AI Agents That Optimize Your Entire Revenue Cycle
Deploy 8 specialized AI agents that handle every step of your revenue cycle — from eligibility verification and prior authorization to claims validation, denial management, and payment posting — all autonomously.
8 AI Agents for Complete RCM Automation
Purpose-built AI agents covering every stage of the revenue cycle, from patient intake through final payment reconciliation.
Eligibility Verification Agent
Automated real-time insurance eligibility checks across all major payers with instant benefit breakdowns, coverage status validation, and proactive re-verification scheduling.
Coverage Coordinator Bot
AI-driven coverage coordination and benefits discovery that identifies hidden coverage, coordinates multi-payer benefits, and surfaces optimal billing pathways.
Prior Authorization Agent
Automated PA submission, status tracking, and appeal management with intelligent form completion, payer-specific requirements matching, and deadline monitoring.
Claims Validation Agent
Pre-submission claim scrubbing and error detection powered by AI that validates coding accuracy, checks payer-specific rules, and ensures clean claim submission.
Denial Management Agent
AI-powered denial categorization, root cause analysis, and appeal routing with automated appeal letter generation, trend identification, and prevention recommendations.
AI Coding Assistant
Automated CPT/ICD-10 code suggestion from clinical documentation using NLP, with compliance checks against OIG guidelines and real-time code validation.
Payment Posting Agent
Intelligent ERA/835 parsing and payment matching with automated reconciliation, variance detection, and exception routing for underpayments and denials.
Financial Clearance Agent
Patient cost estimation and financial clearance automation with propensity-to-pay scoring, payment plan recommendations, and upfront collections optimization.
From Verification to Reconciliation
AI agents orchestrate the entire revenue cycle through four seamless stages of automated processing.
Verify
Eligibility checks and coverage coordination
Code
AI-assisted coding and claim validation
Submit
Clean claim submission and PA management
Reconcile
Payment posting and denial resolution
Intelligent RCM Capabilities
Advanced AI capabilities that predict denials, optimize coding accuracy, and autonomously reconcile payments across your entire revenue cycle.
Predictive Denial Prevention
Machine learning models analyze historical denial patterns, payer behavior, and claim attributes to predict and prevent denials before submission.
Intelligent Code Optimization
AI-powered coding engine that analyzes clinical documentation to suggest optimal CPT/ICD-10 codes, ensuring maximum reimbursement with full compliance.
Autonomous Payment Reconciliation
Automated ERA/835 processing with intelligent payment matching, variance detection, and exception handling for complete revenue cycle closure.
Why Choose Our RCM AI Platform
Industry-leading compliance, interoperability, and intelligence built for healthcare revenue cycle excellence.
X12 Compliance
Full EDI 837/835/270/271 transaction support for seamless payer communication.
FHIR R4 Integration
Native FHIR R4 support for interoperability with EHRs and health information exchanges.
Real-time Eligibility
Instant eligibility verification across 900+ payers with automated re-checks.
AI Appeal Generation
Automated appeal letters with clinical evidence compilation and payer-specific formatting.
OIG Compliance Monitoring
Continuous OIG exclusion screening and compliance monitoring across all providers.
CMS Price Transparency
Automated compliance with CMS price transparency rules and good faith estimates.
Maximize Revenue, Minimize Leakage
- Reduce claim denials by 45% with AI-powered pre-submission validation
- Cut eligibility verification time from 15 minutes to under 30 seconds
- Recover $2M+ annually through automated denial appeals and underpayment detection
- Achieve 98% clean claim rate with intelligent coding and scrubbing
- Decrease A/R days by 35% with autonomous payment posting and reconciliation
Enterprise-Grade Compliance
Ready to Transform Your Revenue Cycle?
See how 8 specialized AI agents can optimize every step of your revenue cycle — from eligibility verification to payment posting. Schedule a personalized demo today.
