AI Claim Review

The AI Claim Review feature gives billers a second set of expert eyes before claims are submitted, helping catch issues early, reduce denials and avoid costly rework. You can also access the Unapproved Encounters Report to view a list of encounters with a Draft, Review, or Rejected status and their denial risk level and probability.

Note: This feature is included with Tebra's AI Billing Assistant. For more information, contact your Sales Representative or Account Manager.

Run AI Claim Review Create a new encounter or edit an encounter. The New Encounter or Edit Encounter window opens. Click AI Claim Review at the bottom of the window. The AI Claim Review runs then the Denial Probability banner displays.
Select the AI Claim Review tab. The AI Claim Review information displays.
Scroll as necessary to review the details, potential issues, and recommended resolutions. To provide feedback, select a star rating between Disagree and Agree that reflects how correct and helpful the AI Claim Review details were for the claim. If applicable, click the Similar Denied Claims drop-down arrow and review previously denied claims that match the current claim's details to help identify the correction(s) needed. Note: Only previously denied claims submitted through Tebra on or after January 1, 2026 are included. When finished, select the General tab to return to the encounter then update and complete the encounter as necessary. To rerun AI Claim Review after the encounter has been updated, select the AI Claim Review tab and click Rerun.