The Standard of Excellence in AI-Assisted Medical Coding
Built on advanced AI models and guided by Centers for Medicare & Medicaid Services (CMS) standards, AlphaCoding is a next-generation medical coding software that delivers evidence-based coding recommendations to home health and hospice coders through the use of AI (augmented intelligence).1
Start with coding accuracy. Scale with AI medical coding software.
Regulatory complexity continues to increase for home health and hospice organizations, with frequent updates to CMS guidelines and payer-specific requirements creating a moving target for accuracy. Meanwhile, manual chart review remains time-intensive, requiring coders to comb through lengthy records. This often leads to burnout, slow turnaround times and exposure to compliance errors.
These challenges are what AlphaCoding was purpose-built to help overcome. By grounding AI in a foundation of deep coding proficiency and accuracy, AlphaCoding aims to accelerate the value of automation, helping coders work smarter, mitigate risk and achieve high quality coding at scale.
Watch the video to get a sneak peek at Netsmart AlphaCoding.
Combining the best of technology and medical coding experience
AlphaCoding unites institutional coding experience with intuitive, AI-powered medical coding software.
Record
Extraction
Extracts and reviews notes,
labs and reports for
a patient episode via secure
encryption protocols.
Clinical Concept
Recognition
Identifies clinical details such
as conditions, symptoms
and other factors that impact
ICD-10 coding.
Code Determination Based
on CMS Guidelines
Suggests ICD-10 codes based on
CMS guidelines, giving McBee coders
an efficient, trusted starting point.
Coder
Verification
McBee coders confirm
accuracy, sequencing and
compliance, maintaining control
of final decisions.
Final Validation
and EMR Update
Verified codes are entered
into the EMR for clean claims
and downstream accuracy.
The Trusted Standard for Secure, Quality Coding
See the standard of excellence for yourselfTrust experience, not experiments.
AlphaCoding is raising the standard of medical coding excellence through three foundational differences
- Built with certified coder experience from day one, so the logic mirrors real-world workflows
- Does not “learn” from prior coded charts - code generation is based off the CMS coding guidelines to facilitate accurate and compliant coding
- Humans remain fully in the loop - McBee coders remain in control by making final code and sequencing decisions
The targeted result is an AI-assisted solution that aims to amplify human judgment, help safeguard quality and set a higher bar for coding performance.
“By delivering clear, CMS‑aligned explanations, citation links and access to underlying documentation, AlphaCoding helps our coders make informed decisions efficiently while supporting strong compliance and effective revenue cycle management."
- Kayla Wormser, VP of Coding & OASISOur standard of medical coding excellence is powered by people, strengthened by knowledge and elevated by technology
Outsourced Medical Coding Services
Outsourcing and experienced coding support for real-world coding needs.
OASIS and Coding Services delivered by medical coding professionals with years of experience in home health and hospice coding. Outsourced OASIS and coding services delivered by McBee (part of Netsmart) support home health and hospice organizations by facilitating coding accuracy, refining processes and elevating documentation to meet and exceed industry standards.
- Trusted to handle 800K+ charts2
- 96% targeted accuracy rate in OASIS and coding
- Average 48-hour turnaround time (excluding weekends and holidays)
OASIS and ICD-10 Coding Education
Online coding and OASIS education to help elevate your staff expertise.
Post‑Acute Academy offers structured online training to help clinicians stay current on OASIS, ICD-10 coding and regulatory changes. The courses reinforce suggested best practices that support stronger documentation and decision‑making across home health and hospice care.
- Pinpoint opportunities for organizational growth through learning
- Support staff satisfaction and retention
- Drive quality care outcomes
Medical Coding AI Software
Prioritize accuracy and performance with AI-assisted coding services.
AlphaCoding is categorized as ‘augmented intelligence’ because McBee certified coders remain at the center of the process, using AI to surface relevant diagnoses, help reduce manual chart reviews and apply CMS coding guidelines with confidence. The goal of equipping our coders with augmented intelligence? Efficient, accurate coding to support clinical compliance and stronger revenue for your organization.
- Code determination based on CMS guidelines
- Secure data transmission and HIPAA-compliant
- Processes various types of clinical documentation
- Support audit-ready insights
Providing AI-assisted medical coding support for communities that need it most
The Netsmart AI Strategy
At Netsmart, we embrace Augmented Intelligence, technology that amplifies human expertise rather than replacing it. Our approach combines powerful automation with essential critical thinking, making the role of technology a “coach,” not a crutch. The targeted result is faster work without sacrificing accuracy, less manual burden, clearer data for leaders, and stronger compliance.
Learn more about the Netsmart AI strategy
AlphaCoding FAQs
AlphaCoding analyzes patient clinical documentation retrieved from a Home Health and Hospice Electronic Health Record (EHR) and generates recommended ICD-10 diagnosis codes for coding the patient chart. It leverages augmented intelligence to review documentation and suggests codes guided by CMS coding guidelines. The AlphaCoding system serves as a productivity tool that aims to help McBee coders work more efficiently and improve accuracy that helps reduce denials.
The official CMS ICD-10 coding guidelines are provided as contextual information to the AI model during the code recommendation process. This helps inform the recommendations and guide the AI model according to current coding standards.
The AlphaCoding system can process various types of clinical documentation typically found in EHR systems including progress notes, history and physical examinations, consultation and operative results, discharge summaries, and laboratory and diagnostic results.
No, AlphaCoding does not save or keep patient information or Protected Health Information (PHI). During analysis, patient documentation is accessed temporarily and is not stored by the AI engine. Our system is designed in accordance with HIPAA standards to help ensure proper handling of PHI.
Patient documentation is transmitted securely via industry-standard encryption protocols. Data in transit is safeguarded by TLS/SSL encryption, facilitating protection against unauthorized access or interception.
The system uses CMS ICD-10 coding guidelines within the AI model to support standard coding compliance. However, McBee coders are responsible for reviewing and validating the code recommendations for accuracy.
Yes, AlphaCoding can work with nearly any EHR system. The documents are extracted from the EHR through a secure channel and passed through to the model to read and predict the codes.
AI medical coding uses augmented intelligence to analyze clinical documentation and works toward generating accurate, CMS-compliant ICD-10 codes. Tools like AlphaCoding combine AI technology with human validation with the goal of improving coding efficiency and accuracy.
1 Solution currently under development and testing with early adopters. Netsmart makes no guarantees when, or if, solution will be generally available.
2 Total client charts reviewed by McBee from January 2025 – December 2025
2 Total client charts reviewed by McBee from January 2025 – December 2025