Abridge expanded its artificial intelligence capabilities into the mid-revenue cycle workflow. The company launched a pre-bill review capability designed specifically for clinical documentation integrity (CDI), coding, and revenue cycle teams.
The pre-bill reviews inpatient claims before submission, comparing coded diagnoses and diagnosis-related groups (DRGs) against what the clinical documentation supports to identify potential discrepancies and provide supporting evidence, the company announced on Monday.
Abridge started with ambient listening and AI-powered clinical notes and has steadily expanded beyond clinical documentation to tackle other admin tasks, developing what it calls a "clinical intelligence" platform. The company has built its platform around the clinical conversation and is expanding both upstream to support visit preparation and downstream into administrative and revenue cycle workflows.
Abridge says its clinical AI technology captures the record as the clinical interactions happen and the company can extend that into reimbursement workflows. Extending that same platform into pre-bill review allows Abridge to compare the clinical record with the diagnoses and DRG on the claim and show where they do not align. CDI and coding teams can then determine before submission whether the coded record accurately reflects the documented complexity of care.
The company says it doesn't change documentation, codes, or claim status—CDI teams maintain control over what to hold, correct, or release.
“Health systems aren't reimbursed for the care that they deliver. They're reimbursed for the care they document that they delivered," Shiv Rao, M.D., CEO and co-founder of Abridge, said in a statement. "We've been working on that gap directly at the point of care—surfacing diagnoses as the note is written, raising the question before anyone has left the room. But weeks and a dozen hands separate the encounter from the claim, and detail fades at every step. In June, we described a platform that carries clinical context into every decision a health system makes. When a clinician and a CDI specialist are working from the same record, the claim ends up matching what actually happened.”
Abridge says it works with 300 of the largest and most complex health systems in the U.S., and its platform will support more than 100 million patient-clinician conversations this year.
The pre-bill claim review tool marks the next evolution of Abridge's AI platform as it extends into more clinical and administrative workflows. A year ago, the company unveiled what it dubbed a "contextual reasoning engine" that produces billable notes that support appropriate claims at the point of care. The company is also working with Highmark Health to co-design an AI-powered prior authorization solution at the point of care.
At the annual J.P. Morgan Healthcare Conference in January, Abridge announced it was partnering with real-time health information network Availity to fire up AI-powered prior authorization. The company also developed an AI-based decision support solution, which it has since made available to every clinician at its partner health systems.
Abridge said the pre-bill review tool is the first product in its portfolio built for the mid-revenue cycle and one of a growing set of capabilities that follow a case from clinical conversations to the submitted claim. Each works with the same record, from bedside to bill, so a clinician documenting a case and a coder reviewing it are working with the same intelligence, according to the company.
“Our partnership with Abridge started with documentation and has kept growing because each step earned the next one," Muhammad Siddiqui, Reid Health's chief digital and information officer, said in a statement. "It's in the ED and urgent care, with our nurses and medical assistants in ambulatory. What makes their pre-bill work compelling is that it doesn't ask us to stand up a separate system with its own view of the patient. It runs on the same record our clinicians are already creating. We're looking forward to rolling this out to our CDI and coding teams.”
Reid Health is a not-for-profit health system serving east central Indiana and west central Ohio.
When the pre-bill tool identifies a discrepancy, it surfaces the supporting documentation, allowing CDI teams to review it through their existing query workflow. The capability also helps teams assess whether a condition was present on admission (POA), a determination that affects hospital-acquired condition (HAC) reporting and publicly reported quality scores, according to Abridge.
“From a CFO and revenue cycle perspective, getting the claim right the first time matters enormously. An inaccurate claim creates far more than a denial—it creates rework, delays cash, consumes scarce clinical and administrative resources, and adds unnecessary cost,” Sharon Kelley, former health system revenue cycle chair and CFO, and advisor to Abridge, said in a statement. “What is particularly compelling about Abridge’s approach is the ability to carry intelligence from the clinical conversation through pre-bill review, creating a more connected process that can strengthen both documentation integrity and reimbursement accuracy.”
Several large health tech players offer AI-powered CDI and billing tools such as Waystar and Solventum. A growing number of healthcare AI startups are also expanding into RCM workflows. Ambience offers an ICD-10 clinical document integrity assistant for inpatient care. OpenEvidence, which initially launched as an AI-powered medical search engine, also developed an AI medical coding feature embedded in its clinical AI assistant.
AI medical coding company CodaMetrix has seen rapid growth among health systems, reporting that organizations partnering with the company now represent over $180 billion in net patient revenue.
Healthcare AI spending hit $1.4 billion in 2025, according to Menlo Ventures, and two categories dominated that hefty investment: ambient clinical documentation, at $600 million, and coding and billing automation, with $450 million invested.