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AI Revenue Cycle Management

Capture Revenue. Eliminate Leakage.

Your AI Revenue Cycle Management Teammate automates charge capture, claim submission, denial management, and payment posting — reducing A/R days, boosting clean claim rates, and recovering revenue that falls through the cracks.

HIPAA Compliant SOC 2 Type II Fully Auditable
What This Teammate Does

End-to-End Revenue Cycle — Fully Automated

From charge capture to payment posting, your AI teammate handles every step of the revenue cycle with speed and accuracy.

Charge Capture

Automatically identifies and captures all billable services from clinical documentation, ensuring no charges are missed and revenue leakage is eliminated at the source.

Claim Submission

Validates, scrubs, and submits claims electronically with payer-specific formatting — catching errors before submission and driving clean claim rates above 98%.

Denial Management

Analyzes denial patterns, auto-generates appeal letters, and prioritizes denials by recovery potential — turning lost revenue into recovered dollars.

Payment Posting

Automatically posts payments, reconciles ERA/EOB data, and identifies underpayments — ensuring every dollar owed is accounted for and discrepancies are flagged instantly.

A/R Follow-Up

Prioritizes aged accounts receivable by likelihood of collection, automates follow-up workflows, and escalates high-value accounts for human intervention.

Revenue Analytics

Delivers real-time dashboards on denial rates, collection trends, payer performance, and revenue leakage — giving leaders actionable insights to optimize the revenue cycle.

Who It's For

Built for Revenue Cycle Leaders Who Need Results

Designed for the executives and operations leaders responsible for financial performance, cash flow, and billing efficiency.

CFO / Revenue Cycle Director

Financial leaders and revenue cycle directors accountable for net revenue, cash flow predictability, and cost to collect — looking for measurable financial impact within 30 days.

  • Reduce denial rate by 50%+
  • Achieve 98%+ clean claim rate
  • Shorten A/R days by 35%

HIM Director

Health Information Management directors responsible for coding accuracy, documentation integrity, and compliance — who need AI that improves quality while reducing manual review burden.

  • Improve coding accuracy and compliance
  • Reduce manual claim corrections
  • Streamline audit readiness

Practice Manager

Practice managers who need to scale billing operations, reduce overhead, and improve collections efficiency without adding headcount to their teams.

  • Automate repetitive billing tasks
  • Reduce cost to collect by 40%
  • Improve net collection rate
What It Replaces

Replace Manual Billing with Intelligent Automation

AI Revenue Cycle Management directly displaces costly, error-prone manual billing processes — without disrupting your existing workflows.

Traditional Model
AI Teammate
Manual charge capture and entry
Automated charge identification
Outsourced billing and coding teams
In-house AI with full audit trail
Manual denial review and appeals
AI-driven denial analysis and appeals
Spreadsheet-based A/R tracking
Intelligent A/R prioritization
Manual payment reconciliation
Automated payment posting and matching
Measurable Impact

KPIs That Move the Business

Every AI RCM deployment is benchmarked against the metrics that matter most to healthcare financial leaders.

↓35%Days in A/R

Faster claim submission, automated follow-up, and intelligent prioritization shorten the time from service to payment.

98%Clean Claim Rate

AI-powered claim validation ensures near-perfect first-pass acceptance, eliminating costly rework and resubmissions.

50%Denial Rate Reduction

Proactive claim scrubbing and payer-specific validation catch errors before submission, dramatically reducing denial rates across all payers.

↓40%Cost to Collect

Automation reduces manual labor across the revenue cycle, lowering the cost to collect on every dollar of revenue.

↑15%Net Collection Rate

Better charge capture, fewer denials, and automated follow-up recover revenue that was previously lost in the cycle.

↓30%Write-Off Reduction

Intelligent denial management and proactive A/R follow-up recover dollars that would otherwise be written off as bad debt.

Seamless Integration

Connects to Your Existing Revenue Cycle Systems

Your AI teammate integrates with the EHR, billing, and clearinghouse systems you already use — no rip-and-replace required.

Epic Resolute

Native integration with Epic Resolute for charge capture, claim management, and payment posting workflows.

Cerner RevEnue

Bi-directional sync with Cerner revenue cycle modules for billing, collections, and financial reporting.

Clearinghouses

Integrates with Availity, Change Healthcare, and Waystar for electronic claim submission and remittance processing.

Payer Portals

Connects to major payer portals for eligibility verification, prior authorization status, and claim status inquiries.

Billing Platforms

Supports athenahealth, eClinicalWorks, and other billing platforms via pre-built connectors and secure APIs.

API & EDI Support

RESTful APIs, X12 EDI transactions, and configurable webhooks for any system not covered by standard connectors.

Deployment Timeline

Live in Weeks — Not Quarters

A structured, phased deployment that delivers measurable results from the first sprint. No multi-year transformation required.

Week 1–2

Discovery & Configuration

  • Map existing revenue cycle workflows and pain points
  • Configure EHR and clearinghouse integrations
  • Define payer rules, denial categories, and priority logic
  • Set up HIPAA controls and audit logging
Week 3–4

Pilot Launch & Validation

  • Deploy AI on a selected payer or service line
  • Human-in-the-loop validation of claim accuracy
  • Benchmark: denial rate, clean claim rate, A/R days
  • Iterate on payer rules based on real claims data
Week 5+

Scale & Optimize

  • Expand to all payers and service lines
  • Continuous improvement from denial pattern analysis
  • Onboard additional departments and facilities
  • Quarterly reviews with revenue cycle ROI benchmarking
Governance & Trust

Enterprise-Grade Security for Revenue Operations

Every claim is auditable. Every action is governed. Built from the ground up for HIPAA-regulated healthcare billing environments.

Human-in-the-Loop by Default

High-value claims and edge cases route to billing specialists. AI handles the volume — your team retains decision authority.

HIPAA Compliant & Audit-Ready

Full audit trails, role-based access control, and compliance logging designed for payer audits and regulatory reviews.

Data Residency & Encryption

PHI and financial data encrypted at rest and in transit, configurable data residency, and strict retention policies.

Works With Your Billing Systems

Connects to Epic, Cerner, clearinghouses, and payer portals via secure APIs and standard EDI protocols.

Get Started in 30 Days

Launch Your AI Revenue Cycle Pilot

See measurable results — fewer denials, shorter A/R days, and higher clean claim rates — within your first month. No multi-year commitment. No rip-and-replace. Just results.

Live in 2–4 Weeks HIPAA Compliant Human-in-the-Loop No Data Lock-in