Aelix Pulse, revenue cycle automation
Cut denied claims by a third,
in 6 months.
Aelix Pulse deploys intelligent RPA and smart bots to automate your revenue cycle, accelerate patient intake, and eliminate manual billing errors. Recover 14 to 22% of denied revenue inside the first 90 days.
Agentic AI · Aelix Pulse agents · Design-partner preview
From scripted bots to reasoning agents that show their work.
Aelix Pulse already runs the bots that read X12 EDI, draft claims, and process invoices. The agentic layer evolves each bot from a fixed script into a reasoning agent that plans, calls tools, explains its decisions, and escalates to a human at defined gates. Every irreversible action (submit a claim, write to the EHR, send an appeal) stays gated. The agent does the judgment. A human signs.
Autonomous Medical Coding Agent.
Reads clinical documentation and proposes CPT, HCPCS, ICD-10-CM, and modifiers with a written rationale and a citation to the source note line. NCCI edits and medical-necessity checks run as deterministic post-checks, not model judgment. The coder approves every claim by default.
Denial Management Agent.
Reads the 835 ERA, classifies the denial (eligibility, coding, auth, timely-filing, bundling, medical necessity), and decides fix or appeal. Low-dollar deterministic resubmits run within policy thresholds. Appeal letters are drafted, never sent without a human.
Prior Authorization Agent.
Determines whether a service needs prior auth, assembles the clinical justification, drafts the medical-necessity narrative, and tracks status to decision. The clinician or auth specialist approves the narrative before submission. Peer-to-peer pends always escalate.
Patient Onboarding Agent.
OCRs and classifies intake documents, normalizes demographics, runs 270/271 eligibility, and writes a clean registration to the EHR. Clean intakes auto-complete. Anything ambiguous routes to a front-desk reviewer with the agent's findings pre-filled.
Coding Quality-Audit Agent.
Independent second-pass reviewer that audits coded claims for upcoding, downcoding, unbundling, modifier misuse, and documentation gaps. Read-only. Flags and explains. The Coding Agent's thresholds calibrate to its findings.
AP Invoice Agent.
Ingests vendor invoices, performs PO and receipt matching, proposes GL coding, and flags exceptions. Clean three-way matches auto-post within tenant thresholds. Exceptions wait for a human.
Tenant Copilot.
Natural-language analyst over a tenant's RCM data: 'why are dermatology claims denying this month', 'show appeal win-rate by payer'. Read-only. Recommendations only. Action routes back through the gated workflow.
Trust architecture
Retrieval-grounded, not model memory.
Codes come from licensed code-sets exposed as tools. Payer policies, NCCI edits, and medical-necessity rules come from versioned reference data. The model proposes. The validator decides.
Citation or strip.
Every code, every appeal claim, every medical-necessity narrative must cite a specific note line, FHIR resource, payer policy, or chart fact. Uncited output is discarded before it reaches a human.
Irreversible action stays human-approved by default.
Submit a claim, send an appeal, write to the EHR, post a payable. Each is a dedicated, gateable tool the platform intercepts. Dollar thresholds and timely-filing deadlines are enforced deterministically, not by the model.
Tenant-scoped, audit-logged, BAA-covered.
The agent runs under the caller's role and tenant. PHI never leaves the trust boundary. Every action lands in the same hash-chained audit log as a human action. Inference runs inside a signed BAA boundary.
What ships first
Phase 1 ships the Coding Agent in shadow mode for outpatient professional E/M and common-procedure coding, with the Quality-Audit Agent as its checker. Shadow, assistive, scoped-autonomous. Auto-accept graduates per code-category only after measured coder agree-rate clears the threshold. Inpatient DRG and facility coding are deliberately out of MVP scope. We do not ship 'fully autonomous' as a default.
The cost of manual work
Hospitals lose millions to manual processes. It's time to automate.
Revenue leakage
Claim denials and coding errors silently drain hospital margins.
Staff burnout
Your team spends hours on data entry instead of patient care.
Poor patient experience
Drag at onboarding and intake leads to no-shows and dissatisfaction.
What Pulse automates
Intelligent revenue cycle management
Deploy smart bots for medical coding, billing, and denial management. Pulse cross-references claims against current payer rules before submission, cutting denial rates by up to a third in 6 months.
Smoother patient onboarding
Replace the clipboard. Automate patient intake, insurance verification, and appointment reminders to dramatically reduce wait times.
AI-powered invoice validation
Stop overpaying vendors. Pulse uses RPA and AI to automatically flag discrepancies in hospital supply chain invoices before they are paid.
Works with what you have
Built to work with your existing systems.
Aelix Pulse doesn't require ripping out your EHR. Our bots interact with Epic, Cerner (Oracle Health), MEDITECH, and athenahealth via FHIR R4 and HL7 v2, just thousands of times faster than a human user. Fully aligned with HIPAA, HITRUST, and SOC 2.
Proven at scale
$262B
Lost annually to claim denials.
US hospitals lose $262B per year to claim denials (CAQH Index, 2024). Pulse recovers 14 to 22% in the first 90 days by pre-validating claims against current payer rules.
Calculate your ROI
Stop processing. Start caring.
Find out how many hours and dollars Aelix Pulse can recover for your health system.
Need this tailored to your environment?
Every Aelix product can be configured, extended, or built bespoke for your industry, data sources, and compliance constraints. Talk to our engineers about what would change.
Configurable workflows
Adapt rules, thresholds, and approval flows to match your operational policies.
Custom data integrations
Connect to your specific ERP, MES, SCADA, CRM, or proprietary systems.
Bespoke modules
Build product extensions tailored to your industry, region, or compliance needs.