Submit, reconcile, appeal — from one queue.
Encounters become claim XML. DHPO sends remittance. Denials get an AI-drafted appeal letter ready to fire back. You watch the queue clear.
| Claim | Patient | Payer | Status | AED |
|---|---|---|---|---|
| CLM-2026-0432 | Khalifa Al Mazrouei | Thiqa | Submitted | 1,820.00 |
| CLM-2026-0431 | Aisha Khan | NEXtCARE | Adjudicated | 320.00 |
| CLM-2026-0429 | Mariam Al Suwaidi | Daman | DeniedDraft appeal | 640.00 |
| CLM-2026-0427 | James O'Connor | Bupa | Amended | 1,150.00 |
| CLM-2026-0425 | Hessa Al Nuaimi | Daman | Adjudicated | 280.00 |
End-to-end, no spreadsheet handoffs.
A note signed in the room becomes a claim, gets paid, and the denial loop closes itself — without anyone re-keying.
Encounter
Doctor signs note
AI codes
ICD-10 + CPT suggested
Claim XML
Sent to DHPO
Remittance
Auto-posted
Appeal
AI drafts the letter
The reports you wished your old EMR had.
Anything older than 60 days deserves a phone call to the payer.
Outstanding claims by days since submission. Filter by payer, status, or service line. Click through to the encounter and the audit log of every DHPO transaction.
Outstanding by age (AED)
Which payer is bleeding you?
Avg days-to-payment and denial rate per carrier. Spot the outlier before it becomes the quarter's revenue surprise.
| Payer | Days | Denial |
|---|---|---|
| Daman | 18d | 6% |
| Thiqa | 22d | 9% |
| NEXtCARE | 34d | 14% |
| MEDNET | 41d | 19% |
Drafted in seconds. Cite-ready.
Sonnet drafts a letter using the encounter, the SOAP note, and the denial reason. Coder reviews, then resubmits as a Correction or Internal Complaint.
Subject: Internal Complaint — CLM-2026-0429, denied with code MNEC-005…
The denial cites medical necessity, but the SOAP note for this encounter documents acute symptom onset and clinical exam findings consistent with…
Patient gender is "non_binary" — eClaim MemberGender must be 0 (female) or 1 (male). UAE eClaim 2.0 is binary; this claim will reject at the post-office gate.M-GEN
demographics · GENDER_NOT_BINARY
CPT 99214 billed with a procedure on the same encounter — modifier 25 usually required.99214
modifier · EM_PROCEDURE_SAME_DAY_NO_25
Diagnosis E11.9 is unspecified, but the note mentions "with retinopathy". Use a more specific code (e.g. E11.31).E11.9
medical_necessity · UNSPECIFIED_ICD_WITH_SPECIFIER
Migraine, unspecified → ICD-10 G43.909. Auto-add for the coder.G43.909
icd10 · ICD10_HINT_AVAILABLE
Real audit panel from /dashboard/claims/encounters/[id]. 40+ rules across schema, demographics, modifiers, medical necessity, eClaim 2.0 conformance.
The claim runs an audit before DHPO does.
The DHPO post-office gate rejects on schema violations, missing demographics, and obvious medical-necessity issues. Our audit runs the same checks first — plus a Sonnet-backed pass that reads the SOAP note and flags weak documentation per code, before a single byte ships to eClaimLink.
- 40+ rules across 10 categories. Schema (eClaim 2.0 conformance), demographics, dates, modifiers, NCCI bundling, medical necessity, frequency, duplicates, place-of-service.
- AI-backed documentation check. Per-code: does the SOAP support the level billed? Is time documented for time-based E&M? Is the laterality preserved?
- Block on critical, warn on the rest. Critical findings (gender, DOB, dose-unit, missing principal dx) hard-block submission. Warnings show inline; coder dismisses with a reason.
- Sourced from real adjudication rules. ECRI 2026, AAPC modifier guidance, Shafafiya v3.5, DHA Adjudication Rules v2025, ISMP error-prone abbreviations.
What we’re aiming for · targets, not customer averages
12%
Denial rate target
21d
Avg days to payment target
85%
First-pass clean claim target
55%
Auto-appeal recovery target