The AI Agents Behind RepriceBill

RepriceBill isn't one AI feature — it's a team of specialized agents working across your bill review operation. Each one takes a piece of the manual load; together they form the operating layer your reviewers work on top of. Your team always has the final say.

Intake

Intake Agent

Turns incoming claim documents into structured, review-ready bills.

  • Reads UB-04, CMS-1500, and pharmacy claim forms — typed or scanned
  • Creates the bill with claim numbers, dates, and identifiers in place
  • Matches patients, providers, and payers to your existing records instead of duplicating them

Value: bills start at review, not at data entry.

Documents

Document Agent

Makes sense of the package around the bill.

  • Identifies what kind of document arrived — claim form, EOR, supporting records
  • Handles very large packages by focusing review on the pages that matter
  • Keeps the complete document attached to the claim for reference and audit

Value: 150-page packages stop being special projects.

Repricing

Repricing Agent

Applies the right rates to every line.

  • Prices against the correct state workers' comp fee schedule automatically
  • Applies PPO and network logic with the reasoning shown
  • Produces recommended allowances your reviewers confirm or adjust

Value: schedule-accurate repricing without rate books or tribal knowledge.

Explanations

EOR Agent

Turns completed reviews into defensible explanations.

  • Generates the explanation of review from the review itself
  • States the basis for every adjustment, line by line
  • Applies reason codes consistently across reviewers and bills

Value: disputes answered with documents, not recollection.

Outcomes

Outcome & Audit Agent

Remembers what actually happened, permanently.

  • Records each bill's outcome — repriced, denied, no reduction, duplicate
  • Keeps an audit trail of steps, decisions, and who confirmed them
  • Feeds outcome-level reporting: savings, denial patterns, throughput

Value: reporting that reflects reality, ready for clients and auditors.

Assistant

Review Assistant

Answers questions right where your team works.

  • Explains a bill's history, pricing, and documents on demand
  • Helps draft provider and client communications from the bill's context
  • Turns natural-language questions into operational reports

Value: institutional knowledge on tap for every reviewer.

See the agents working on your own bills — your states, your document mix, your workflows.

Book a Free Workflow Audit