Claims Review Agent

Category: Revenue Cycle & Operations · Signals: Claim line items · Payer edit rules · Modifier logic · NCCI edits

Catch claim errors before they leave the practice — surface fix suggestions, not just rejections.

Configuration

Field	Description
`payer_edits`	Payer edit rule library
`ncci`	NCCI edit set
`modifier_policy`	Modifier policy
`approval_workflow`	Pre-submission approval workflow

Expert	Role
Payer Edit Rule Expert	Carrier-specific edits
NCCI Edit Expert	National Correct Coding Initiative
Modifier Expert	Modifier logic + validation
Claim Structure Expert	Line item + total validation

Backend: POST /api/billing/claims/scrub · POST /api/billing/claims/submit.

Framework + 24 agents.

Typed expert registry.

Compose your own workflow.

REST surface.