Solutions
Start where it hurts. Grow without a new vendor.
Four entry points, one accountable system. Every engagement runs on the same operators, models, agents, and portal, so scope can expand from a single worklist to the full cycle without a second contract.
Solutions
Four ways in. One system underneath.
Start with the part of the cycle that hurts. Every engagement runs on the same operators, models, agents, and portal, so scope can grow without a new vendor.
- 01
Revenue Cycle Optimization
We take ownership of the full cycle, or the parts that leak: patient access, coding and charge capture, claims, denials, A/R follow-up, and patient balances. Our operators work inside your PM and EHR, with our automation underneath them.
- Patient access & intake
- Eligibility & prior auth
- Coding & CDI
- Charge capture
- Claims & edits
Claim lifecycle · Northline Health Systemlive- 01
Eligibility
99.2%
verified 48h prior
- 02
Coding
1.1d
charge lag
- 03
Submission
96.1%
clean claim
- 04
Adjudication
5.9%
first-pass denied
- 05
Posting
same day
835 posted
- 06
Follow-up
33.8d
days in A/R
- 02
AI-Driven Solutions
Not a chatbot. Models trained on claim and remittance data that predict denials before submission, suggest codes from documentation, draft appeals with the right evidence, and keep payer rules current. Every recommendation is reviewed by a person until it earns autonomy.
- Denial prediction
- Coding assist
- Appeal drafting
- Payer rule intelligence
- Propensity to pay
Denial prediction · pre-submissionlive- CLM-2411204CO-197Auth missing · request retro authconf 0.91
- CLM-2411219CO-16NDC absent on line 2 · add before submitconf 0.96
- CLM-2411231CO-4Modifier 25 supported · appendconf 0.84
- CLM-2411240No issues predictedconf 0.99
Reviewed by a coder until the model earns autonomy for this payer and task.
- 03
Automation
Eligibility checks, claim status, payment posting, prior-auth follow-up, payer portal logins. We build and run the bots, monitor every run, and route exceptions to people. Your team gets the hours back.
- Eligibility (270/271)
- Claim status (276/277)
- ERA posting (835)
- Prior auth follow-up
- Payer portal agents
Automation run log · todaylive06:12:04eligibility.verify412 patients · 6 gaps flaggedok06:05:11denial.triage17 categorized · 3 to appeal draftok06:00:40claim.status3,210 checked · 88 updates writtenok05:48:22auth.followupAetna portal changed · 8 to Priyaexception05:30:09era.post$1,284,210 posted · 11 variancesokRuns today
6,723
Straight-through
98.4%
Hours returned
353
- 04
Strategic Consulting
Diagnostics, benchmarks, system selection, and transformation roadmaps from people who have sat in the revenue cycle director’s chair. We tell you what to fix first, and we can stay to fix it.
- 30-day diagnostic
- KPI benchmarking
- EHR / PM selection
- Vendor consolidation
- Interim leadership
Transformation roadmap · 6 monthsliveM1M2M3M4M5M6Diagnostic
Eligibility automation
Denial worklist redesign
Coding assist pilot
Payer escalation program
Each item has an owner, a cost, and the KPI it is supposed to move. Tracked in the portal.
How we engage
Thirty days to a plan. A quarter to see it move.
- 01Days 1 to 30
Diagnose
We pull your claims, remits, and worklists, sit with your team, and measure every KPI one way. You get a prioritized findings report with the dollars attached to each finding.
DeliverableFindings report and 12-month plan
- 02Days 30 to 60
Design
Workflows are redrawn around the exceptions. Automations are specified against your systems. Roles change so that one person owns each dollar.
DeliverableWorkflow and automation blueprint
- 03Days 60 to 120
Deploy
Agents go live under supervision. Operators join your queues. Models start in review mode and earn autonomy task by task.
DeliverableLive automations and staffed queues
- 04Ongoing
Operate
We run it with you. KPIs are visible daily in the portal, reviewed monthly, and tied to how we are paid.
DeliverableOutcome-based operations
Speak to an expert
Let’s find the revenue you’re leaving on the table.
What happens next
- 01
A 30-minute call with an operator
Not a sales rep. Someone who has run a revenue cycle and will ask about yours.
- 02
A scoped diagnostic proposal
Fixed fee, 30 days, with the data we need listed up front.
- 03
Findings with dollars attached
You keep the report whether or not we continue together.