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.
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.
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.
Measured results
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
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.
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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.
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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.
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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.
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 callThe 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.
Monitored and maintained by us. We check the runs and update the workflow when payer processes or your systems change.
We assess each workflow separately. A project can cover one task or several connected processes, depending on the work and the expected return.
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.
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