Fix DRG risk before the claim is sent
AI-driven pre-bill DRG optimization that improves accuracy, protects revenue, and reduces downstream denials before billing.
Pre-Bill DRG Review
Active Queue: 47 cases
94%
Accuracy Rate
2.1
Avg DNFB Days
18%
Denial Reduction
Why pre-bill accuracy breaks down
The gap between clinical care and accurate billing creates costly downstream problems.
Coding teams work under time pressure
Incomplete clinical clarity and high volume create conditions for missed opportunities.
DRG risk discovered too late
Problems surface only after denial or audit, when correction is expensive and disruptive.
Manual reviews do not scale
Expert reviewers cannot touch every chart, leaving significant revenue exposure unaddressed.
Post-bill correction costs more
Fixing issues after billing delays cash, increases touches, and strains payer relationships.
How Neurex Pre-Bill works
Neurex Pre-Bill introduces an AI-first, expert-validated workflow that identifies DRG risk, surfaces documentation gaps, and resolves issues before the claim leaves the building.
Agentic AI reviews the full chart, identifies DRG risk, sequencing issues, MCC/CC gaps, and coding inconsistencies.
Senior coders and CDI specialists review flagged cases through a structured queue with AI guidance.
Targeted, compliant queries are issued only when clarification is required.
Claims are released with higher confidence, cleaner DRGs, and lower downstream risk.
What health systems see
Measurable improvements across DRG accuracy, DNFB, and denial prevention.
Improved DRG accuracy
Prior to bill drop
Reduced DNFB days
Faster claim release
Lower denial volume
Downstream prevention
Faster coder throughput
AI-assisted workflows
Audit-ready trails
Complete documentation
Pre-Bill DRG Optimization Workflow, SLAs, and KPIs
Operationally grounded. Measurable. Built for scale.
Workflow
Ingestion from EHR via secure HL7, FHIR, or SFTP with auto-triage
AI pre-read across DRG, MCC/CC, sequencing, OR vs non-OR
Senior coder and CDI validation queues
Provider query SLA-bound workflows
DRG finalization prior to billing
Post-bill monitoring and governance feedback loop
SLAs
AI pre-read within hours of discharge
Full review turnaround typically within 24 to 72 hours depending on case type
Provider query issuance within 24 hours when required
Platform uptime 99.9%
HIPAA-aligned security and access controls
KPIs
DRG accuracy rate
Query acceptance rate
DNFB days impact
Net revenue impact per 1,000 discharges
Audit pass rate
Built for compliance and audit confidence
Every recommendation is traceable, every decision is documented, and every workflow is governed.
Every AI recommendation is traceable
Human validation at defined control points
Role-based access controls
Full audit logs and decision history
No model training on customer data
HIPAA Compliant
Full Audit Trail
Human-in-the-Loop
Data Isolation
Who this is for
Built for revenue cycle, HIM, coding, and compliance leaders.
Protect revenue and reduce leakage before claims are submitted.
Scale expert review capacity with AI-assisted workflows.
Focus on high-impact cases with prioritized queues and AI guidance.
Ensure defensibility with complete documentation and audit trails.
See Neurex Pre-Bill on your cases
We will walk through your DRG mix, workflows, and expected impact.
Book a Demo