ClaimRio reviews every claim before it leaves your practice — catching billing errors, code mismatches, and payer-specific issues so clean claims flow straight through to payment.
Every payer has different requirements. BCBS, Aetna, UHC, Medicare — the rules change constantly, and one missed modifier or wrong code sends a claim back weeks later. By then, the damage is done.
Wrong ICD-10 codes, deleted diagnosis codes, CPT mismatches — automatically caught before submission.
Prior auth requirements vary by payer, plan, and procedure. ClaimRio flags missing auth numbers every time.
E&M level too high for the diagnosis? ClaimRio catches visit complexity mismatches before payers do.
"Every denied claim costs us time, money, and momentum we can't afford to lose."
ClaimRio works alongside your existing eClinicalWorks + Trizetto workflow. No new software to learn. No changes to how you submit.
Your biller creates claims in eClinicalWorks as normal. ClaimRio automatically pulls draft claims via the FHIR R4 API — no manual exports, no copy-paste.
Our AI engine analyzes each claim against payer rules, ICD-10/CPT relationships, authorization requirements, and billing best practices. Flags surface in plain English.
Your biller sees exactly what's wrong and how to fix it. One click to resolve each flag. Clean claims submit through eCW and Trizetto as normal — fewer denials.
Real flags from a real claim. Plain English. Specific fixes. Not a vague error code.
BCBS Florida requires prior auth for CPT 99214 on this plan type. Claim will auto-deny without an authorization number in Box 23.
NPI 1234567890 is a commonly used test number. Verify the rendering provider's valid PECOS-enrolled NPI before submitting.
99214 requires moderate medical decision-making. J06.9 (unspecified URI) typically supports a lower-level visit. Ensure documentation justifies the complexity billed.
ClaimRio is built specifically around the eClinicalWorks + Trizetto workflow — not a generic billing tool bolted onto your stack.
Pulls claims directly from your eCW instance via the FHIR API. No exports, no manual uploads.
ClaimRio never writes to eCW. Your records stay exactly as your team left them.
Reads remittance data (835) from Trizetto to analyze denial patterns and generate appeal drafts.
Built on AWS with business associate agreements in place. PHI stays within HIPAA-covered infrastructure end to end.
ClaimRio is currently in pilot with eClinicalWorks practices in the DFW area. If your practice is experiencing high denial rates and you use eCW + Trizetto, we'd like to talk.
Request Pilot Access