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FirstClaim

Medical billing errors cost US providers over $125B annually.

Core trick

Claude extracts diagnosis and procedure codes from clinical notes, then checks them against a 72,000-entry ICD-10 table and age-sex rules.

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Description

Medical billing errors cost US providers over $125B annually. Doctors' notes must be translated into standardized codes (ICD-10, CPT) to get paid. Wrong code, missed modifier, or impossible pairing means a denied claim. FirstClaim is an AI-native billing application powered by Claude Opus 4.6. Paste clinical notes and a validation pipeline extracts diagnoses and procedures, matches them against a 72,000-entry ICD-10 database, runs compliance checks (age/sex rules, code compatibility, medical necessity), flags errors with dollar amounts at risk, and calculates a risk score. It caught a mammogram billed for a 30-year-old male before it reached an insurer. The claim workspace makes every finding actionable. Fix issues through conversation: "remove that line item," "swap this code," "bill at a lower level." The claim updates, findings resolve, and risk recalculates in real time. Session history lets you pick up where you left off. Cleaner claims, better reimbursement, the first time.

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