Healthcare documents are PHI-laden, code-heavy, and arrive in every imaginable format.
Medical billing accuracy
UB-04, CMS-1500, and itemized bills carry CPT, ICD-10, HCPCS, and modifier codes that drive payment. Manual code entry produces errors that snowball into denials, audits, and rework.
Prior auth turnaround
Prior authorization requests pile up while patients wait. Manual review of clinical documentation and policy criteria delays care decisions, frustrates providers, and increases administrative cost per request.
PHI handling under HIPAA
Every document touching a patient's chart is PHI. Most general-purpose AI platforms aren't configured for HIPAA — no BAA, unclear LLM data flow, default-on logging that captures protected health information.
Clinical documents, structured. Compliance, built in.
Cogneris extracts medical bills, prior auth packages, patient intake, and clinical notes — under a HIPAA BAA, with code validation, code-set normalization, and zero-retention LLM access on the critical path.
- Medical bill line-item parsing — CPT, ICD-10-CM, ICD-10-PCS, HCPCS, modifiers, charges, allowed amounts, and provider taxonomy extracted as structured arrays, code-validated against current CMS code sets.
- Prior authorization triage — clinical documentation, member info, and policy criteria extracted from PA packages with auto-routing to clinical reviewers when criteria are ambiguous.
- Patient intake digitization — handwritten and faxed intake forms parsed to discrete fields ready to populate the EHR, with confidence flags for human review on low-confidence fields.
- HIPAA BAA on Enterprise — Business Associate Agreement, PHI-aware retention, zero-retention LLM API, and an immutable per-request audit trail your compliance team can show during a HIPAA Security Rule audit.
Built for the documents that drive payment and care.
Healthcare documents arrive in every imaginable format — UB-04 hospital bills, CMS-1500 professional claims, EOBs from payers, prior authorization packages, faxed referrals, handwritten intake forms, and clinical notes. Cogneris's healthcare configuration handles the full bundle: every document parsed, every code validated, every PHI field tracked through the audit trail.
Code-set validation
CPT, ICD-10-CM, ICD-10-PCS, HCPCS Level II validated against current CMS code sets. Mismatches and retired codes flagged for review before downstream adjudication.
EOB & remittance parsing
Explanation of Benefits, remittance advice (835), and denial codes (CARC/RARC) parsed to structured form for revenue cycle management workflows.
Prior auth packages
Multi-document PA packages — clinical notes, lab reports, member info, prescription details — extracted as a unit, with criteria matching against your medical policy.
PHI redaction in logs
Operational logs and audit trails carry pseudonymized identifiers, not PHI in plain text. Field-level lineage preserved without re-exposing protected information.
Lives where your clinical and billing systems already run.
Cogneris integrates with the major EHR platforms and claims clearinghouses through FHIR APIs, HL7 v2 interfaces, and 835/837 EDI — so extracted document data flows directly into patient charts and claims workflows without an intermediate data-entry step.
- Epic — FHIR R4 integration with App Orchard published connector. Extracted bill data populates patient accounts and claims with full document provenance.
- Oracle Health (Cerner) — FHIR + Cerner Open Developer Experience. Multi-document bundles arrive as structured chart documents, ready for clinical review.
- Athenahealth — Marketplace integration via athena.io APIs. Patient intake forms and clinical documents flow into athenaClinicals automatically.
- eClinicalWorks & Meditech — HL7 v2 ADT/DFT/MDM messages and FHIR endpoints supported for both platforms.
- Clearinghouses — Change Healthcare, Availity, Waystar — 837 claims and 835 remits ingested and parsed for revenue cycle workflows.
The document types behind claims, prior auth, and patient onboarding.
Healthcare back office runs on faxed referrals, prior-auth packets, insurance claims, and patient intake forms. Cogneris extracts each input into structured fields with HIPAA-aligned controls and a full audit trail.
For category context, see the IDP buyer's guide, the 2026 State of Document AI report, or estimate ROI at your volume.
- Insurance claim extraction — claim forms (CMS-1500, UB-04), EOBs, and remittance advices with payer, dates of service, codes, and amounts pulled to a single claim object.
- KYC document extraction — government IDs, proof of address, and insurance cards for patient identity verification and coverage validation at intake.
- Contract extraction — provider contracts, payer agreements, and BAAs with parties, term, reimbursement rates, and HIPAA flow-down terms extracted.
Common questions.
Is Cogneris HIPAA compliant?
How does Cogneris handle PHI sent to LLM providers?
Can Cogneris parse CPT, ICD-10, and HCPCS codes?
How long is PHI retained?
Does Cogneris integrate with EHR systems?
Send us a sample bundle. We'll show you what comes out.
Send 50–100 sample documents (de-identified or under NDA + a draft BAA). We'll run them through Cogneris and return a structured-extraction report with code-validation results, confidence distribution, and time-to-process. No commitment.