Medical Billing & Revenue Cycle Management

Automated charge capture from EHR encounter data, ICD-10/CPT/HCPCS coding assistance with AI-powered suggestions, claim scrubbing against 1,500+ edit rules, and X12 837 electronic claims submission to all major clearinghouses — with real-time claim status tracking.

Real-time denial classification by payer and denial reason code, automated appeal letter generation with supporting clinical documentation, denial trend analytics by provider and service line, and workflow queues that route denials to the appropriate billing specialist.

X12 835 electronic remittance advice ingestion, automated contractual adjustment posting, secondary claim generation, patient responsibility calculation, and exception queues for remittances that cannot be auto-posted — eliminating days of manual payment posting.

Every RCM platform we build is instrumented to measure the KPIs that matter — clean claim rate, denial rate, days in A/R, and net collection rate — so your revenue improvement is quantified and defensible.

We build payer-specific claim editing rules, appeal templates, and authorization workflows based on the major commercial and government payers — Medicare, Medicaid, UnitedHealth, Aetna, Cigna, BCBS — reducing denials at the source.

Bidirectional FHIR and HL7 integration with all major EHRs ensures that charge data, clinical documentation, and coding suggestions flow between clinical and billing systems without manual transcription.