Enterprise Revenue Cycle Management (RCM)
Maximize financial performance, eliminate claim denial backlogs, automate clearinghouse EDI submissions, and reduce days in accounts receivable (A/R) with an integrated clinical billing engine.
End-to-End Medical Billing Automation
From front-desk copay capture to post-discharge claim scrubbing and ERA reconciliation.
Automated Claim Scrubbing
Pre-submission rules engine validates ICD-10 and CPT coding combinations, modifier rules, and insurer-specific guidelines to achieve 98%+ first-pass clean claim rates.
EDI Clearinghouse Integration
Native ANSI X12 bridges for direct electronic transmission: EDI 837 (claim submission), EDI 835 (remittance/payment posting), and EDI 276/277 (claim status checks).
Denial Management & Appeals
Smart classification of denial reason codes (CARC/RARC). Pre-populated appeal letter templates and task reassignment ensure prompt re-submission of rejected claims.
Patient Payments & E-Billing
Offer transparent digital patient statements via SMS and email. Patients can view itemized hospital charges, set up recurring payment plans, and pay instantly online.
Electronic Remittance Posting
Automatic reconciliation of insurance payments with patient accounts. Eliminates manual check posting errors and flags contractual underpayments automatically.
A/R Days & Financial Analytics
Executive financial dashboards tracking Days in A/R, net collection ratio, aging buckets (30/60/90/120+ days), and revenue by clinical department.