SmarterDx uses AI to help hospitals capture earned revenue

SmarterDx is building AI that helps hospitals translate complex clinical data into accurate billing codes, capture lost revenue, and give doctors back time for patients. Taking part in AWS Activate and relying on a range of AWS solutions, the company is delivering a secure, scalable platform to healthcare providers.

"Every year in this country, we spend US $4 trillion on healthcare and of that, north of US $500 billion is spent on the administration of revenue cycle," says Josh Geleris, MD, Co-Founder, and Chief Product Officer at SmarterDx. The reason: doctors and billing systems speak different languages.

Physicians think in patient problems, diagnoses, and treatments, but the revenue cycle has to translate that clinical reality into documentation, ICD and CPT codes, and payment logic. The result is lost revenue, denied claims, and clinicians spending more time on paperwork than on patients. SmarterDx identified this as a translation problem and built AI to solve it.

Speaking the same language

SmarterDx’s platform helps health systems capture what was earned, protect what was billed, and recover what was denied. It translates complex clinical data into the ontology of the revenue cycle, so hospitals get paid for the care they provide.

Achieving this requires processing an extraordinary volume of information. "On average the patients have something like 30,000 data points per hospitalization," says Geleris. This spans laboratory results, medications, orders, clinical notes, imaging, pathology, and more. Clinical records in their entirety have to be understood in minute detail for a hospital to obtain the right diagnosis and procedure codes.

A natural place to apply AI

SmarterDx's platform uses AI to process patient records, scanning for evidence that may have been missed or incorrectly documented. This allows care providers to improve the accuracy of their records, reduce manual efforts, and recover an average of US $3.5 million in net new annual revenue for every 10,000 patient discharges. This typically translates to an improvement of 50 basis points or more in net patient revenue (NPR) for health systems, helping them capture every dollar at a time when financial sustainability is increasingly critical.

It also helps physicians directly. The platform ingests the whole clinical record and uses generative AI to create a draft of their note, "so that they don't have to take the first pass," explains Geleris, "accelerating their ability to spend time with patients and focus on the things that matter."

The traditional revenue cycle wasn't built to understand this level of clinical complexity. And with tens of thousands of data points per patient and thousands of possible diagnosis and procedure codes, neither were humans. "Nobody can remember all of them and know when to use the right ones consistently for every patient," says Geleris.

AI, on the other hand, can. "It's something that AI is uniquely good at, searching through this mound of data and applying the right code at the right time." It's a problem that hospitals spend millions of dollars on today, and a natural place for technology to step in.

A trusted foundation for growth

SmarterDx has been working with AWS since the beginning. Managing highly sensitive patient data meant security, uptime, reliability, and privacy were top priorities for the startup.

“AWS was the no-brain choice” for ensuring all of these needs were met, says Geleris. “Having a partner in AWS, which has a track record of delivering security, reliability and uptime, has been one of the most important decisions that we've made as a company.”

With this foundation of trust established, SmarterDx was able to focus its engineering on what differentiates the business, not on infrastructure. “Startups want to innovate in the business space,” says Geleris. “If an infrastructure provider like AWS can come in and solve problems for you without you having to think about it, that just gives you more cycles to focus on what actually matters for the business.”

AWS is also helping SmarterDx build better AI models faster, which translates directly into more accurate codes and more recovered revenue for its hospital customers.

SmarterDx uses Amazon SageMaker Hyperpod to support its analytics and AI workloads, giving teams unified access to data and an environment in which they can run multiple experiments. “We use SageMaker HyperPod to run many experiments a day so that we can learn how to improve our models faster and deliver more value for our customers.”

As the company’s velocity has increased — they were acquired for over US $1B in 2025 and now have thousands of employees — the tool has become more important. “It’s enabled us to really focus on what we're trying to do as a business from a modeling effort and not worry about infrastructure.”

SmarterDx's relationship with AWS began with participation in the AWS Activate Program and AWS Activate Credits, which allowed the startup "to worry less about cash flow and focus solely on building the business," says Geleris. Since then, supported by the partnership with AWS, SmarterDx has continued to scale. In 2026, the startup is on track to deliver over US $1.8 billion in value back to healthcare providers. “That's money that they otherwise wouldn't have gotten but have earned through the care that they delivered to patients,” says Geleris. “It’s money that can be reinvested in the community and used to ensure that patients live healthier lives.”

What’s next?

SmarterDx plans to continue refining its approach and integrating new technologies, such as generative AI and agents. “AWS has been at the forefront of enabling companies to use these technologies in novel ways,” says Geleris. AWS offers the underlying interfaces and capabilities that enable AI agents to interact with its services, meaning SmarterDx can deploy agents to tackle new problems without having to build those connections from scratch. This reduces the development effort required, helping the team move more quickly from experimentation to delivering new value for its customers.

By automating complex, time-consuming tasks, AI is giving healthcare providers more capacity to redirect their expertise and “spend more time with patients and focus on clinical care,” says Geleris. And when you do that, he continues, “it enables you not only to save costs and generate more value, but also to refocus on what actually matters in healthcare: taking care of patients.”