Adjudicore — Mobile, AL
Pilot Active
Pre-submission claim intelligence

Catch denials before
they leave the building.

Adjudicore reads the claim before it goes to the payer — not after it comes back denied. The platform validates EMR exports and superbills pre-submission, flags what the payer will reject, and prescribes the fix. Every decision documented to its source. Denials that slip through? Handled too. But the goal is to send claims that don't come back.

— Press & inquiries
contact@adjudicore.com
Pre-Submission Review #A4F2-71
↑ Upstream · Before Submission
claim_id CLM-738291
source EMR Export
cpt_code 99214
verdict hold_for_fix
confidence deterministic
— Issues caught upstream
Modifier 25 missing — required with E/M + procedure
Dx code I10 not linked to procedure line
— Provenance Chain
CPT Guidelines §I.E (AMA 2026)
Payer Policy CCI v2026.04
Auth. Rank: Primary Source
— Category comparison

Most "AI billing tools" operate after the damage is done.

Reactive denial management starts the work after the payer says no. Adjudicore starts it before the claim is sent.

— Capability
AI Denial Management
Adjudicore
When it acts
After the denial. Reactive.
Before submission. Preventive.
Decision basis
Statistical inference. Probabilistic.
Deterministic rules. Traceable to source.
Auditability
Black box. "The model said so."
Every output cites its authority.
HIPAA posture
Often non-compliant. PHI sent to third-party APIs.
HIPAA-compliant by architecture.
Economic effect
Recover some of what was lost.
Stop the loss from happening.
01 / Architecture

Deterministic, not probabilistic.

A validated decision engine. Same input, same output, every time. Defensible in any payer audit because the reasoning is documented, not inferred.

02 / Provenance

Every output traceable to source.

Decisions cite the regulation, the policy, the manual section. Knowledge corpus organized by authority rank. Provisional patent filed April 2026.

03 / Discipline

Built for independent practices.

Enterprise RCM is priced for hospital systems. AI tools can't be audited. Adjudicore is right-sized for the practices the others ignore.