Netsmart, an industry-leading provider of healthcare IT for post-acute and human services providers, announces the launch of AlphaCoding, an augmented intelligence (AI) solution designed to help transform clinical coding by driving accuracy, efficiency and compliance. Built on advanced AI models and guided by Centers for Medicare & Medicaid Services (CMS) standards, AlphaCoding delivers near real-time, evidence-based coding recommendations to support healthcare professionals across care settings.
The AlphaCoding solution aims to assist healthcare organizations by surfacing relevant information to support confident and informed coding decisions. Within the AI-driven solution is Benny, the AI coding assistant. Benny functions as a supportive tool for an organization’s coding staff, by offering suggestions for coders to react to, ultimately working to reduce the manual effort often associated with medical coding. Benny’s coding assistant skill set includes record extraction, clinical concept recognition, code determination, coder verification and final validation/electronic health record (EHR) updates.
Key features of AlphaCoding and Benny include:
- ICD-10 Suggest – Rapidly analyzes clinical documentation to recommend precise diagnosis and procedure codes.
- Computer-Assisted Coding – Supports coders by automating code suggestions based on in-depth clinical review.
- Quality Reporting – Assists with aligning coding with CMS quality metrics, supporting compliance efforts.
- Productivity Enhancement – Streamlines coding workflows to help reduce time spent on documentation and review.
The computer-assisted coding tool reviews clinical records, which are often up to more than 50 pages per day1, identifying key patient details and helping to guide coders in achieving accurate coding outcomes. Each recommendation includes source citations and clear explanations, empowering clinical coders to make confident, compliant decisions.
“AlphaCoding has already made a measurable impact on our coding accuracy and efficiency,” said Melissa Ward, R.N., Post-Acute Care Executive, Adventist Health. “It’s intuitive and enhances our clinicians’ expertise by surfacing the appropriate details and helping align with CMS guidelines, allowing us to code faster and more confidently than ever before.”
Initially applied to ICD-10 coding, AlphaCoding will extend into palliative and behavioral health inpatient coding, with future plans to support CPT and HCPCS coding across additional service lines2.
“AlphaCoding is the next step in expanding our Alpha platform for revenue cycle management innovations,” said Erica Gregory, SVP & GM of Revenue Cycle Management, Netsmart. “Our goal with AlphaCoding and Benny the coding assistant is to empower healthcare professionals with a clinical augmentation tool that enhances accuracy and efficiencies in medical coding. By providing logical explanations aligned with CMS guidelines, citation links and the ability to review underlying documentation, AlphaCoding supports coders in making informed decisions quickly, ultimately improving compliance and revenue cycle management.”
The launch of AlphaCoding exemplifies the Netsmart commitment to expanding its revenue cycle management (RCM) solution suite designed to help providers accelerate cash flow, streamline productivity and enhance profitability. Within the Alpha platform, AlphaCollector™ utilizes AI and robotic process automation (RPA) to help collection staff work the right claims at the right time, ultimately aiming to accelerate cash. By infusing automation from AlphaCollector into their workflows, community-based care organizations have decreased bad debt write-offs by 61%3, decreased average days in AR by 46%4 and saved more than 51,000 hours of manual work for their collectors5. A key component of AlphaCollector is Benny, the digital collections sidekick. Similar to Benny the coding assistant, Benny the digital collections sidekick functions as part of the team, providing intelligent recommendations to help guide next steps in the collections process. With Benny’s assistance, an organization has achieved a 46% reduction in collector actions to payment6.
AlphaCoding supports the evolving portfolio of Netsmart AI, machine learning, RPA and agentic technologies, enhancing automation capabilities across areas of the business for community-based healthcare providers.
Home health, palliative care, hospice and private duty agencies attending the National Alliance for Care at Home Annual Meeting & Exposition are invited to visit booth 105 to learn more about AlphaCoding, connect with industry experts and explore the Netsmart Meaningful AI and automation solutions.
About Adventist Health
Adventist Health is a faith-based, nonprofit, integrated health system serving more than 80 communities on the West Coast and Hawaii with over 400 sites of care. Founded on Adventist heritage and values, Adventist Health provides care in hospitals, clinics, home care, and hospice agencies in both rural and urban communities. Our compassionate and talented team of 37,000 includes employees, physicians, allied health professionals, and volunteers driven in pursuit of one mission: living God's love by inspiring health, wholeness, and hope. We are committed to staying true to our heritage by providing patient-centered, quality care. Together, we are transforming the healthcare experience with an innovative and whole-person focus on physical, mental, spiritual, and social healing to support community well-being.
Learn more at adventisthealth.org.
About Netsmart
Netsmart is an industry-leading healthcare technology organization empowering providers to deliver value-based care to the individuals and communities they serve. The Netsmart CareFabric® platform serves as a unified, connected framework of solutions and services for human services, post-acute, payer and public sector communities. Together with our clients and Marketplace vendors, we develop and deliver innovative technology, including electronic health records (EHRs), interoperability, analytics, augmented intelligence (AI), population health management and telehealth solutions and services that assist organizations in transforming the care they deliver. The result has helped make a positive impact on the lives of more than 165 million individuals.
For more than 55 years, Netsmart has helped provider organizations in their efforts to improve the health and wellbeing of the communities we collectively serve. To learn more, visit ntst.com and connect with us on LinkedIn, Facebook or X.
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1 |
Based on data collected during a pilot engagement with Adventist Health, conducted from July 1, 2025, through August 15, 2025. |
2 |
This functionality is under development. Netsmart does not promise when or if functionality will be available. |
3 |
Per outcomes from a human services client success story. The stat is attributed to multiple denial types, including Timely Filing, Eligibility and Authorization Denials. Comparing pre-AlphaCollector go live data from January – June 2024 and post-Alpha Collector go live data from October 2024 – March 2025, excluding self-pay data. |
4 |
Per outcomes from a human services client success story. Comparing four months of 2024 pre-go live data across commercial, Medicare and Medicaid payers to six months of 2024 and 2025 post-go live data across commercial, Medicare and Medicaid payers, excluding self-pay data. |
5 |
Per outcomes from a post-acute client success story. Presumes 5 minutes spent per claim touch across 616,818 accounts. |
6 |
Comparing average touches needed to close claims with and without Benny in August 2024. |
View source version on businesswire.com: https://www.businesswire.com/news/home/20251104324461/en/
“AlphaCoding has already made a measurable impact on our coding accuracy and efficiency,” said Melissa Ward, R.N., Post-Acute Care Executive, Adventist Health.
Contacts
Netsmart Media Contact:
Natalie Caruso
ncaruso@ntst.com
913.308.2080
