Reinventing the Clinical Note

What if writing a clinical note could automatically get your hospital paid faster, and more accurately? That’s the question driving a bold new partnership between Pieces and SmarterDx. And according to founder and CEO Dr. Ruben Amarasingham, health systems are already lining up to try it.

At its core, Pieces helps physicians write smarter, more structured clinical notes. SmarterDx, on the other hand, lives on the backend, handling complex revenue cycle tasks like billing and coding. The recent merger brings these two worlds together into a new product called SmarterNotes.

The goal is to turn the everyday physician note into a powerful engine for both clinical clarity and financial accuracy.

For years, Pieces had been quietly developing tools to make doctors’ documentation better—more precise, more usable, and less painful. But as Amarasingham and his team looked toward the next phase, they realized something: great notes are only half the battle. Without tying into the backend revenue machinery, vital details were getting lost in translation.

That’s where SmarterDx came in.

“We had a thesis,” Amarasingham explains. “If we combine our front-end note capabilities with Smarter’s deep expertise in revenue collection and coding, we could deliver something uniquely valuable to health systems.”

Ask anyone in healthcare IT, and they’ll tell you that documentation and billing usually live in separate silos. The physician writes a note. Later, someone else tries to extract the right codes for reimbursement.

SmarterNotes flips that model.

Now, the clinical note itself can drive billing accuracy right at the point of care.

One health system exec called the combo “magical,” Amarasingham says. Another said, “We didn’t know who would do this first, but we’re glad it’s you.”

Several health systems that already use both Pieces and SmarterDx are first in line to test the integrated SmarterNotes product this year. Those early deployments are moving fast, and Amarasingham is eager to learn from real-world usage.

“We want to have solid evidence and insights by January,” he says. “That way we can iterate and make sure the product truly delivers.”

SmarterNotes is built for health systems, and the physicians inside them, who are tired of duplication, delays, and denial-prone documentation. It’s especially appealing for organizations that already work with multiple Smarter Technologies companies, including Access Healthcare and Thoughtful AI, which are also part of the growing suite.

By aligning clinical accuracy with billing precision, SmarterNotes promises a smoother workflow for doctors and a cleaner revenue stream for hospitals.

Amarasingham isn’t just betting on product integration. He’s also betting on cultural fit. “What excites me is the entrepreneurial spirit across the whole Smarter Technologies group,” he says. “These are founder-led companies coming together, and that gives us the agility to move fast and think big.”

Long-term, he sees SmarterNotes as a blueprint for how AI can work hand-in-hand with physicians. Not as a replacement, but as an assistant that helps make both care and payment more seamless.

The merger of Pieces and SmarterDx isn’t just a tech story. It’s a case study in strategic alignment. By combining structured note-writing with the revenue engine behind the scenes, they’re solving one of healthcare’s most persistent problems at the source.

If it works, Amarasingham says, “It’s going to raise the bar across the board, for competitors, for systems, and most importantly, for what doctors and patients can expect from their technology.”