Hospital revenue cycle integrity

Stop losing three to eight percent of gross revenue.

Three instruments for revenue cycle directors. Codex extracts HCPCS codes the day the patient leaves. ClaimAct finds the leak your compliance audit misses by design. MergeAct catches encounter overlaps before submission. Every charge captured, every overlap caught, every leak surfaced before the claim goes out.

See where the revenue leaks → Start with Codex
Three to eight percent of gross revenue recovered Nothing retained · BAA before production
The number nobody puts on the board

Across a 50,000 claim year, three to eight percent of gross revenue is quietly lost.

Not fraud, not theft. Severity that was treated but never coded. Modifiers a payer rule rejected. Encounters that overlapped on the calendar. Compliance audits are built to catch what was overstated. This leak runs the other way, and it stays invisible by design.

3—8%
Gross revenue gap
The typical spread between what was treated and what reached the claim, measured across a full inpatient year.
~1.5s
Paper to claim row
The time Codex takes to turn a printed superbill into submission ready HCPCS rows, validated against the current CMS dataset.
0
Denials filed
An overlap caught before submission never enters your rework pipeline. The denial that never gets filed is the cleanest claim in the system.
Three instruments. One floor.

A claim leaks at three points. Each instrument holds one of them.

Start with the instrument that solves your loudest problem today. Codex gives billers their coding hours back. ClaimAct makes the leak visible. MergeAct stops overlap rejections before the payer sees them. Adopt one, add the next when you are ready.

Live · codex.nomoi.ai
Codex — extraction
The coding hours your billers get back.
Reads the printed HCPCS superbills, CMS 1500 forms, and clinic tick sheets that still move through every hospital. A deterministic PyMuPDF preprocess handles clean scans without burning a token. A two model consensus across Claude Sonnet 4.6 and Claude Opus 4.7 catches its own mistakes before output. A crosswalk validator checks every row against the current CMS HCPCS Level II dataset with payer specific modifier rules.
Open Codex
From $49/month · five extractions free
Live · claimact.nomoi.ai
ClaimAct — audit
The leak your compliance audit will never find.
Reads every inpatient claim leaving the hospital and asks one question: did this capture the full severity of what was actually treated. Shadow Leakage Audit, EMV Dispatch, HTLOS Outlier Monitor, and Portfolio Exposure Scanner run entirely in the browser with no backend, so the claim never leaves your machine. The leak becomes visible before the claim leaves the building.
Open ClaimAct
Included free during active development
Commercial pilot · mergeact.nomoi.ai
MergeAct — pre submission
Overlaps caught before the payer sees them.
The pre submission integrity layer. MergeAct catches the CLAI 008 encounter overlaps that bounce claims back from SEHA, Medicare, and most commercial payers, and reconciles HCPCS and charge lines across the same submission. Its detection engine runs in live hospital use and sharpens with every correction, so your instance inherits the floor's lessons. The denial you prevent is the one that pays you back.
Talk to us about MergeAct
Commercial pilot, scoped per hospital
The claim, in five frames

From the paper on the desk to a claim that stays above the floor.

A patient is discharged. The paperwork moves the way it always has. Revenue Floor sits underneath that motion and checks the claim at every step, so what leaves the building has nothing missing.

01
Paper arrives
A discharge produces a superbill, a CMS 1500, or a clinic tick sheet. Printed, handwritten, scanned. The desk does not change.
02
Codex extracts
Each line becomes a structured HCPCS row in roughly a second and a half, validated against the current CMS Level II dataset.
03
ClaimAct audits
The claim is read against what was actually treated, and any severity that never made it onto the claim is surfaced.
04
MergeAct checks
Encounter dates are compared. Any overlap that would trigger a CLAI 008 denial is flagged before submission.
05
The claim clears the floor
What leaves the building is fully coded, fully audited, and free of overlap. Nothing was left on the table.
What changes, what does not

Your billers keep their workflow. The leak loses its cover.

Revenue Floor does not replace your billing team or ask them to learn a new system end to end. It sits underneath the work they already do and removes the failure modes that quietly cost the hospital money.

Stays the same
  • The paper on the desk. Superbills, CMS 1500 forms, and tick sheets move the way they always have.
  • The billing team. No headcount change, no end to end system migration.
  • Your clearinghouse and your payer contracts. Revenue Floor runs before submission.
  • The discharge process on the clinical floor. Nothing changes for the clinician.
Stops happening
  • Coding hours spent keying printed superbills line by line.
  • Severity that was treated, documented, and then never coded onto the claim.
  • Modifier errors a payer rule rejects after the claim has already left.
  • CLAI 008 overlap denials entering the rework queue weeks after the fact.
Built for protected health information

Where the data goes is the first decision, not the last.

Hospital billing data is protected health information. Revenue Floor treats that as an architecture constraint, not a checkbox. Nothing is retained, no claim data trains a model, and a BAA is signed before any production use.

Nothing retained
Codex processes the document and returns the rows, then the source file is not stored. MergeAct runs every pre submission check server side and retains nothing once the claim clears. ClaimAct runs entirely in the browser with no backend.
No model training
No claim data, no superbill, and no patient record is used to train any AI model. Inference runs under no training agreements with the providers behind it.
BAA before production
A Business Associate Agreement is executed before the first production claim is processed. The trial runs on synthetic and de-identified data until that paperwork is in place.
Questions revenue cycle directors ask

Before a pilot, directors ask the same five things.

Do I have to adopt all three instruments at once?
No. Each instrument stands on its own. Most directors start with Codex because the coding hours it returns are visible inside a week. ClaimAct and MergeAct add the audit and pre submission layers when you are ready. The floor gets deeper as you add instruments, but the first one already holds.
What exactly is the three to eight percent leak?
It is the gap between the severity that was treated and documented and the severity that was captured on the claim. It includes uncoded comorbidities, modifiers a payer rule rejects, and encounter overlaps. Compliance audits are built to find overstatement, so understatement runs in the opposite direction and stays invisible. Across a 50,000 claim inpatient year, three to eight percent of gross revenue is the typical spread.
How does Codex avoid coding errors of its own?
Three layers. A deterministic PyMuPDF preprocess handles clean scans without an LLM in the loop. A two model consensus across Claude Sonnet 4.6 and Claude Opus 4.7 compares outputs and catches disagreement before anything is returned. A crosswalk validator checks every row against the current CMS HCPCS Level II dataset with payer specific modifier rules. Disagreement is surfaced, not hidden.
What is a CLAI 008 denial and why does MergeAct matter?
CLAI 008 is the rejection a payer issues when two encounters overlap on the calendar. SEHA, Medicare, and most commercial payers bounce every overlapping claim. By the time the denial returns, the claim has aged and entered your rework pipeline. MergeAct compares encounter dates before submission and flags the overlap while it can still be corrected.
Is our claim data safe?
Codex does not retain source documents after an extraction completes. MergeAct runs server side under a Business Associate Agreement and retains nothing once a claim clears its checks. ClaimAct runs entirely in the browser with no backend, so the claim never leaves your machine. No claim data trains any model. A BAA is executed before the first production claim is processed.
What does it cost?
Codex starts at $49 per month, with five extractions free so you can measure it before you commit. ClaimAct is included free during active development. MergeAct is in commercial pilot, scoped to your volume and your payers. A system pilot across all three is scoped per hospital. We invoice; there is no credit card form on the internet.

Put one floor under every claim you submit.

If you direct a hospital revenue cycle and you want Codex, ClaimAct, and MergeAct working together under your claims, write to us. We scope the pilot to your volume, your payers, and your existing billing workflow.

Talk about a system pilot Or start free with Codex