Agentic Index
Fathom vs Nym (2026)
Both vendors last verified
Fathom and Nym both sell autonomous medical coding through sales, with no public price, and both send confident charts straight to billing and the rest to the customer's coders. That verdict is the Agentic Index coverage score, graded from each vendor's own published materials.
Fathom adds a real time audit of coders' work and risk adjustment coding for health plans, and its HITRUST, HIPAA and SOC 2 Type 2 compliance is audited. Nym codes encounters in seconds above a stated 95 percent confidence threshold, with the findings and guidelines behind every code. Nym must reach 95 percent accuracy on a review of the customer's historical charts before launch, while Fathom sells coding automation, coder audit and risk adjustment as three separate offerings. Choose Fathom if you also code risk adjustment for a health plan. Choose Nym for an audit trail and a launch bar behind every code.
On the Agentic Index healthcare agent ranking, neither Fathom nor Nym clears the bar, which asks for all five chart loop capabilities documented in full. Fathom documents none of the five in full; Nym does not document security and identity governance in full, nor human oversight and guardrails. 4 of the 69 vendors in the lane clear it. See the healthcare agent ranking
This comparison is published by Agentic Index, an independent agentic AI vendor research platform. Fathom and Nym are each graded against the same 14 capability Agentic Index taxonomy, from the vendor's own public materials under the Agentic Index verification standard, alongside 1,084 researched vendors. No vendor pays for placement and no vendor has reviewed this page. How this evidence is graded
Choose Fathom if
- You code risk adjustment for a health plan as well as provider charts.
- Your coders' own work should be audited in real time.
- A HITRUST audit is a requirement.
Choose Nym if
- Every code should carry the findings and guidelines behind it.
- Accuracy should be held to a stated bar, 95 percent at go live and after.
- Every code should link to the clinical findings and guidelines behind it.
| Feature | F Fathom |
N Nym |
|---|---|---|
| Action & orchestration | ||
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Integrations & Tool Calling Ability to connect agents to real systems through native integrations, OAuth-authenticated actions, custom tools, APIs, webhooks, or MCP-compatible tools. |
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FathomIntegrations & Tool Calling Coded charts go direct to bill, and the Your Health deployment connected to athenahealth through Data View across all care settings in one deployment. No integration catalog, write back mechanism or list of supported EHRs is published by Fathom. SourceFathom, fathomhealth.com/insights/your-health-deploys-fathom-autonomous-medical-coding-to-achieve-95-5-automation-rate-at-98-3-accuracy-rate-across-all-service-lines and /servicesread 2026-10-06 |
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NymIntegrations & Tool Calling The engine integrates with major EHRs to take in patient encounters and routes successfully coded encounters directly to the billing system, running in the background of existing workflows. Supported EHRs include Epic, Oracle Health (Cerner) and Meditech, connected through a FHIR based integration designed during discovery. SourceNym, nym.health/autonomous-medical-coding/nym-engine and /implementationread 2026-10-05 |
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Workflow Orchestration Ability to sequence, branch, retry, route, and combine deterministic workflow nodes with autonomous agent steps. |
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FathomWorkflow Orchestration In one step, incoming charts are reviewed, those the system can code are coded and sent direct to bill, and the remainder pass to the customer's coding operation, across facility and professional fee service lines and every place of service. Each chart is either coded without a touch or routed to a coder, and no flow builder is offered. SourceFathom, fathomhealth.com/services and /insights/your-health-deploys-fathom-autonomous-medical-coding-to-achieve-95-5-automation-rate-at-98-3-accuracy-rate-across-all-service-linesread 2026-10-06 |
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NymWorkflow Orchestration The engine parses the chart with CLU, assigns codes and routes the encounter to billing when coding confidence exceeds 95 percent, returning the rest to the customer's coders. Sourcenym.health/autonomous-medical-coding/the-technologyread 2026-09-29 |
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Triggers & Channel Coverage How agents wake up and where they work: schedules, webhooks, message events, CRM events, inbox events, chat, email, voice, and collaboration tools. |
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FathomTriggers & Channel Coverage Incoming charts reach the system without a person launching each one, and the audit product looks at every coded chart in real time. Fathom does not describe how charts are fed in. SourceFathom, fathomhealth.com/servicesread 2026-10-06 |
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NymTriggers & Channel Coverage The engine runs in the background, taking a first pass at patient encounters as they arrive and coding them in seconds without a person starting each one. Nym says the engine assigns those codes with zero human intervention. SourceNym, nym.health and /autonomous-medical-coding/nym-engineread 2026-10-05 |
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| Knowledge & context | ||
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Knowledge Grounding & RAG Ability to ground agent behavior in company data through document ingestion, retrieval, external knowledge APIs, semantic search, or RAG layers. |
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FathomKnowledge Grounding & RAG Codes are calibrated to the customer's coding guidelines and payer mix. At Your Health that reaches down to ICD sequencing and combination codes, G2211 add on capture and modifier 25 handling. Revised guidelines such as the emergency medicine E/M changes are adopted centrally. The coding knowledge lives in a model trained on more than 750 million encounters, and Fathom names no maintained knowledge source the system retrieves from. SourceFathom, fathomhealth.com/insights/your-health-deploys-fathom-autonomous-medical-coding-to-achieve-95-5-automation-rate-at-98-3-accuracy-rate-across-all-service-linesread 2026-10-06 |
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NymKnowledge Grounding & RAG Clinical Language Understanding combines machine learning with rules based clinical ontologies encoding AMA, CMS and WHO coding guidelines, which Nym's compliance and clinical teams update on each effective date (annual CPT and ICD-10, quarterly NCCI, ongoing HCPCS). Each code links to the guidelines it applied. CLU reads clinical context, negation, timing and subjectivity, so a note saying the patient denies chest pain is not coded as chest pain. SourceNym, nym.health/autonomous-medical-coding/the-technologyread 2026-10-05 |
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Memory & State Persistence Ability to persist context across a run, conversation, workflow, user, team, or longer-term memory layer. |
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FathomMemory & State Persistence Each chart is coded from its own documentation, against guidelines and payer mix calibrated for the customer. Fathom describes no memory layer. SourceFathom, fathomhealth.com/services and /insights/your-health-deploys-fathom-autonomous-medical-coding-to-achieve-95-5-automation-rate-at-98-3-accuracy-rate-across-all-service-linesread 2026-10-06 |
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NymMemory & State Persistence Each encounter is coded on its own, from its own documentation against maintained guidelines. Nym names no memory for the engine, what it would keep or for how long. SourceNym, nym.health/autonomous-medical-coding/the-technologyread 2026-10-05 |
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| Control & trust | ||
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Human Oversight & Guardrails Approval steps, consent checkpoints, escalation rules, structured guardrails, policy constraints, and pause/resume controls. |
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FathomHuman Oversight & Guardrails Charts the system cannot code pass to the customer's coders, but coded charts go direct to bill with no human intervention required. Fathom names no approval step and publishes no threshold before a code commits. The audit product edits errors in coders' work and flags problematic coding for a person to review. SourceFathom, fathomhealth.com/services and fathomhealth.comread 2026-10-06 |
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NymHuman Oversight & Guardrails A 95 percent confidence threshold decides which encounters go straight to billing and which return to human coders. Coded encounters reach billing without humans approving the codes, so people review only the encounters that fall below the threshold. After launch, the customer needs no regular staff time for daily production. SourceNym, nym.health/autonomous-medical-coding/nym-engine and /implementationread 2026-10-05 |
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Security, Identity & Governance RBAC, SSO, auditability, encryption, least-privilege tool access, compliance posture, and data handling policy. |
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FathomSecurity, Identity & Governance A Certified Public Accounting firm audited Fathom's HITRUST (i1 certified), HIPAA and SOC 2 Type 2 compliance. Its policies cover application and infrastructure security, business continuity, incident management, data privacy, threat and vulnerability management, disaster recovery, access management and workforce training. Vulnerabilities can be reported to security@fathomhealth.com. Access management is named only as a policy area, and Fathom names no SSO, roles or permission model for the customer's own users. SourceFathom, fathomhealth.com/securityread 2026-10-06 |
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NymSecurity, Identity & Governance Nym is SOC 2 Type II certified and ISO/IEC 27001:2022 certified for its coding software, and HIPAA compliant. It names no SSO, roles or permission model for the customer's users. Sourcenym.health/autonomous-medical-coding/nym-engineread 2026-09-29 |
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Observability & Auditability Traces, logs, execution histories, metrics, audit events, and debugging detail for production agent behavior. |
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FathomObservability & Auditability There is no published record of what the automation read and coded for each chart, and no reporting surface. The Audit complete product looks at every coded chart and flags potential denials or unnecessary downcoding. It reviews the work of coders or a coding vendor, not the system's own actions. SourceFathom, fathomhealth.com/servicesread 2026-10-06 |
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NymObservability & Auditability Every coded encounter carries an audit trail showing the clinical findings behind each code, links to the guidelines applied and the reasoning for the assignment, and customized dashboards report coding performance in real time. Sourcenym.health/why-nymread 2026-09-29 |
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Deployment & Data Residency Deployment modes and options, including SaaS, dedicated cloud, VPC, on-prem, hybrid, local runtime, and self-hosting. |
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FathomDeployment & Data Residency No hosting region, region choice, customer environment or on premises option is published. Fathom has infrastructure security and disaster recovery policies but does not say where the platform runs. SourceFathom, fathomhealth.com/securityread 2026-10-06 |
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NymDeployment & Data Residency Implementation takes 3 to 6 months from contract to launch, in five phases, with a project champion, a coding lead and a technical team on the customer's side. Nym names no hosting region, region choice, customer environment or on premises option. SourceNym, nym.health/autonomous-medical-coding/implementationread 2026-10-05 |
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| Solution readiness | ||
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Prebuilt Agents, Templates & Packs Ready-made workflows, packaged employees, templates, blueprints, industry solutions, and role-specific agents that reduce time-to-value. |
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FathomPrebuilt Agents, Templates & Packs There are three separate offerings. Coding automation handles facility and professional fee charts with E/M capture and provider assignment, Audit complete checks a coder's or coding vendor's work in real time, and retrospective risk adjustment coding for health plans and value based providers captures HCCs exhaustively for accurate RAF scores and has its own RFP guide. Fathom reports more than 63 million encounters coded. SourceFathom, fathomhealth.com and /servicesread 2026-10-06 |
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NymPrebuilt Agents, Templates & Packs One coding engine covers six specialties and service lines, which are emergency medicine, radiology, outpatient surgery, outpatient visits, inpatient professional services and urgent care. They are specialties within a single product, not separate products. SourceNym, nym.health/autonomous-medical-coding/nym-engineread 2026-10-05 |
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| Platform extensibility | ||
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Model Flexibility & Routing Ability to work across multiple foundation models, route tasks to different models, or let buyers bring their own providers and keys. |
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FathomModel Flexibility & Routing Fathom runs its own deep learning and NLP models, trained on over 750 million patient encounters, with no customer model choice or routing. SourceFathom, fathomhealth.com/insights/your-health-deploys-fathom-autonomous-medical-coding-to-achieve-95-5-automation-rate-at-98-3-accuracy-rate-across-all-service-lines; fathomhealth.com/insights/fathom-secures-strategic-investment-from-cvs-health-ventures-to-accelerate-enterprise-wide-autonomous-codingread 2026-10-06 |
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NymModel Flexibility & Routing Coding runs on Nym's own machine learning models and rules based clinical ontologies (CLU). Nym names no third party model, routing or customer choice. It does not name its model architectures either. SourceNym, nym.health/autonomous-medical-coding/the-technologyread 2026-10-05 |
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APIs, SDKs & MCP Extensibility Composability layer: stable APIs, SDKs, MCP tool consumption/serving, custom tools, and integration into internal systems. |
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FathomAPIs, SDKs & MCP Extensibility Fathom publishes no API, SDK or MCP server for its platform, and the one named EHR connection runs through athenahealth's Data View. SourceFathom, fathomhealth.com and /insights/your-health-deploys-fathom-autonomous-medical-coding-to-achieve-95-5-automation-rate-at-98-3-accuracy-rate-across-all-service-linesread 2026-10-06 |
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NymAPIs, SDKs & MCP Extensibility The EHR and billing connections move data, and Nym's team builds them as designed during discovery. Nym publishes no API, SDK or MCP server for customers to build on. SourceNym, nym.health/autonomous-medical-coding/implementationread 2026-10-05 |
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Testing, Debugging & Optimization Testing, debugging, scoring, retries, fallbacks, quality gates, and optimization loops for improving agent workflows before and after deployment. |
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FathomTesting, Debugging & Optimization No evaluation harness, test set or quality gate for the customer to run on the automation is published. Before go live, Fathom runs a proof of concept on a high volume of the customer's encounters and measures accuracy at the encounter level. At Your Health, accuracy rose from 96.3% to 98.3% and 95.5% of encounters were coded on day one. KLAS surveys are third party customer interviews, and the Audit product reviews coders' work. SourceFathom, fathomhealth.com/insights/your-health-deploys-fathom-autonomous-medical-coding-to-achieve-95-5-automation-rate-at-98-3-accuracy-rate-across-all-service-lines and /services; fathomhealth.com/servicesread 2026-10-06 |
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NymTesting, Debugging & Optimization Launch requires 95 percent or better accuracy on a user acceptance audit of the customer's historical charts, along with a 12 hour turnaround. Nym's auditing team audits a random subset of records the engine coded for critical errors, and Nym and the customer evaluate accuracy against the 95 percent threshold on an ongoing basis. SourceNym, nym.health/autonomous-medical-coding/implementationread 2026-10-05 |
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| Specialist automation | ||
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Browser & Computer Use Browser, desktop, or remote/local computer control for workflows that cannot be handled through stable APIs alone. |
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FathomBrowser & Computer Use The system codes from clinical documentation and sends charts to billing. Fathom names no browser, desktop or computer control. SourceFathom, fathomhealth.com/servicesread 2026-10-06 |
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NymBrowser & Computer Use The engine works on clinical text through EHR and billing interfaces, layered on top of the customer's existing enterprise IT stack. Nym names no browser, desktop or computer control. SourceNym, nym.health/autonomous-medical-coding/nym-engineread 2026-10-05 |
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Pricing snapshot
Sourced from the Index pricing dataset · open each vendor's profile for full detail.
| Pricing | F Fathom |
N Nym |
|---|---|---|
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Entry price Lowest public entry point |
Contact sales | Contact sales |
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Pricing confidence How public the numbers are |
Contact only | Contact only |
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Billing Primary billing axis |
— | — |
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Variable cost Workload / overage exposure |
High variable cost | High variable cost |
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Free tier / trial Try before you buy |
No free tier
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No free tier
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Buying motion Self-serve vs sales call |
Sales call | Sales call |
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Pricing verified When this pricing was last checked |
Both vendors' outcome figures come from the vendors themselves.
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