Adam

JSON twin: https://www.healthaidb.com/software/adam.json

Company Name

CombineHealth

Product URL

https://www.combinehealth.ai/adam-ai-denial-management-software

Company URL

https://www.combinehealth.ai

Categories

• revenue Cycle
• ai Clinical Documentation Integrity
• Denials Management
• Revenue Cycle Management
• Ai-powered Solutions

Summary

Adam is an AI-driven denial management solution that automates revenue cycle processes, enhancing collections and reducing claim denials.

Description

Adam by CombineHealth is an AI-powered denial management tool that integrates directly into existing revenue cycle workflows to identify, prioritize, and resolve claim denials. It utilizes AI-driven calls, IVR navigation, and payer portal interactions to retrieve claim updates, generates call summaries, recommends next steps, and drafts payer-specific appeal letters shaped by past writing patterns. Adam continuously adapts to evolving payer rules, provides detailed reasoning for each action, and partners with other CombineHealth AI tools to support comprehensive revenue recovery.

Api Available

yes

Certifications

• SOC 2 Type 2

Company Founding

2022

Company Offices

• United States

Compliance

• HIPAA
• SOC 2 Type 2

Customers

• Amy by CombineHealth

Data Residency

US-only

Data Standards

• ICD-10
• CPT
• HCPCS
• NCCI edits
• Medical necessity guidelines

Deployment Model

• SaaS

Features

• Automated denial and root cause analysis
• Customizable A/R follow-up workflows
• Intelligent denials prioritization
• AI-driven calls to payers
• IVR navigation and live agent interactions
• Call recording and summarization
• Appeal deadline tracking
• Payer-specific rule updates
• Payer scorecards
• Predictive analytics for denial prevention
• Customizable call scripts
• Real-time automated updates
• Integration with existing revenue cycle workflows
• Continuous learning from emerging payer patterns
• Human-in-the-loop collaboration for complex denials
• Detailed explanations for denial analysis decisions
• Adaptive learning to maintain compliance across payers
• Integration with CombineHealth's AI solutions for comprehensive revenue recovery

Id

SW0810

Integration Partners

• EHRs
• other healthcare systems

Integrations

• EHR systems
• Payer portals
• Billing software
• Practice management systems
• ERA/EOB systems
• Amazon Web Services
• Microsoft cloud services

Languages Supported

• English

Last Updated

2025-10-11

License

commercial

Market Segment

• enterprise
• smb

Optional Modules

Os Platforms

• Web

Pricing Details

contact vendor

Pricing Model

subscription

Privacy Features

• BAA available
• Data residency controls
• Data minimization
• Anonymization
• Consent management

Product Code

SW0810

Product Name

Adam

Ratings

• 4/5 on G2
• 3.5/5 on G2

Regions Available

• United States

Related Urls

• https://elion.health/products/adam-by-combinehealth

Release Year

2022

Security Features

• End-to-end encryption (AES-256)
• Secure data transmission protocols
• Single Sign-On (SSO) integration
• Role-based access control
• API security protocols
• Session management
• Real-time threat detection
• Automated incident response
• Vulnerability management
• Audit trails / activity logs

Specialties

• General Ambulatory Care
• Radiology
• Pathology
• Psychiatry
• Orthopedics
• Family Medicine

Support Channels

• email
• phone
• chat
• ticketing
• community
• 24x7

System Requirements

Target Users

• medical billers
• medical coders
• revenue cycle managers
• billing administrators
• hospital finance teams
• ambulatory practice administrators

Training Options

• documentation
• webinars
• live_online
• onsite
• certification

Type

product

User Reviews

• "I love the analytical capabilities and automation." "The process of custom builds. The advancement of internal capacity is integral." "Features available for health services means there is less customization required." "Not enough information about how and what we can use Health Cloud for." "It helps us gather all the information related to members like doctor, nurses or other partner." "It is really hard to integration in HealthCloud."

Version

1.0

Alternatives

See related products

Canonical JSON

{
  "product_name": "Adam",
  "company_name": "CombineHealth",
  "product_url": "https://www.combinehealth.ai/adam-ai-denial-management-software",
  "company_url": "https://www.combinehealth.ai",
  "related_urls": [
    "https://elion.health/products/adam-by-combinehealth"
  ],
  "product_code": "SW0810",
  "summary": "Adam is an AI-driven denial management solution that automates revenue cycle processes, enhancing collections and reducing claim denials.",
  "description": "Adam by CombineHealth is an AI-powered denial management tool that integrates directly into existing revenue cycle workflows to identify, prioritize, and resolve claim denials. It utilizes AI-driven calls, IVR navigation, and payer portal interactions to retrieve claim updates, generates call summaries, recommends next steps, and drafts payer-specific appeal letters shaped by past writing patterns. Adam continuously adapts to evolving payer rules, provides detailed reasoning for each action, and partners with other CombineHealth AI tools to support comprehensive revenue recovery.",
  "categories": [
    "revenue Cycle",
    "ai Clinical Documentation Integrity",
    "Denials Management",
    "Revenue Cycle Management",
    "Ai-powered Solutions"
  ],
  "market_segment": [
    "enterprise",
    "smb"
  ],
  "target_users": [
    "medical billers",
    "medical coders",
    "revenue cycle managers",
    "billing administrators",
    "hospital finance teams",
    "ambulatory practice administrators"
  ],
  "specialties": [
    "General Ambulatory Care",
    "Radiology",
    "Pathology",
    "Psychiatry",
    "Orthopedics",
    "Family Medicine"
  ],
  "regions_available": [
    "United States"
  ],
  "languages_supported": [
    "English"
  ],
  "pricing_model": "subscription",
  "pricing_details": "contact vendor",
  "license": "commercial",
  "company_offices": [
    "United States"
  ],
  "company_founding": "2022",
  "deployment_model": [
    "SaaS"
  ],
  "os_platforms": [
    "Web"
  ],
  "features": [
    "Automated denial and root cause analysis",
    "Customizable A/R follow-up workflows",
    "Intelligent denials prioritization",
    "AI-driven calls to payers",
    "IVR navigation and live agent interactions",
    "Call recording and summarization",
    "Appeal deadline tracking",
    "Payer-specific rule updates",
    "Payer scorecards",
    "Predictive analytics for denial prevention",
    "Customizable call scripts",
    "Real-time automated updates",
    "Integration with existing revenue cycle workflows",
    "Continuous learning from emerging payer patterns",
    "Human-in-the-loop collaboration for complex denials",
    "Detailed explanations for denial analysis decisions",
    "Adaptive learning to maintain compliance across payers",
    "Integration with CombineHealth's AI solutions for comprehensive revenue recovery"
  ],
  "optional_modules": [],
  "integrations": [
    "EHR systems",
    "Payer portals",
    "Billing software",
    "Practice management systems",
    "ERA/EOB systems",
    "Amazon Web Services",
    "Microsoft cloud services"
  ],
  "data_standards": [
    "ICD-10",
    "CPT",
    "HCPCS",
    "NCCI edits",
    "Medical necessity guidelines"
  ],
  "api_available": "yes",
  "system_requirements": "",
  "compliance": [
    "HIPAA",
    "SOC 2 Type 2"
  ],
  "certifications": [
    "SOC 2 Type 2"
  ],
  "security_features": [
    "End-to-end encryption (AES-256)",
    "Secure data transmission protocols",
    "Single Sign-On (SSO) integration",
    "Role-based access control",
    "API security protocols",
    "Session management",
    "Real-time threat detection",
    "Automated incident response",
    "Vulnerability management",
    "Audit trails / activity logs"
  ],
  "privacy_features": [
    "BAA available",
    "Data residency controls",
    "Data minimization",
    "Anonymization",
    "Consent management"
  ],
  "data_residency": "US-only",
  "customers": [
    "Amy by CombineHealth"
  ],
  "user_reviews": [
    "\"I love the analytical capabilities and automation.\" \"The process of custom builds. The advancement of internal capacity is integral.\" \"Features available for health services means there is less customization required.\" \"Not enough information about how and what we can use Health Cloud for.\" \"It helps us gather all the information related to members like doctor, nurses or other partner.\" \"It is really hard to integration in HealthCloud.\""
  ],
  "ratings": [
    "4/5 on G2",
    "3.5/5 on G2"
  ],
  "support_channels": [
    "email",
    "phone",
    "chat",
    "ticketing",
    "community",
    "24x7"
  ],
  "training_options": [
    "documentation",
    "webinars",
    "live_online",
    "onsite",
    "certification"
  ],
  "release_year": "2022",
  "integration_partners": [
    "EHRs",
    "other healthcare systems"
  ],
  "id": "SW0810",
  "slug": "adam",
  "type": "product",
  "version": "1.0",
  "last_updated": "2025-10-11",
  "links_json": {
    "self": "https://www.healthaidb.com/software/adam.json"
  }
}