SmarterDx
Pre-bill AI review that finds missed revenue and quality
Our take
SmarterDx, founded in 2020 by physicians Michael Gao and Josh Geleris, runs a clinical AI review of every inpatient chart after discharge but before the bill goes out. It cross-checks documentation, labs, meds, and notes to find diagnoses the CDI team and coders missed, surfacing DRG and quality-metric corrections with a full clinical evidence trail. SmarterDenials extends the same engine to drafting appeals for clinical denials, and SmarterNotes (via the Pieces acquisition) pushes upstream into note generation.
The company raised $71M through a 2024 Series B led by Transformation Capital, then became an anchor asset of Smarter Technologies, the platform New Mountain Capital formed in May 2025 by combining SmarterDx, Access Healthcare, and Thoughtful.ai. It serves 85+ health systems including Novant Health, McLaren, and UAMS, claims an average 5:1 ROI and about $2M in net new revenue per 10,000 discharges, and integrates natively with Epic, Oracle Cerner, and MEDITECH. Among pre-bill AI vendors it has the strongest public proof points, with the trade-off that it now lives inside a PE roll-up.
What it does
- Reviews 100% of inpatient charts pre-bill
- Finds missed diagnoses, DRG shifts, and CC/MCC capture
- Generates AI-drafted appeals for clinical denials
- SmarterNotes ties note generation to revenue cycle intelligence
- Shows clinical evidence trail for every recommendation
Where it's strong
- Physician-founded pre-bill engine with audited results: roughly $2M net new revenue per 10,000 discharges, a 98 KLAS satisfaction score, and reported 100% client retention.
- Reviews every discharge rather than a sample, which is what makes the second-look economics work.
- New Mountain Capital backing pairs it with Access Healthcare's services scale inside Smarter Technologies.
What buyers should weigh
- Now part of a PE roll-up (merged with Access Healthcare and Thoughtful.ai in May 2025), so expect cross-sell pressure and possible roadmap shifts toward the combined platform.
- Value is concentrated in inpatient DRG reimbursement; ambulatory-heavy or critical-access organizations will see less benefit.
- It functions as a second-look layer on top of your existing CDI team and tech, an added cost line rather than a replacement.
Latest
In 2025 SmarterDx was combined with Access Healthcare and Thoughtful.ai into New Mountain Capital's Smarter Technologies platform, then acquired Pieces Technologies in September 2025 and launched SmarterNotes, uniting inpatient documentation with revenue cycle intelligence.
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