AI medical coding,
built on your data.
Capsa reads the same note your coder reads and bills every service the chart supports — tuned to your providers' documentation, your payers' rules, and your team's coding patterns. 93–96% accuracy, every code traceable to the chart.
Published coding guidelines are only half the job.
After a provider signs a note, a coder must bill every service performed — vaccines, screenings, vision and hearing checks. Easy to miss, inconsistent between coders, hard to audit later.
Lost, fully compliant revenue — gone for good
Billable work the coder didn't capture is money you earned and won't see. At scale, a few missed codes per visit is a seven-figure annual leak.
Audit risk and clawback exposure
Codes billed without support in the chart invite denials and recoupment. The goal isn't “more billing” — it's the right amount, provably.
Good coders quietly tune their work to each hospital.
Hand the same signed note to coders at two different hospitals and you can get two different — equally correct — claims. The difference is local context.
Same note.
Same services performed.
Coded differently depending on where it happened — because three things change per site.
Documentation habits
Which phrases this site's providers actually use to record the work.
Local payer rules
Contract and visit conditions specific to this hospital's payers.
Coding patterns
How this team has historically coded similar encounters.
A stranger's AI prompts can't code for your hospital.
Most “AI coding” is a fixed set of prompts written by an engineer somewhere else and dropped into your hospital — never adapted to it. Capsa is the opposite: it's built on your data.
Generic, off-the-shelf AI
A static prompt set, identical for every customer — blind to everything that makes coding work at your site:
- Your providers' documentation phrasing
- Your payers' contract and visit rules
- Your team's established coding patterns
- Your own paid-claims history
Capsa, built on your data
Your own data becomes the system — so it learns exactly the context a stranger's prompts can't see:
- Your providers' documentation phrasing
- Your payers' contract and visit rules
- Your team's established coding patterns
- Your own paid-claims history
You don't buy AI prompts — you get the pipeline.
Capsa turns your own material into a living coding system: your guidelines, cohorts, coding patterns, and paid claims drive a loop you control.
Build
Encode your rules, codes, and worked examples into an explicit, human-readable guideline.
Validate
Compare predictions to what your coders actually billed — scope-aware precision and recall.
Adjust
Refine rules from real disagreements, applied as traceable, versioned diffs.
Monitor
Track accuracy continuously over time as documentation and payers change.
coding accuracy, measured against what your coders actually billed.
“If your human coders can code it, the AI can too.”
Internal, validated results across two live coding skills (vaccines and health screening), measured on cases your team already coded. Not an external certification.
Every code traces to the exact chart words.
Recommended vs. billed codes, the rule behind each recommendation, and the verbatim chart evidence — then scored against what your coders actually billed. Answer “why this code?” in one click.
Transparent by design — and yours to govern.
Every code traces to the chart
Code → rule → the verbatim chart text that triggered it, at the exact version that ran. Unsupported quotes are dropped before a coder ever sees them.
Versioned and auditable
Rules, codes, and examples are versioned together with full history and side-by-side diffs. When a payer rule shifts, the change — and every code made under it — is on the record.
No model lock-in
All clinical logic lives in explicit, human-readable rule sets — not weights baked into a model. One engine runs every category, wired to no single EMR or guideline source.
One coding engine. A growing family of products.
Capsa Charge Capture is live today and the foundation of everything that follows. The same build-validate-adjust loop extends to the categories below — tell us which matters most and we'll bring you in first.
Capsa Charge Capture
Surface every billable code the signed note supports, cited to the chart and scored against what coders billed.
Explore & book a pilotCapsa E&M Coding
Defensible evaluation & management level selection from the documented history, exam, and decision-making.
Join the waitlistCapsa ED Coding
Emergency-department facility and professional coding with the same evidence-cited, audit-ready approach.
Join the waitlistCapsa CDI
Clinical documentation integrity that flags gaps before the claim goes out — governed by your CDI team.
Join the waitlistSee Capsa on cases your team already coded.
We'll build a guideline from your rules, run it against your cohorts and paid claims, and show you scope-aware precision and recall on visits you've already billed. No rip-and-replace.
- Built on a sample of your own visits
- Accuracy measured vs. what your coders billed
- Every recommendation cited to the chart
- No EMR or vendor lock-in
Request a demo / pilot
We'll get back to you within one business day.