# Custom RCM Automation Solutions | Flobotics

Canonical: https://www.flobotics.io/rcm-automation

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[Home](https://www.flobotics.io/)/[What we do](https://www.flobotics.io/what-we-do)/Custom RCM automation

Workflows we automate

# Revenue Cycle Management Automation

We automate the repeated work across your revenue cycle, from patient intake and insurance checks to claim follow-up and payment posting. We start with the tasks that take your team the most time and assess whether the savings justify the cost.

[Discuss your workflow →](https://www.flobotics.io/contact)[See client results](#results)

Illustration of one custom workflow: payer correspondence and claim follow-up. Three payer messages arrive. The first is matched to its claim and the status is saved with a next check date. For the second, the requested document is found, sent and its receipt saved. The third letter has an unclear claim reference, so it goes to staff with the original letter. The example ends with 2 records updated and 1 needing review.

Payer correspondence and claim follow-up

- Read

- Match

- Update

- Flag exceptions

Payer messages · today

- A. Rivera · claim R-3041Status messageStatus updated · next check recorded

- J. Okafor · claim R-3042Document requestDocument sent · receipt saved

- M. Chen · claim R-3043Payer letterStaff review · claim match unclear

2 records updated · 1 needs review

Current message · A. Rivera · claim R-3041

MessageStill under review

Claim referenceR-3041

Message →Billing record← Update

Billing recordMatched

ActionStatus updated

Saved10:14

Next checkIn 7 days

Status saved to the billing record · next check recorded

Example with made-up patients and claims. This is one workflow we can build around your systems. PauseReplay

Client result · California medtech company

## How a medtech company automated denial work and payer correspondence

The company's team handled denial records and payer correspondence across XiFin and payer portals. We built workflows for document handling, reconsiderations, and record updates. Staff review the cases that cannot follow the agreed process.

[Read the medtech case study →](https://www.flobotics.io/case-studies/50k-saved-in-1-month-ai-agent-for-denials-management)

Measured results

~6 min →to ~30 sper case in the automated denial workflow

80% in 3 weeksof a 3,000-claim denial backlog cleared

95% lessmanual correspondence handling

These results come from different workflows in the same client's project.

SuperBill reduced its document-to-claim cycle from about 24 hours to about 7 hours with a separate document-processing workflow. [Read the SuperBill case study →](https://www.flobotics.io/case-studies/70-faster-claim-turnaround-time-ctt-claim-management-automation)

What we automate

## Repeated tasks across your revenue cycle.

Some teams need one task automated. Others need several workflows connected. These are the areas we can work on, with the scope agreed for your project.

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01Prepare

Get patient, order, and billing information into the right records.

- Pull patient details, orders, and appointment information into the systems that need them.

- Check eligibility and capture available benefit details.

- Gather documents and prepare authorization requests.

- Move and validate data between systems, including during a migration.

-
02Submit

Prepare and send supported requests and claims.

- Transfer recorded service codes, charges, and provider details into billing records.

- Check required fields, formatting, and agreed billing rules.

- Submit claims and authorization requests through supported connections or portals.

- Save confirmations and attach the related documents to the right records.

-
03Follow up

Keep open work current and send exceptions to staff.

- Check claim and authorization statuses on an agreed schedule.

- Read payer correspondence and record the required action.

- Prepare supported denial corrections, reconsiderations, and appeal documents.

- Track open balances and follow-up dates in your accounts receivable queues.

-
04Reconcile

Match payments and keep billing records consistent.

- Match remittance details to claims and post payments and approved adjustments.

- Prepare patient statements and approved reminders from recorded balances.

- Compare payments with recorded charges and agreed payer rates where data is available.

- Produce reports and flag unmatched amounts or inconsistent records.

We agree which tasks to automate, where results are saved, and which cases go to your team. You can start with one workflow and add others when they make sense.

Some cases still need billing, coding, clinical, or financial judgment. Automation cannot guarantee payer approval, payment, or a positive return for every process.

Is it a good fit?

## RCM automation usually pays off when most of these are true.

- Your team repeats the same billing tasks many times each week.

- Staff move information between systems that do not exchange it automatically.

- Work waits for manual entry, document handling, or status checks.

- You can identify the normal process and the cases that need a person.

What affects your savings

- How often each task is repeated

- How much hands-on work and rework it takes

- Which system connections, documents, and source data are available

- How often the process needs judgment or changes

- What it costs to build and maintain

The return is different for every organization. Schedule a call and we'll give you a quick, honest estimate of which workflow is worth considering first.
[Schedule a call →](https://tidycal.com/team/flobotics/flobotics-intro-call-w)

How RCM automation works with your systems

## The automation moves information between the systems your team uses.

Your staff keep using the systems they know. We use direct connections where available, UiPath or Python for work in portals and desktop apps, and AI where documents or messages need reading. We agree what can run automatically and what needs staff review.

Example of one custom workflow between three places. The automation reads a payer message and saves the status to the matching claim in the billing system. For a second message, it finds the requested document in the billing system, sends it through the payer portal and saves the receipt. A third letter has an unclear claim reference, so it goes to the staff review queue without changing any claim record.

Your billing system · open claims

ClaimPatientDocumentsStatus

R-3041A. Rivera—Open

R-3042J. OkaforItemized billOpen

R-3043M. Chen—Open

Itemized bill · R-3042

Flobotics automation

Your rulesMatch the claimSave the payer updateUnclear match → staff

Payer portal and correspondence

- Message · claim R-3041 · still under review

- Message · claim R-3042 · send itemized bill

- Letter · claim reference unclear

Send document

Receipt—

Your staff · review queue

Payer letter · 10/14Claim match is unclear. Review the original payer letter.

No exceptions yet

Monitored and maintained by us. We check the runs and update the workflow when payer processes or your systems change.

Example with made-up patients and claims. Each project uses its own systems, rules, and review steps. PauseReplay

We assess each workflow separately. A project can cover one task or several connected processes, depending on the work and the expected return.

Related workflows

## Common revenue cycle workflows we automate.

-
01[Eligibility & benefits](https://www.flobotics.io/agents/eligibility-check-automation)Check coverage before the visit and save the result in the patient record.~40 s per checkPTCoA · [Case study](https://www.flobotics.io/case-studies/100-roi-in-just-23-days-we-automated-eligibility-checks)→

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02[Prior authorization](https://www.flobotics.io/agents/prior-authorization-automation)Prepare and submit authorization requests, then check for updates.85% less submission timePTCoA · [Case study](https://www.flobotics.io/case-studies/85-faster-submissions-8-ftes-saved-prior-authorization-automation)→

-
03[Claims management](https://www.flobotics.io/agents/claims-management-automation)Prepare, submit, and track claims.98% less manual claim preparationGentem Health · [Case study](https://www.flobotics.io/case-studies/98-reduction-in-manual-claim-prep-claims-management-automation)→

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04[Denials management](https://www.flobotics.io/agents/denials-management-automation)Prepare supported corrections and appeals, then track payer responses.Up to 300 resubmissions a dayPathGroup · [Case study](https://www.flobotics.io/case-studies/up-to-80-higher-throughput-in-rcm---denials-management-automation)→

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05[Document processing](https://www.flobotics.io/healthcare-document-processing)Turn faxes, scans and PDFs into checked data for your systems.~70% shorter document-to-claim cycleSuperBill · [Case study](https://www.flobotics.io/case-studies/70-faster-claim-turnaround-time-ctt-claim-management-automation)→

Talk to us

## Which revenue cycle tasks are worth automating?

Book a 30-minute call with Karl, our CTO. If you'd rather write, send us a message.

[Book a 30-minute call →](https://tidycal.com/team/flobotics/flobotics-intro-call-w)[Send us a message](https://www.flobotics.io/contact)

30-minute callKarl MielnickiCo-founder, CTO

Walk me through the billing tasks taking up your team's time. Within the first 15 minutes, we can usually identify where automation might make sense. We'll discuss the work involved and what we'd need to estimate the cost.

Karl
