ComplyIQ AI: Ensure Medical Necessity & Clean Claims
ComplyIQ AI analyzes provider notes against payer rules, validates CPT/ICD-10/modifier combinations, and learns from your expert billers to produce clean claims before submission.
Everything you need for clean claims
ComplyIQ AI analyzes clinical notes, validates codes against payer rules, learns from your billers, and submits clean claims directly from eClinicalWorks.
Medical Necessity Analysis
Analyzes progress notes against payer requirements and highlights exactly what documentation is missing to meet medical necessity.
Reimbursement Prediction
Evaluates CPT, ICD-10, and modifier combinations to determine if they are reimbursable and calculates the likelihood of payment.
Continuous Learning Loop
ComplyIQ learns from your expert billers. When a biller suggests a correction, ComplyIQ researches it, applies the fix, and remembers it for future clean claims automatically.
Payer Rule Engine
Upload and manage custom payer-specific LCD/NCD rules. ComplyIQ scrubs every claim against these rules before submission to stop denials before they happen.
Clean Claim Submission
Once all edits are resolved, ComplyIQ produces a clean claim and submits it directly to the payer from within your eClinicalWorks environment.
Native eClinicalWorks Integration
Works silently inside your existing eCW workflow, eliminating double-data entry and portal fatigue. No new system to learn.
From progress note to clean claim
ComplyIQ AI guides every step — from analyzing the provider's note to signing, routing, and submitting a clean claim.
Analyze Progress Note
ComplyIQ reads the provider's note and compares it against the payer's medical necessity requirements, flagging exactly what's missing.
Apply Suggested Fixes
The provider reviews ComplyIQ's findings and applies the recommended documentation additions with one click.
Sign & Lock Note
The provider signs and locks the note, making it read-only and ready for the billing workflow.
Send to Billing
ComplyIQ routes the signed note to the biller queue and opens the biller workspace automatically.
Scrub & Learn
The biller scrubs CPT/ICD-10/modifier combos against payer rules. Expert suggestions teach ComplyIQ for future claims.
Submit Clean Claim
Once all edits are resolved, ComplyIQ submits a clean claim directly to the payer from within eClinicalWorks.
Transform your revenue cycle management
Close Documentation Gaps
Identify missing medical necessity elements before the patient leaves.
Stop Denials Before Submission
Proactively catch and correct coding and documentation errors before claims are sent to the payer.
Learns From Your Expert Billers
When a biller suggests a correction, ComplyIQ researches it, applies the fix, and remembers it for next time.
Native eClinicalWorks Workflow
Works silently in the background of eCW to guide providers and billers in real-time.
Interactive Analytics Dashboard Preview
Revenue trends, denial rates, and coding accuracy.
Calculate your potential ROI
See exactly how much revenue you could recover by preventing denials before submission.
ROI Calculator
Estimate your savings and recovered revenue