medirev — Consulting and AI tools for medical clinics

Moving forward

Tools that take the daunting work off your plate.

Three AI-powered solutions that run inside athenahealth every day, with your staff approving the results.

Clinical inbox

Clinical Inbox Sorting

Sort the clinical inbox so you can get to what matters easier.

Faxes, labs, imaging and referrals read as they arrive
Each one filed under the right document type
Providers open an inbox that is already organized
Staff review and approve before anything is filed

Coding & billing

Coding & Billing

Visits coded and claims billed, so you can focus on medicine.

E/M level, add-ons like G2211 and diagnosis pointers proposed from the note
Every code traced back to what the provider documented
Claims created from checked-out visits
Duplicate claims blocked automatically

Spreadsheets

Charge Import

Turn third-party spreadsheets into claims in minutes.

Care-management vendor exports for CCM, PCM and RPM
Reads each vendor's layout, even when it changes
Checks billing-frequency rules before a claim goes out
Problems held for review instead of billed wrong

Looking back

The Missed Revenue Audit: money still on the table.

An in-depth review of the work your clinic has already done. It finds where money may still be owed, and points you in the right direction for the future.

Stuck claims

A/R that can still be collected

Every held or denied claim gets its cause, the fix, who does it, and the deadline.

Downcodes

Visits paid at a lower level

Each downcode read against the note: appeal the wrongful ones, accept the rest.

Underpaid

Visits paid below the normal rate

Found from what payers actually paid, not from your charge master.

Missed codes

Codes the visit earned

G2211, injection admin and wellness-visit add-ons supported by the note but never billed.

Diagnoses

Chronic conditions not coded

Conditions in the assessment and plan that never made it onto the claim.

Deadlines

What's still collectable

Each finding checked against the payer's filing and appeal windows, so effort goes where money can still come in.

Fees

Your fees vs. what payers pay

Codes where payers pay your full charge, which usually means the fee is set too low.

Compliance

Risks caught early

Billing the documentation doesn't support, flagged for you before a payer audit finds it.

What you get: a worklist of every finding sorted by dollars and deadline, and a plan for keeping the same problems from coming back.

See the audit in my own clinic →

Why I built this

Built in my own clinic, for clinics like it.

I'm an athenahealth user myself. Every tool here started as a problem in my own clinic: an inbox nobody could keep up with, claims stuck for reasons nobody had time to find, and codes we earned but never billed.

I built the fixes, used them on our own claims and patients, and watched what they caught. Now I bring the same tools and know-how to other clinics.

When a problem is bigger than a tool, I work through it with you as a consultant, hands-on, until it's resolved.

Who this is for Sound familiar?

Your staff is stretched thinBilling, front desk and referrals are handled by the same few people.

Your A/R keeps growingClaims sit on hold and nobody has time to find out why.

New codes feel riskyYou aren't sure when G2211 or an add-on applies, so you leave it off.

You're on athenahealthMy tools connect to the system your team already uses. Nothing new to learn.

How it works

Start with a consult. See your own numbers.

Consult

A conversation about your clinic, your payers and what's taking up your team's time.

Free

Missed Revenue Audit

I connect to athenahealth read-only and review 12 months of claims. You get every finding, sorted by dollars and deadline.

Nothing in your system changes

Move forward

We set up the tools that fit your clinic, Inbox Sorting, Coding & Billing or Charge Import, so the work stays done.

Priced on the scope you choose

Safe by design

The note decides. Your team approves.

Every code is earned

Nothing is added unless the visit note supports it.

You approve the changes

We test on a few claims you check, then work in batches you authorize.

Every save is verified

Each claim is logged before and after, and read back from athenahealth.

Patient data stays private

The AI runs on hardware I operate. No chart data goes to an outside AI service, and I sign a BAA first.

Understand when to bill new codes

2,023 visits had earned G2211. Now they're billed.

Medicare added G2211 in 2024 for the ongoing work of managing a patient's care. Most clinics still leave it off, because nobody is sure when it applies.

$32,000

in add-on charges put on claims that already qualified, at about $16 per visit.

2,023claims corrected in athenaOne

0added without a note that supports it

Each visit note was read before the code went on. G2211 was added only when the visit met Medicare's rules:

The patient has an ongoing relationship with this provider.
A serious or chronic condition is being managed over time.
The note shows a plan for continued care, such as a follow-up.
It points to the chronic diagnosis, never to a one-time problem.

Going forward: providers and coders get a one-page guide to when G2211 applies, so new visits are billed right the first time.

Downcode review

Payers lowered the visit level. The notes proved them wrong.

When a payer pays a 99214 as a 99213, most clinics accept it. Each note was read against current E/M rules to decide which ones to fight.

visits wrongfully downcoded. The note supported the level the provider billed, and an appeal is written for every one.

51appeals written

41of them billed as 99214

Every downcode got a clear answer and the reason behind it:

Appeal: the medical decision-making in the note meets the billed level. The appeal cites the parts of the note that prove it.
Accept: the payer was right, so staff don't spend time on an appeal that will lose.
Learn: the patterns behind the downcodes, by payer and by provider, so fewer happen next month.

Most wrongful downcodes came from two Medicare Advantage and marketplace payers. Knowing which payers do it tells you where to look first.

More codes your visits may be earning

Small codes. Every visit. They add up.

G2211

Complex care add-on

Ongoing management of a serious or chronic condition.

Bill when the note shows a continuing relationship and a plan of care.

96372

Injection administration

Giving an IM or subcutaneous injection in the office.

Bill when the drug is documented as given. Add modifier 25 to the E/M visit.

G0444

Depression screening

The annual screen with a scored tool, like the PHQ-9.

Bill when it's done at a subsequent annual wellness visit and the score is in the note.

HCC dx

Chronic conditions coded

Conditions the provider assessed but left off the claim.

Code when the condition is in the assessment and plan, not just the history.

An extra hand for clinics with too much on their plate.

Two weeks inside my own clinic.