Medical Coding Agent
Turn documentation into review-ready coding
Rinova reads available clinical documentation, applies configured coding guidance, checks for missing information, and prepares routine encounters for submission while routing low-confidence or sensitive cases to qualified staff.
From signed note to coded encounter
Synthetic records only. No patient information.
Human review branch: see “Insufficient documentation”, where the agent stops and a person takes over.
Documentation supports every suggestion, so the encounter moves to the approved next step.
Current step
CompletedReady for the next step
High-confidence routine work moves to the approved next step with a full audit trail.
- Next action
- Release to the ready-to-bill queue
Select a suggested code to highlight the synthetic documentation that supports it. All note text is synthetic and contains no protected health information.
Step 6 of 6. Ready for the next step. Completed.
What to expect
5 to 15 seconds
To prepare a routine note for review
60 to 80%
Coding automation, depending on specialty and documentation
100 percent auditable
Coded cases show the supporting documentation
Human review for low-confidence and configured sensitive cases
Results vary by organization, specialty, payer mix, claim volume, system access, workflow scope, and starting performance.
What the agent can handle
- Reads approved signed clinical documentation
- Suggests ICD-10, CPT, HCPCS, modifiers, and evaluation and management levels based on configured scope
- Applies specialty-specific and organization-specific guidance
- Links suggestions to supporting documentation for review
- Scores confidence at the code or encounter level
- Checks for missing documentation and configured inconsistencies
- Routes low-confidence, complex, or sensitive encounters to qualified staff
- Preserves an audit trail of inputs, suggestions, edits, approvals, and final output
Confidence determines the next step
Rinova does not present every suggestion as final. Customer-defined thresholds determine which routine encounters can proceed and which require coder review. Staff can see the code, supporting documentation, confidence, and reason for escalation in one place.
Coding logic that can be maintained
Rinova's coding configuration can incorporate current code-set updates and the organization's approved guidance. The maintenance process is confirmed with each organization during implementation.
Medical Coding questions
It automates routine preparation and configured coding work. Complex, sensitive, or low-confidence encounters can remain with qualified coding staff according to the organization's policy.
Yes. The workflow is designed to show the supporting documentation, applicable checks, confidence, and any reason the case was escalated.
Rinova supports all specialties by configuring the workflow and guidance for each organization. The automation level varies with documentation patterns, case complexity, and review requirements.
Related AI Agents
- Claim Submission AgentValidates configured claim fields, submits through the approved path, records acknowledgments, and routes front-end issues.View agent
- Rejection and Denial Management AgentReads payer responses, classifies root causes, completes approved corrections, and prepares review-ready appeal work.View agent
See how coding would work with your documentation
Bring a representative, de-identified workflow and your review rules. We will show how the agent prepares routine work and handles exceptions.