Every visit, fully coded.
Every dollar, defensible.
From the EMR to the audit trail. One agent, with citations.
Layrd takes every visit a provider closes and produces a complete, defensible coded chart within minutes. E&M with MDM justification, optimized assessments with HCC mapping, care-gap closure, practice-wide dashboards, and a reference-pinned audit trail. The physician reviews and approves each recommendation. Every line cites the chart that supports it.
Three places, one agent.
The same reasoning works on a single visit, rolls up across the practice, and runs the long-running work between visits, with one shared audit trail.
Every closed visit opens as a chart with 8 panels.
- E&M with MDM justification
- Optimized assessment list
- Care gaps across all programs
- Add-on services + modifiers
- Pre-submission validators
- Visit-level dollar impact
- Reasoning trace
- Attestation + override + audit hooks
Manager view, drill-through to every encounter.
- Population dashboard
- HCC dashboard with RAF tiers
- Care-gap dashboard
- MIPS projection
- Batch coding across cohorts
- Filterable by org · sub-practice · provider · payer · program · date
Everything that doesn’t happen in the exam room.
- Care-gap closure pipeline
- Attestation queue
- Practice settings
- Payer policy ingestion
- Care-management revenue tracking
- Audit log + reference-data pinning
- Daily coding queue
One memory layer · one audit trail · one source of truth for every recommendation.
The coded chart.
Eight panels. One source of truth.
Every visit a provider closes opens as a chart with 8 panels. Each panel is a recommendation, never an execution, with the chart evidence behind it. The physician approves, modifies, declines, or defers.
MDM-justified, with the time path in parallel
- Overall level = 2nd-highest of the 3 elements (CMS 2-of-3 rule)
- Gaps that would support a higher level, surfaced
- Overstatements that risk a downcode on audit, surfaced
“3 chronic w/ exacerbation”
“BMP + CMP + 2 prior notes”
“Rx mgmt of warfarin”
More accurate, more specific, more complete
- Specificity upgrades cited to the chart sentence
- Combination coding (payer- and HCC-aware)
- HCC suspects surfaced via MEAT criteria from the full chart
- Inactive / 24mo-stale conditions flagged
Every measure the patient is in the denominator for
- 6 closure states: open · closed at visit · closed by extrinsic · refused · excluded · doc gap
- CPT-II numerator codes appended automatically when the visit closes a gap
- Drill into the measure spec, chart evidence, and closure deadline
Every billable code the encounter qualifies for
- Each gated on the documented work + payer policy
- Dollar value at the patient’s rate
- One-line rationale per code
| Code | Rationale | $ |
|---|---|---|
| G2211 Longitudinal-care add-on | Established relationship · no Mod 25 · no global day | +$16.05 |
| 99490 CCM 20+ min | 22 min logged this month · on track | +$62.16 |
| 3046F CPT-II numerator | Auto-appended for HbA1c gap closure | |
| G0439 Annual Wellness Visit | Eligible: 14 months since last AWV | +$172.81 |
Every edit the payer enforces, run before the queue
- Revise · add documentation · override (with reason → audit trail)
- Practice keeps final authority on every line
- Edits versioned per payer; pinned to time of service
Mod 25 finding: recommend removing. No separately identifiable E&M from preventive service.
Findings flag, never block. Override logs to audit trail.
Five categories, kept separate because they pay differently
- Practice revenue valued at the CMS fee schedule for the locality and specialty
- HCC capitation valued at MA RAF dollars
- Quality bonus at the practice’s current Stars / MIPS percentile
Methodology cited on every number. Any figure on any rollup is defensible against an auditor.
What the agent looked at, cited, validated, and published
- Physician questioning a recommendation can see the chain of evidence
- Coder defending a claim under audit has the full trace
- Exportable to PDF or CSV per visit or per cohort
Four actions on every recommendation, and a learning loop
- Decline reasons flow to a per-organization audit log
- Permanent overrides tied to user, timestamped
- Every override is reversible from the audit trail
After 3 consecutive declines of the same HCC suspect with the same evidence, Layrd offers a permanent override, logged with the reason, so it stops re-surfacing.
Three dashboards.
Every figure drills to the encounters behind it.
Filterable by provider, payer, program, and date range. Every figure drills to the encounters behind it.
The panel-wide view
Every coded visit, deduplicated to one row per patient. Every number drills to the encounters behind it.
- · KPIs: panel size, visits, revenue, capitation, gap closure, agent spend
- · Sections: E&M distribution, HCC capture, per-program gap closure
- · Batch coding: select a cohort, run the agent across all uncoded visits
- · CSV export on every table
Risk capture for the year, and the revenue still on the table
Current RAF vs. potential RAF if every suspect were attested. Annual opportunity from the suspect pool. Recapture against last year’s captures.
- · RAF tiers: Low (<1.0) · Medium (1.0–2.0) · High (>2.0)
- · Top 10 HCCs by frequency for the practice
- · 5-year recapture status sorted by RAF impact
- · Suspect-conditions grouped by HCC for assigning attestation work
Quality performance and the dollars behind it
Every measure the practice reports against, with per-measure compliance and patient drill-downs. A separate MIPS projection report flags where small closure gains move the practice into a higher benchmark decile.
- · Eligible / compliant / due-soon / overdue / excluded / unknown per measure
- · Patient list sorted by who’s closest to closing
- · MIPS category breakdown: Quality · PI · IA · Cost
- · Dollar impact on practice Medicare Part B revenue
| Measure | Eligible | Compliant | Rate |
|---|---|---|---|
| HEDIS · CDC HbA1c control | 142 | 110 | 77.6% |
| HEDIS · SUPD Statin DM | 118 | 92 | 77.9% |
| MIPS Q236 · Controlling High BP | 287 | 218 | 76.0% |
| USPSTF A · Colorectal screening | 614 | 488 | 79.5% |
| NCQA · CBP screening | 1,041 | 822 | 79.0% |
Closing 12 more BP-control gaps moves the practice into the next benchmark decile. Estimated +$8.4K Part B impact.
Seven tools for the work that
doesn’t happen in the exam room.
Gap closure that accepts faxes as evidence. An attestation queue ordered by dollar impact. Payer policies that ingest themselves into enforceable rules. Care-management revenue tracked monthly. And every change logged to an audit trail that pins the reference data used at the time of service.
Care-gap closure pipeline
Gaps that can’t close at the encounter become tracked closure attempts with a state machine. Extrinsic evidence (Cologuard results, colonoscopy reports, mammograms) runs through Layrd document triage and closes the gap automatically with a citation.
- · States: pending · complete · refused · pending data · cancel
- · Re-evaluates a patient’s gap list when coverage or diagnoses change
- · Outreach queue tracks patients needing contact
Cologuard, colonoscopy reports, mammograms that arrive by fax run through Layrd document triage. When they satisfy a numerator, the gap closes automatically with a citation. Outreach queue tracks the patients still needing contact.
…Modifier 25 may be appended to an E&M service when, on the same day a procedure with a global period of 0 or 10 days is performed, the E&M service is significant and separately identifiable from the procedure. The medical record must support distinct documentation of the…
Timely-filing window: 90 days from DOS. Prior auth required for…
Payer policy ingestion
The manager uploads a payer’s policy document. Layrd extracts the structured rules: accepted codes, required modifiers, exclusions, the timely-filing window, Mod 25 conditions, prior-auth requirements. Shown next to the source text for review before activation.
- · Once active, rules apply to every subsequent visit under that payer
- · Violating claims flagged with the rule citation
- · Deactivate, replace, or revert. Every change logged.
Attestation queue
Every recommendation across every visit the provider hasn’t yet acted on. Sortable by type, visit date, patient, and dollar impact.
Work the high-value suspects first.
Practice settings
Programs enrolled, performance year, site type, ACO participation, payer contracts, provider rosters, care-management enrollment.
Every change timestamped, tied to the user.
Care-management revenue
CCM, PCM, RPM, BHI, TCM, APCM tracked monthly against time and consent thresholds. Billing report by program, provider, and patient.
Eligible, on track, or ineligible. At the plan rate.
Audit log + reference pinning
Every decision logged. Every reference version (CMS-HCC, MIPS, HEDIS, ICD-10) pinned to the analysis at the time of service.
A claim coded 2 years ago is still defensible against the rules in force then.
Daily coding queue
The day’s visits grouped by status. Pulled from eClinicalWorks, coded, in the run queue, with open recommendations, ready to bill.
One action runs the agent across the day’s batch.
Any number on any rollup,
defensible against an auditor.
The agent recommends. The practice approves. Every line has a paper trail. Every dollar has a citation. Every override is reversible.
Every line cites the chart that supports it
A side panel shows the documents read, the CMS guideline sections cited, the ICD-10 and HCC references used, the validators run, and the findings published. Browsable and exportable per visit or per cohort.
Physician questioning a recommendation can see the chain of evidence. Coder defending a claim under audit has the full trace.
Every decision logged. Every override reversible.
Coding decisions, overrides, policy ingestion, settings changes: written to a per-practice audit log, exportable as CSV. Permanent overrides are tied to the user and the reason, and stay reversible from the audit trail.
When CMS or NCQA publishes a new version, the practice stages it, compares it against pending visits, and promotes or reverts.
The rules in force then are still the rules now
Every reference version (CMS-HCC, MIPS, HEDIS, ICD-10) is pinned to the analysis at the time of service. A claim coded 2 years ago is still defensible against the rules that applied at the time it was coded.
Updates are opt-in. Versions never silently shift under your audit history.
Built for audit defense, not audit risk.
HIPAA-compliant. BAA-signed. AES-256 encrypted in flight and at rest. Every decision tied to a user, a timestamp, and a reason.
Be among the first
to code with Layrd.
We are finishing the final builds. Join the waitlist and we will reach out the moment Coding & Analytics opens for your practice.