Exactrx

Exactrx reads a clinical note, codes the visit against the relevant payer rules, produces a defensible claim, and submits it with a 99% first-pass approval rate.

Ambulatory practices have to pay people to do that work manually. Coders read notes and pull codes, billers chase adjustments and file appeals, and the work keeps growing every year as payers get more aggressive.

I started Exactrx in 2024 to take that workflow and run it through agents. Exactrx handles claim submission, then reviews every payer adjustment to identify where the practice can recoup lost revenue. The CBO sees each action and can override anything, with a full audit trail underneath.

The work runs in two loops, both currently in production:

1. Submission: note to codes to claim
2. Adjustments: evaluate CARC and RARC codes to surface where the practice can recoup lost revenue

For the practices we work with, the workflow runs faster and more reliably. Adjustments get worked the day they hit, notes don't sit waiting to be coded, and there's a complete audit trail of what was done and why.