systems already in the environment: clinical record retrieved, codes extracted and validated for specificity, payer identified, ruleset applied, claim validated before submission, exceptions routed with the failure reason identified. AI handles the unstructured documentation; deterministic rules execute the process logic.

Ready to submit clean claims on your existing stack?

Live in 45 days. No API prerequisites. No coding migration project.

Enterprise-grade security

SOC 2 TYPE I & ISO 27001

Made in Europe

Based in London & Lisbon

Copyright ©2026, Noxus. All rights reserved.

Enterprise-grade security

SOC 2 TYPE I & ISO 27001

Made in Europe

Based in London & Lisbon

Copyright ©2026, Noxus. All rights reserved.

Enterprise-grade security

SOC 2 TYPE I & ISO 27001

Made in Europe

Based in London & Lisbon

Copyright ©2026, Noxus. All rights reserved.

PROCESS IMPLEMENTATION

Book a working session with our experts designed around one of your processes

Bring a process you want to improve. Our experts show how it runs on Noxus, on your systems and data, and quantify the return, so you leave with a business case, not a demo.

Half a day · With our experts · Based in London & Lisbon

What you'll leave with

01

Prioritized business case

The highest-value processes in your operation, identified and ranked by impact.

02

Functional proof of concept

A working configuration of Noxus running on your real systems and data.

03

IT roadblock analysis

A structured assessment of integrations, security, and dependencies for IT approval.

PROCESS IMPLEMENTATION

Book a working session with our experts designed around one of your processes

Bring a process you want to improve. Our experts show how it runs on Noxus, on your systems and data, and quantify the return, so you leave with a business case, not a demo.

Half a day · With our experts · Based in London & Lisbon

What you'll leave with

01

Prioritized business case

The highest-value processes in your operation, identified and ranked by impact.

02

Functional proof of concept

A working configuration of Noxus running on your real systems and data.

03

IT roadblock analysis

A structured assessment of integrations, security, and dependencies for IT approval.