MediRegs Advocate
Help  |  Contact Us
Advocate  —  Expert AI answers questions. Advocate fights your denials.

Code Check

One code in. Everything that applies, out. A coder can't hold six cross-mapped code systems in their head. Type any code — CPT, HCPCS, ICD-10, or NDC — and Advocate runs it through every mapping it knows: device requirements, revenue codes, prior auth, unit limits, deletions and replacements, drug crosswalks, and specificity. Including the ones you didn't know to check.

Try:
loading protected-dollars ledger…

Runs the committed synthetic fixture (fixtures/claims_demo.csv, 30 claims) through the deterministic battery.

Paste a denial letter. Parsing is deterministic; the version check runs against the effective-date regulatory content.

Select a stage →

Why AI fails coders

Hallucination risk

AI assigns codes confidently with no citation. Coder can't verify the reasoning — and the FCA doesn't care if the AI was wrong.

Policy version blindness

A claim from 2023 must be adjudicated under 2023 rules. Most AI tools have no version memory — they apply today's LCD to a 2-year-old DOS.

No audit trail

When an auditor asks "why did you bill this code," the answer can't be "the AI said so." Liability stays with the provider, not the vendor.


What earns trust

Cite or shut up

Every output traces to a specific CMS document, revision date, and policy section — not a summary, the source.

Version-proof reasoning

The LCD version controlling on date of service — not today — is retrieved and applied. Payer cited a superseded version? Flagged.

Human stays in the loop

Advocate reviews coded claims, never codes charts. It replaces research time — not the coder's judgment or signature.

Prior Authorization Checker

Enter a procedure code to check prior authorization requirements across Medicare OPD program, UHC, and Aetna PA lists.

CDM Validator

Enter a procedure code to check expected revenue code, device requirements, and OPPS status indicator from CMS Addendum B.

Pre-Bill Checklist

Quick single-code pre-bill check: MUE, device crosswalk, prior auth, CDM revenue code, common denial prediction.

Remittance Decoder

Paste denial codes from an 835 remittance or EOB. Advocate decodes each CARC/RARC to plain English with action guidance.

CDI Assistant

Enter an unspecified ICD-10 code to see more-specific options, documentation requirements, and a ready-to-send physician query template.

Ask Advocate

context: none (select a claim row or check a letter)