UB-04, CMS-1500, and itemized bills carry CPT, ICD-10, HCPCS, and modifier codes that drive payment. Manual code entry produces errors that snowball into denials, audits, and rework.
Prior authorization requests pile up while patients wait. Manual review of clinical documentation and policy criteria delays care decisions, frustrates providers, and increases administrative cost per request.
Every document touching a patient's chart is PHI. Most general-purpose AI platforms aren't configured for HIPAA — no BAA, unclear LLM data flow, default-on logging that captures protected health information.
fluex extracts medical bills, prior auth packages, patient intake, and clinical notes — under a HIPAA BAA, with code validation, code-set normalization, and zero-retention LLM access on the critical path.
Healthcare documents arrive in every imaginable format — UB-04 hospital bills, CMS-1500 professional claims, EOBs from payers, prior authorization packages, faxed referrals, handwritten intake forms, and clinical notes. fluex's healthcare configuration handles the full bundle: every document parsed, every code validated, every PHI field tracked through the audit trail.
CPT, ICD-10-CM, ICD-10-PCS, HCPCS Level II validated against current CMS code sets. Mismatches and retired codes flagged for review before downstream adjudication.
Explanation of Benefits, remittance advice (835), and denial codes (CARC/RARC) parsed to structured form for revenue cycle management workflows.
Multi-document PA packages — clinical notes, lab reports, member info, prescription details — extracted as a unit, with criteria matching against your medical policy.
Operational logs and audit trails carry pseudonymized identifiers, not PHI in plain text. Field-level lineage preserved without re-exposing protected information.
fluex integrates with the major EHR platforms and claims clearinghouses through FHIR APIs, HL7 v2 interfaces, and 835/837 EDI — so extracted document data flows directly into patient charts and claims workflows without an intermediate data-entry step.
Send 50–100 sample documents (de-identified or under NDA + a draft BAA). We'll run them through fluex and return a structured-extraction report with code-validation results, confidence distribution, and time-to-process. No commitment.