PRIOR AUTHORIZATION AUTOMATIONAI CLAIM SUBMISSION

Lowestcostperclaim.
Compoundingmargin
perclient.

RCM.ai is the next technology company to every day. Built on Grdn Platform, our AI workflows helps increase performance for modern revenue cycle operations.

Platform Interface
98%
CLEAN CLAIM RATIO
<3%
DENIAL RATE
<3%
COST TO COLLECT
Performance Basis

Numbers that hold up under operator scrutiny.

RCM.ai is built on workflows already proven in production environments, with performance backed by existing operational results.

Claim Integrity
Clean Claim Ratio (First-pass)98%
Denial Rate (Avg 5-10%)Below 3%
Front-End Rejection Capture90%
First-Pass Resolution Rate95–97%
$
Financial Efficiency
Net Collection Rate96–99%
Days in Accounts Receivable25–35
Cost to Collect (% of revenue)Under 3%
Gross Collection Rate92–95%
Operational Performance
Charge Entry Accuracy99%
Coding accuracy97–99%
Claim Submission TAT<24 hrs
Denial Recovery Rate85–90%
Automation Rate60-80
Manual Intervention Rate<20%
"

The industry is shifting from reactive to predictive.

RCM.ai is built for what comes next.

"Clearinghouses become rails. Intelligence becomes the product. The value is no longer in the transmission of data, but in the autonomous accuracy of its creation."

— RCM.AI PERSPECTIVE

The Paper Arms Race

Payers are already using AI to find reasons to deny. If your billing operation is still using manual humans to fight algorithms, you have already lost.We provide the counter- algorithm.

Autonomous Operations

True margin growth doesn't come from hiring cheaper offshore labor. It comes from removing the labor requirement entirely through high-fidelity AI charge entry and predictive eligibility.

A productized AI engine for the modern RCM shop.

RCM.ai isn't just another dashboard. It is a sovereign software application that lives within your workflow. Built on the enterprise-grade Grelin Platform, it integrates with your existing EHRs to automate the most labor-intensive parts of the revenue cycle.

Grelin Core

Secure, scalable AI infrastructure built for healthcare scale..

🧠

Neural Logic

Proprietary models trained on millions of clean claim patterns.

Platform Interface

The Autonomous Workflow

Five stages from encounter to claim, powered by AI.

📊

1. Data Intake

EHR data into a secure system of intelligence

👁️

2. Patient Claims

Auto-verification of demographic info

📋

3. Visit Creation

Dynamic mapping of clinical codes

🤖

4. AI Charge Entry

New and accurate charge entry & codes

5. Claim Submission

Automated submission to payers

CASE STUDY

An RCM company processing 2,400 daily encounters implemented RCM.ai across their specialty accounts.

88%
Human Free
12hrs
Reduced TAT
Before RCM.ai
12 FTEs required for charge entry
8.5% initial denial rate
42 day average AR cycle
After RCM.ai
2 FTEs for QA/Exceptions
2.1% initial denial rate
28 day average AR cycle

Purpose-built for your operational model.

Multi-Specialty RCM

Multi-Specialty RCM

Handle varied coding requirements across 40+ specialties with AI engine.

MSO-Owned

MSO-Owned

Standardize financial outcomes across disparate acquired practices instantly.

Specialty-Focused

Specialty-Focused

Deep-model training for complex fields like Pathology or Cardiology.

Offshore Ops

Offshore Ops

Supercharge offshore teams with AI-driven quality assurance and productivity.

Built to fit inside an RCM operation.

Supported Platforms

Athena HealthEpicCernerMeditechNextGeneClinicalWorks

Integration Methods

Bi-directional APIs
🔗SFTP & HL7 Data Flows
📁RPA Emulation
🔄Real-time DB Mirroring
Platform Interface

Security & Compliance

Enterprise-grade security for every operation.

HIPAA Compliant

HIPAA Compliant

End-to-end BAA execution with enterprise-grade security, strict data sovereignty policies, and compliance-focused access controls.

SOC2 Type II

SOC2 Type II

Audited operational security and organizational trust.

RBAC Control

RBAC Control

Granular user permissions mapped to your org chart.

Audit Logging

Audit Logging

Immutable audit logs tracking every AI-generated decision and all human edits with complete transparency and traceability.

Lower cost per claim is the only RCM metric that compounds.

Every dollar saved through automation multiplies across your entire book of clients. RCM.ai is the engine that makes compounding possible at scale.

JAM
Trusted by 200+ Healthcare Operators

Ready to automate?

Join leading RCM operations that are replacing manual oversight with AI-powered intelligence. The future of revenue cycle runs itself.