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Description
Compatibility Level
Clients
Product Capabilities
Use cases
EHR integrations
Client types
Differentiators
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Company details
Jump to:
Categories
Solutions
Description
Compatibility Level
Clients
Product Capabilities
Use cases
EHR integrations
Client types
Differentiators
Keywords
Media
Company details

Categories

Solutions

Description

Product Description:

Agentic AI employees for healthcare

Explore our custom AI employees for critical back office, revenue cycle, and administrative healthcare workflows. Some of our most popular include full automations for:

  1. Prior authorizations
  2. Claims processing
  3. Insurance verification
  4. Payment posting
  5. Patient enrollment
  6. Denial management
  7. Claim scrubbing
  8. Credentialing
  9. Charge reconciliation

How Magical works

Fully automate rev cycle workflows

Use an AI employee trained specifically in revenue cycle management to automate entire processes end-to-end. (No human oversight required.)

Lower your cost to collect

Unlock the efficiency of a machine. Magical pulls patient patient data directly from one system into another, to minimize insurance denials and delays.

Built for enterprise security

Maintain the highest levels of security and privacy. We never store any personal health info on our servers. 

Daily Automated Testing | Automation Logs | SOC2 & HIPAA Compliant

Best-in-class reliability

Get over 90% success rates on end-to-end automations of any complex workflow. Magical uses multi-agent evaluation infrastructure to ensure your automations are running smoothly. 

Performance monitoring

Dive into complete logs of every single step of every single automation to give your team clear visibility into success rates and edge cases. 

Who we are

A blended team of 40+ technology and healthcare experts. Not only will you be working with agentic AI engineers, but also seasoned rev cycle experts. 

Why we’re trusted

Over 100,000+ companies—including WebPT, Phreesia, SonderMind, and Curalta—trust Magical automations for the following reasons:

  1. Fast: 1 week average implementation time
  2. Reliable: 90%+ average success rate end-to-end
  3. Proven: 100% agentic automation (no bots)
  4. Scalable: Magical runs entirely on virtual machines
  5. Interoperable: Magical can rapidly integrate with any system
  6. Compliant: Magical is SOC 2 and HIPAA-compliant
About Magical:

Magical is an agentic AI platform that fully automates complex workflows in just one week. Put your back office on autopilot with AI employees that use human-like decision-making and best-in-class reliability. 

Who we are

A blended team of 40+ technology and healthcare experts. Not only will you be working with agentic AI engineers, but also seasoned rev cycle experts. 

Why we’re trusted

Over 100,000+ companies—including WebPT, Phreesia, SonderMind, and Curalta—trust Magical automations for three key reasons:

  1. Fast: 1 week average implementation time
  2. Reliable: 90%+ average success rate end-to-end
  3. Proven: 100% agentic automation (no bots)

About the technology

Fully agentic

Magical AI agents use reasoning models, real- time data retrieval, and goal-based execution to make your automations more reliable than traditional rule-based approaches. They can adapt to changes on the fly, and learn from failures. 

Best-in-class reliability

Get over 90% success rates on end-to-end automations of any complex workflow. Magical uses multi-agent evaluation infrastructure to ensure your automations are running smoothly. 

Performance monitoring

Dive into complete logs of every single step of every single automation to give your team clear visibility into success rates and edge cases. 

Scalable

Magical runs entirely on virtual machines

Interoperable

Magical can rapidly integrate with any system

Compliant

Magical is SOC 2 and HIPAA-compliant

Product Description:

Amy - AI Medical Coding solution revolutionizes healthcare revenue cycle management through advanced artificial intelligence that transforms clinical documentation into accurate, compliant medical codes across CDI, audit, and coding operations.

Clinical Documentation Improvement: Amy analyzes physician notes in real-time, identifying documentation gaps and suggesting clinical details needed for optimal coding. Amy flags incomplete diagnoses and missed documentations, enabling proactive CDI specialist engagement.

Audit Capabilities: Amy performs continuous compliance monitoring by cross-referencing coded claims against clinical evidence. Amy identifies coding discrepancies, highlights high-risk cases, and generates detailed audit trails, reducing compliance risks and claim denials.

Medical Coding Excellence: Amy automates complex coding workflows, handling 80%+ cases autonomously, interpreting clinical narratives and assigning accurate ICD-10, CPT, and HCPCS codes. Amy handles multi-specialty scenarios and HCC management while providing confidence scores for human review.

Customization & Integration: Amy's flexible architecture ingests hospital-specific coding grids, payer requirements, and institutional guidelines. The platform adapts to organizational workflows while maintaining established coding practices, ensuring AI recommendations align with each facility's unique standards.

Healthcare organizations experience improved coding accuracy, reduced administrative costs, enhanced compliance, and faster revenue realization with Amy, who continuously learns from coding patterns and delivers increasingly personalized solutions.

About CombineHealth AI:

CombineHealth AI tranforms Revenue Cycle Management with AI Solutions

Compatibility level

Select which hospital or health system you work at and see a personalized compatibility level.

Clients

Select which hospital or health system you work at and see the client list

Product Capabilities

Make your workflow automations self-driving Traditional automations (RPA) is rigid and fragile, like driving manually to a destination using printed directions. If you miss a turn or make an error, everything quickly breaks. Agentic AI is like a self-driving car that understands your goal and the nuance it takes to get there. This is intelligent automation that course-corrects, identifies shortcuts, and gets smarter over time.

Magical is SOC 2 and HIPAA-compliant

Verify patient insurance in seconds—not hours—with your new AI employee for eligibility and benefits verification. Fully automated verifications Magical AI employees log into payer portals, search for patient eligibility, and pull coverage details—automatically and accurately. Real-time benefit checks Automatically verify deductibles, co-pays, and plan-specific benefits so your team is never in the dark. Catch problems before they become denials Identify inactive policies or mismatched details upfront, so you can fix issues before submitting claims.

Identify, fix, and resubmit denied claims—automatically—with an AI employee that never misses a deadline or a denial reason. Auto-identify denials at scale Magical reviews ERAs, EOBs, and payer responses to flag and categorize denials in real time. Fix root-cause errors instantly Whether it’s a coding mismatch, missing modifier, or eligibility issue—Magical uses context-aware logic to correct and prepare clean resubmissions. Automate appeals and resubmissions Magical navigates payer portals, fills out appeal forms, and resubmits claims—without human input.

Set up an AI employee to automatically monitor the status of all prior authorizations and keep them up-to-date.

Use an AI employee to verify all information and flag any potential errors for human review. If the request looks clean, you can enable your AI employee to automatically submit it.

Automatically open and extract information from any PDF or patient file, as part of the overall workflow automation process.

Use an AI employee to automatically complete forms more reliably than any RPA bot. Get pixel-perfect precision in any EMR or insurance portal, as well as independent AI judges to verify successful form completions.

Eliminate manual data entry and reduce denials by over 50% with your new AI employee that specializes in prior authorizations. Automate prior auths end-to-end using AI Magical reliably moves patient information from your EHR and submits directly into insurance portals and prior authorization systems. Export information to any authorization form Magical recognizes information on insurance portals and automatically maps it to the right fields, getting smarter over time. Human-in-the-Loop Verification Magical combines AI automation with human verification to maintain complete accuracy and compliance in your prior authorization process.

Amy is part of CombineHealth's suite of AI Workforce that collectively manage end to end RCM ecosystem for healthcare organisations, providing a unified platform for revenue cycle intelligence

Amy offers automated solution for routine tasks, ensuring outcomes with high accuracy. One of the key differentiators of Amy is explainability and human-in-the-loop approach, where each automation and decision taken by Amy is transparently communicated to the user

Amy, as part of CombineHealth's platform for end-to-end RCM transformation, collaborates with Lia, AI Medical Scribe solution to predict denials and recommend actions for prevention. These insights are segmented as per different facilities and doctors for nuanced understanding and conduct personalized training.

Amy is compliant with all leading regulations and has over 100+ security features to ensure adherence to various compliances, ensuring trust and security at every step

Amy, as part of CombineHealth's platform for end-to-end RCM transformation, collaborates with Marc and Adam, AI Denial Management and A/R Follow-up solutions to proactively follow-up and draft appeals.

Amy is built on CombineHealth's proprietary AI technology, trained over 1M+ medical charts and 100K+ payor policies establishing industry best benchmark for accuracy and reliability

Use Cases

Description:

None provided

Pediatric use cases:

None provided

Users:

None provided

Description:

Amy's capabilities include

- Medical Coding

- Auditing

- CDI (Clinical Documentation Integrity)

Pediatric use cases:

None provided

Users:

Revenue cycle leaders and revenue cycle management teams

EHR Integrations

Integrations:

Acute care EMR, Ambulatory EMR, Ancillary EMR, ERP system, Patient portal, Pop health platform, Home health, Behavioral health, Community based organizations, ADT, Access +/or revenue cycle, Credentialing, Website / public online sources, Other

EMR Integration & Relevant Hardware:

Use case dependent

EMRs Supported:

Epic, Cerner, Meditech, Allscripts, NextGen, athena, GE, eClinicalWorks, McKesson, Other, Allscripts/Eclipsys, Athenahealth, Azalea Health/Prognosis, CPSI, Evident, Healthland, MEDHOST, MedWorx, QuadraMed, Self-developed, Would prefer not to disclose, Point Click Care

Hardware Compatibility:

Desktop

Integrations:

Ambulatory EMR, Home health, Behavioral health, Access +/or revenue cycle, Credentialing, Website / public online sources

EMR Integration & Relevant Hardware:

Recommended, but not required

EMRs Supported:

Epic, Cerner, Meditech, Allscripts, NextGen, athena, eClinicalWorks, Athenahealth

Hardware Compatibility:

Not applicable

Client Types

Differentiators

Differentiators vs EHR Functionality:

None provided

Differentiators vs Competitors:

None provided

Differentiators vs EHR Functionality:

Intelligence vs Documentation

Amy: Actively analyzes and interprets clinical documentation with 99.2%+ coding accuracy using advanced AI algorithms

EHRs: Primarily store and organize patient data without intelligent code interpretation or suggestion capabilities

Automation vs Manual Processing

Amy: Fully automated medical coding that processes complex provider notes instantly without human intervention

EHRs: Require manual code entry by human coders, leading to potential errors and processing delays

Specialization vs General Purpose

Amy: Purpose-built AI medical coder specializing exclusively in ICD-10, CPT, and HCPCS coding across multiple medical specialties.

EHRs: General-purpose patient management systems with basic coding modules as secondary features.

Proactive vs Reactive Approach

Amy: Proactively identifies coding opportunities, documentation gaps, and compliance issues before claim submission.

EHRs: Reactively store coded information after human coders have already processed the documentation.

Revenue Optimization vs Record Keeping

Amy: Designed to maximize revenue capture through accurate coding, reducing claim denials and improving collections.

EHRs: Focus on clinical workflow and patient record management rather than revenue cycle optimization.

Continuous Learning vs Static Systems

Amy: Continuously updates with new coding guidelines, regulations, and medical procedures through AI learning

EHRs: Require manual updates and configuration changes for new coding requirements and regulations.

Differentiators vs Competitors:

Superior Accuracy Performance

Amy by CombineHealth stands out in the competitive landscape of AI medical coding solutions by delivering unparalleled accuracy and comprehensive automation capabilities. While other AI coding platforms in the market typically achieve accuracy rates between 85-95%, Amy consistently maintains an industry-leading 99.2%+ coding accuracy across all medical specialties. This superior performance translates directly into increased revenue capture for healthcare facilities across the United States, Canada, and other markets where accurate medical coding is critical for reimbursement. Unlike competing solutions that often require extensive human oversight and correction, Amy's advanced artificial intelligence algorithms minimize coding errors and reduce the need for manual intervention, making it the preferred choice for hospitals, clinics, and healthcare systems seeking optimal revenue cycle management.

Integrated Clinical Documentation Integrity (CDI) Capabilities

The integration of Clinical Documentation Integrity (CDI) capabilities within Amy's core platform represents a significant competitive advantage over other AI medical coding solutions. While most competing platforms treat CDI as a separate add-on service or require integration with third-party systems, Amy's built-in CDI functionality proactively identifies documentation gaps and ensures coding compliance from the outset. This integrated approach eliminates the need for healthcare organizations to invest in multiple separate solutions, reducing both implementation complexity and ongoing operational costs. Healthcare facilities in major metropolitan areas like New York, Los Angeles, Chicago, and Toronto benefit from Amy's streamlined approach, which addresses coding accuracy and documentation quality simultaneously without requiring additional software licenses or training programs.

Unified Revenue Cycle Integration

Amy's comprehensive AI solution approach distinguishes it from single-function coding solutions in the healthcare technology market. While other platforms focus exclusively on coding automation, Amy works in tandem with other CombineHealth's AI solution for billing, eligibility verification, charge entry, payment posting and appeals, to provide end-to-end revenue cycle management automation. This integrated solution eliminates the common problem of coding and billing disconnects that plague many healthcare organizations using disparate systems. Healthcare providers across diverse geographic markets, from rural hospitals to large urban medical centers, benefit from this seamless integration that ensures coded claims are processed efficiently through the entire billing cycle without manual handoffs or system compatibility issues.

Specialty-Specific Medical Expertise

Amy's specialty-specific expertise across multiple medical disciplines provides competitive differentiation in markets where other AI solutions offer one-size-fits-all approaches. The platform's deep knowledge of coding requirements for Anesthesiology, Emergency Medicine, Orthopedics, Pathology, and other specialties ensures accurate code assignment regardless of the complexity or specialty focus of the healthcare organization. This specialized intelligence is particularly valuable for multi-specialty practices, academic medical centers, and integrated healthcare systems that require consistent coding accuracy across diverse medical services. Healthcare organizations choosing Amy benefit from a solution that understands the nuances of specialty-specific coding guidelines and grids, resulting in higher reimbursement rates and reduced claim denials compared to generic AI coding platforms in the competitive marketplace.

Keywords

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