TL;DR: the SmarterDx Breakdown.
- SmarterDx uses clinical AI to help hospitals capture missed revenue, improve quality metrics, and streamline appeals—without disrupting workflows or requiring upfront costs. Founded by hospitalists, the company’s SmarterPrebill tool guarantees a 5:1 ROI, while SmarterDenials automates appeal letters in minutes. With easy implementation and clear financial upside, SmarterDx is a no-brainer for hospitals looking for a high-impact, low-risk AI solution.
SmarterDx: The AI-Powered Revenue Boost Hospitals Didn’t Know They Needed
Let’s talk about a universal truth in healthcare: hospitals and health systems work hard, but they don’t always get paid fairly, on time, or fully, for the care they provide. The financial side of running a hospital is a constant battle—coding, documentation, denials, and audits that eat up time and revenue. It’s also a significant, draining amount of administrative work and cost.
So today I want to introduce SmarterDx to Hospitalogists. They’re trying to fix problems with provider organizations getting paid fairly for the services rendered. And when I met with the SmarterDx team, I was shocked by how simple – yet powerful – their value prop is to hospitals.
Let’s dive in.
SmarterDx: A Brief History
Founded in 2020 by two hospitalists, Dr. Michael Gao and Dr. Joshua Geleris, SmarterDx is on a mission to help hospitals capture revenue that’s rightfully theirs while improving clinical quality at the same time. Gao, who previously led applied AI efforts at NewYork-Presbyterian, saw firsthand how much money hospitals were leaving on the table due to documentation gaps. His simple yet profound thought was…”If one of the top hospitals in the country was struggling with this, I can’t imagine what’s happening everywhere else!”
So he and Geleris decided to do something about it.
They built SmarterDx to level the playing field between hospitals and payers – using AI to spot revenue opportunities that humans simply don’t have time to find. As we all know, AI doesn’t get tired. AI doesn’t get bored by reading 30,000 data points for every patient chart and SmarterDx’s AI offering is a great start for any hospital or health system looking to get their feet wet into an AI-first strategy.
Here’s how SmarterDx works…well…smarter.
How SmarterDx Helps Hospitals Get Paid What They Deserve
Why does that matter? Because when hospitals don’t represent the care they already gave to their sickest patients, that means they don’t get paid for that care—lost revenue. That under-documentation and things slipping through the cracks impacts more than revenue though, it also leads to less data for quality metrics.
Datapoints like mortality rates and readmission scores impact reimbursement and rankings. SmarterDx fixes these problems by identifying diagnoses that were missed or under-coded, ensuring hospitals get credit for the work they actually did.
At its core, SmarterDx runs AI against every single patient record—clinical notes, billing codes, lab results, everything. The task at hand is simple. There’s no rocket science (just 2,200 algorithms): they make sure the documentation fully captures what happened during the patient’s visit or stay.
Here’s another point want to be clear on: SmarterDx isn’t an up-coding machine. They’re relentlessly focused on getting the diagnoses and coding RIGHT. There are even instances where SmarterDx’s algorithm will recommend a ‘down’ code to the medical billing team. It’s all about getting paid for what services were rendered, appropriately so.
And here’s the kicker on the SmarterDx offering: they’ve set up their contracting for contingency, meaning SmarterDx only gets paid when hospitals make money incrementally from using SmarterPrebill. Their contingency-based pricing means no upfront budget is required—if they don’t find you more revenue, you don’t pay. SmarterDx themselves will tell you this won’t happen, though. I mean, why else would they offer something like this?
SmarterDx’s Products: Easy to Implement, Big Returns
SmarterDx’s AI-enabled tools and dashboards for clinical documentation integrity (CDI) teams are designed to deliver fast, measurable impacts. Here’s a quick breakdown of what to expect.
1. SmarterPrebill: SmarterDx’s Bread and Butter Product
Hospitals using SmarterPrebill can expect a 5:1 return on investment, bringing in around $2M annual net new revenue for every 10,000 patient discharges. It integrates with the hospital’s EHR, runs its AI analysis, and flags any documentation gaps for the CDI team to review. As always, there’s a human in the loop. SmarterDx can recommend proposed changes to billing or documentation, but the CDI team always holds final sign-off authority. Essentially, the SmarterDx product is designed to help these individuals maximize their time – work at the ‘top of their license’ so to speak (I know I know, buzzwords…).
The thing about SmarterPrebill is…it simply works, and works simply. 65% of recommendations made by SmarterDx are accepted by CDI teams, proving the AI is making clinically sound suggestions. And again, it’s not just about revenue – hospitals also use SmarterPrebill to catch compliance issues before they go out the door, reducing audit risk.
2. SmarterDenials: AI-Powered Appeal Letters in Minutes
Launched in late 2024, SmarterDenials is SmarterDx’s newest product, tackling one of the most frustrating parts of hospital revenue cycle management: fighting denied clinical claims. Typically, writing appeal letters takes a cumbersome amount of time and energy for appeals nurses, but SmarterDx automates the process, generating a ready-to-send appeal in minutes.
So far in SmarterDx’s pilot programs and testing, it’s a game-changer for lower-dollar claims that hospitals often don’t bother appealing. SmarterDx makes those appeals financially viable again.
Overcoming the Usual Pushback
What are some common questions or concerns the SmarterDx team addresses with its partners?
If you work in hospital finance or CDI, you’ve probably heard (or even said) some version of:
- “We already have a documentation team and invested in other technology. We’re good.”
- “Our coding is thorough—we’re already catching everything.”
- “Another tech implementation and integration? Come on”
SmarterDx loves these conversations because they prove their value with data. They’ll happily sit down with you, take your hospital’s historical records, run their AI on it, and show exactly what’s been missed (and revenue that hasn’t been captured). More often than not, that’s all it takes to win over skeptics.
And unlike some tech vendors that require a months-long IT overhaul, SmarterDx is lightweight to implement. Standard EHR connectors mean hospitals can get up and running without distracting their tech teams.
The Best AI Starting Point for Hospitals
AI in healthcare is exploding, but for many hospitals, the idea of rolling out an AI strategy can feel overwhelming. SmarterDx offers a low-risk, high-reward way to start.
- It’s in the back office, not frontline care. No clinical workflow disruption.
- The ROI is clear and easy to measure. It directly links to net new revenue.
- Executives love it. It’s an AI initiative with provable, immediate financial upside (and no upfront investment required).
Hospitals are understandably cautious about AI, especially when it involves patient care. But when it comes to billing, compliance, and documentation, AI can work behind the scenes to make hospitals more efficient, profitable, and fair in their reimbursement.
Final Thoughts
SmarterDx isn’t just another AI company trying to wedge its way into healthcare. It was built by doctors who understand how hospitals actually work. They’ve grown rapidly, now working with more than 35 health systems across 150 hospital sites—and their results speak for themselves.
If your hospital is leaving money on the table (spoiler: it probably is), SmarterDx is an easy win. No heavy lift, no upfront budget, just more revenue, better compliance, and stronger quality scores.
In today’s environment, that’s a no-brainer.
This article was sponsored by SmarterDx and written by me, Blake Madden. I highlight