Eligibility
Verify coverage and benefits before the visit, so nothing bills into a dead policy.
Coding agent · running now
✓Intake1,180 char chartSOAP note received
✓De-identify5 identifiers maskedbefore the model sees it
✓CodeE11.65 · E11.9 · 99213model proposes
✓ValidateE11.42 · 992132 corrected
✓RiskRAF 0.3320.319 documented, never coded
06Claim1500 · 837P · FHIR · XMLready to submit
Runs on our own GPU. Charts are de-identified before the model sees them.Run it
Know whereyour money isbefore it's gone.
Most practices learn about a denial three weeks after it happened, when the appeal window is already closing. Agents run eligibility, coding, denials and collections as the work happens — so you see the gap while you can still do something about it.
No sign-in. The coder runs on our own GPU and de-identifies every chart before the model sees it.
Coding agent · running now
✓Intake1,180 char chartSOAP note received
✓De-identify5 identifiers maskedbefore the model sees it
✓CodeE11.65 · E11.9 · 99213model proposes
✓ValidateE11.42 · 992132 corrected
✓RiskRAF 0.3320.319 documented, never coded
06Claim1500 · 837P · FHIR · XMLready to submit
Runs on our own GPU. Charts are de-identified before the model sees them.Run it
GetMax does it all — eligibility verification, medical coding, medical billing, prior authorization, A/R follow-up, and denial management on one AI revenue cycle platform.
One cycle. Seven agents. No handoff dropped.
Every step passes its work to the next one automatically. Nothing sits in an inbox waiting for a person to remember it — which is where most revenue actually goes.
- 01Live now
Eligibility
Checks coverage, plan status and benefits before the visit.
Hands over: A verified patient, or a flag while the front desk can still act.
- 02Live now
Authorization
Finds what needs prior auth and tracks it to approval.
Hands over: An auth number attached to the encounter.
- 03Live now
Coding
Reads the chart, proposes ICD-10 and CPT, then deterministic rules correct what the model got wrong.
Hands over: Codes that survived every check, with the corrections shown.
- 04Live now
Risk capture
Scores HCC and RAF, and finds conditions the note documents but nobody coded.
Hands over: The revenue you already earned and never billed.
- 05Live now
Claim
Builds the claim in CMS-1500, X12 837P, FHIR and XML.
Hands over: A file the clearinghouse accepts, not a spreadsheet.
- 06Live now
Denials
Reads the remittance, separates a real denial from a contractual adjustment, and drafts the appeal.
Hands over: An appeal inside the filing window instead of three weeks late.
- 07Live now
Collections
Works AR by age and payer, and posts what lands.
Hands over: A shrinking AR you can see daily, not monthly.
All seven run today and you can use them yourself, right now, with no sign-in. Coding uses our own model behind deterministic rules; the other six are deterministic end to end, because a confident wrong answer here costs a filing window.
Run them yourself
- 9
- revenue-cycle stages, end to end
- 24/7
- operations, always on
- 100%
- US healthcare, nothing else
Revenue Cycle Management.
Reinvented with AI.
Every stage of the revenue cycle, run by AI and backed by specialists — so clean claims go out and fewer dollars fall through.
Medical Coding
Accurate ICD-10 and CPT codes, checked against payer rules as they're applied.
Medical Billing
Clean claims submitted right the first time, across every payer and clearinghouse.
Denial Management
Catch, appeal, and prevent denials before they quietly turn into write-offs.
AR Follow-up
Chase aging claims automatically and keep days-in-A/R from creeping up.
Payment Posting
Reconcile ERAs and payments to the penny, and flag every underpayment.
Works across the EHRs you already run.
GetMax is built to plug into the EHRs and clearinghouses healthcare organizations already use — embedding into your existing workflow instead of replacing it.
View integrations
See what your revenue is actually doing.
Most practices find out about a denial weeks after it happened. These are the screens your team works in, so you know where the money is while you can still do something about it.
See every rupee of open A/R, the day it ages.
Total charges, what has actually been collected, and what is still outstanding — on one screen, live from your charges.
Learn more
Charge → Cash
The whole revenue cycle. Handled.
Six services, one platform — from the first eligibility check to the last dollar posted.
Real-time verification
Eligibility
Coverage and benefits verified before the visit.
Faster approvals
Prior Authorization
Authorization secured before care is delivered.
AI + certified coders
Medical Coding
ICD-10 & CPT, checked against payer rules as they're applied.
First-pass clean claims
Medical Billing
Clean claims submitted right the first time, every payer.
Automated worklists
AR Follow-up
Aging claims chased automatically, days-in-A/R held down.
Predict & prevent
Denial Management
Denials flagged before they happen — appealed fast when they land.
We do
it all at
GetMax.
One platform · The entire revenue cycle
You already know these codes.
That's the problem.
Every denial code is revenue stalled — and a payer betting your team is too buried to fight back. Across US healthcare, roughly one in ten claims bounces on first submission, and most denials are never reworked at all.
- CO-16
- Claim lacks information
- CO-29
- Filed too late — deadline missed
- CO-97
- Bundled into another service
- CO-50
- Deemed not medically necessary
- PR-204
- Not covered under the plan
- CO-18
- Flagged as a duplicate claim
- CO-11
- Diagnosis doesn't match procedure
- CO-22
- Another payer should go first
- CO-45
- Charge exceeds the fee schedule
- CO-109
- Wrong payer for this claim
- PR-1
- Applied to patient deductible
- CO-167
- Diagnosis not covered
GetMax exists so your team never memorizes another one — denials predicted and fixed before the claim ever leaves.
Built for modern healthcare.
Book a demoAI-native, not AI-added.
Every workflow is built around automation from the first eligibility check to the last dollar posted — not bolted on afterward. That's why the cycle runs faster, cleaner, and with fewer hands.
Book a demoHIPAA-aligned
Built to HIPAA privacy and security standards from day one, with least-privilege access across every workflow.
Experienced team
Run by people who've lived the US revenue cycle — certified coders, billers, and engineers who know where claims break.
Enterprise scale
Architected to grow from a single clinic to multi-site health systems, across every payer and clearinghouse.
Meet the future of revenue cycle.
Powered by AI.
AI runs every stage of the revenue cycle — coding, eligibility, denial prediction, analytics, and workflow — with specialists in the loop.
Book a demo01
AI Coding
Encounters coded to ICD-10 and CPT automatically, checked against payer rules as they're applied — with certified coders reviewing the edge cases.
02
AI Eligibility
Coverage and benefits verified in real time before the visit, so claims never bill into a dead policy.
03
AI Denial Prediction
Every claim scored for denial risk before submission, with fixes applied up front instead of appeals filed after.
04
AI Analytics
Revenue, denials, and A/R surfaced as they move — patterns flagged early, not buried in a month-end report.
05
AI Workflow Automation
Hand-offs between eligibility, coding, billing, and collections run themselves, keeping claims moving without manual queues.
Questions people ask us
- What does GetMax do?
- GetMax runs the US healthcare revenue cycle: eligibility verification, medical coding, claim submission and scrubbing, denial management, AR follow-up and payment posting. AI agents do the repetitive volume and certified specialists handle what the models escalate.
- What makes GetMax AI-native rather than a billing company with AI added on?
- The agents are the delivery layer, not a feature on top of it. Coding, claim review and eligibility run continuously as work arrives rather than in end-of-day batches, and the models run on GetMax's own GPUs rather than a third-party AI provider.
- Can I try it before talking to sales?
- Yes. The AI coding assistant is open at /demo/coding with no sign-in, no trial timer and no card. Paste a clinical note and watch it de-identify, code, and validate against the live NIH ICD-10-CM set.
- How is patient data protected?
- HIPAA Safe Harbor identifiers are masked to consistent placeholders before any model receives the text, so the model never sees the real chart. The models are self-hosted on GetMax infrastructure rather than sent to an external AI provider.
- Do we have to change our EHR or clearinghouse?
- No. GetMax is built to run on top of the systems you already use. Replacing a clinical system is a separate project and not one we ask you to take on to start.
- Which parts of the agent cycle are live today?
- The coding agent is live and open to use. Eligibility, prior authorization, denials and collections agents are in build, and the cycle diagram on this page labels each one live or in build rather than presenting all of them as shipped.