clinic operating layer
Epic + eCW · connected
DR
Intake
2
Ambient Capture
3
SOAP Note
4
Coding
5
Claim Prep
6
EHR Push
MT
Maria Torres
DOB: 03/14/1978 · F · MRN 00847213 · Aetna PPO
Follow-up · HTN
Dr. R. Chen
● Ambient AI — Recording
Tap mic to advance demo · all audio stays local
Live Transcript Real-time
MD Hi Maria, how have you been feeling since we adjusted the lisinopril dose last month?
PT Mostly better. The swelling in my ankles has gone down a lot. I do get some lightheadedness when I stand up too quickly though.
MD Any chest pain or shortness of breath?
PT No chest pain. A little short of breath when I climb stairs but that's been the same.
AI Observations
Orthostatic hypotension — possible
Patient reports lightheadedness on standing · consider BP check supine + standing
Ankle edema improved — document response to lisinopril increase
ICD-10 I10 · prior visit documented bilateral edema
Dyspnea on exertion — stable, unchanged from prior
No escalation indicated based on transcript
MT
Maria Torres
DOB: 03/14/1978 · F · MRN 00847213 · Aetna PPO
Note generated · 4s
SOAP Note — AI Draft editable · sync on save
S — Subjective
O — Objective
A — Assessment
P — Plan
MT
Maria Torres
DOB: 03/14/1978 · F · MRN 00847213 · Aetna PPO
3 codes suggested
CPT Codes
99214
Office visit — established patient, moderate complexity (25 min)
98%
93000
ECG with interpretation and report (if obtained)
71%
99401
Preventive counseling, individual (approx 15 min)
64%
ICD-10 Diagnosis Codes
I10
Essential (primary) hypertension
99%
I95.1
Orthostatic hypotension
93%
R06.09
Other forms of dyspnea — exertional
87%
Payer alert — Aetna requires orthostatic BP documentation for I95.1
Add to SOAP note before claim submission to avoid denial · Z71.89 counseling code may also be billable
MT
Maria Torres
DOB: 03/14/1978 · F · MRN 00847213 · Aetna PPO
Claim ready · 0 errors
CMS-1500 Claim Preview
Field Value Status
Patient name Torres, Maria A. ✓ verified
DOB 03/14/1978 ✓ verified
Payer Aetna PPO · Group 8812 ✓ active
Rendering provider Chen, Raymond MD · NPI 1234567890 ✓ credentialed
CPT codes 99214, 93000 ✓ validated
Diagnosis codes I10, I95.1, R06.09 ✓ linked
Place of service 11 — Office ✓ confirmed
Modifier 25 — significant, separate E/M ✓ required · added
Est. reimbursement $218.40 ⚡ Aetna fee schedule
Scrub passed — no denial risk factors detected
Modifier 25 auto-attached · documentation complete for I95.1 · ready to submit
MT
Maria Torres
Visit complete · all data synced
Submitted 0:03 ago
4.2s
Total documentation time
↓ 14 min saved vs manual
$218
Claim submitted
↑ Modifier 25 captured
0
Denial risk factors
↓ vs 2.4 avg per claim
EHR Sync Log
Epic — SOAP note written to chart
Encounter ID: EPC-2024-084721 · signed by Dr. Chen pending · FHIR R4
eClinicalWorks — medication list + vitals updated
eCW API v2 · lisinopril 10mg confirmed active · BP entered to flow sheet
Claim submitted — Aetna clearinghouse (Change Healthcare)
Claim ID: ATN-20241105-84721 · ERA expected in 14–21 days
Follow-up task created — orthostatic BP recheck in 6 weeks
Auto-scheduled in Epic · patient SMS reminder queued for 6 weeks out
Intake — completed by patient (pre-visit) Auto-synced to Epic
Chief Complaint
Blood pressure follow-up / medication side effects
Reported Symptoms
Lightheadedness on standing, ankle swelling improved
Medications (self-reported)
Lisinopril 10mg daily, Atorvastatin 20mg nightly
Insurance Verified
✓ Aetna PPO · active · copay $30 · deductible met
94.1%
Clean claim rate
↑ 8.3% vs prior period
$84k
AR under 30 days
↑ $12k recovered this month
3
Open denials
↓ from 11 last month
Denial Queue — Action Required 3 open
$342
James Wu — Cigna — 99215
CO-4: service not covered · missing prior auth documentation
21 days
$128
Sandra Lee — UHC — 90837
CO-97: procedure requires modifier · modifier 59 not included
8 days
$218
Robert Kim — BCBS — 99213
CO-11: diagnosis inconsistent with procedure
5 days
Today's Schedule — Dr. R. Chen
9:00a
Maria Torres ● In visit
HTN follow-up · Aetna PPO · Room 2
Active
9:40a
David Park
Annual wellness · Medicare · Room 1
Checked in
10:20a
Lisa Nguyen
New patient · Cigna · intake pending
Intake ⚠
11:00a
Thomas Bradley
DM management · BCBS PPO
Confirmed
Recent patients
MT
Maria Torres
HTN · last seen today
Active
DP
David Park
Annual wellness · Medicare
Checked in
JW
James Wu
T2DM · Cigna — appeal pending
Denial