End-to-End Custom RCM Software Development
We build complete revenue cycle platforms from the ground up. Patient registration, eligibility verification, charge capture, coding, claims management, denial management, payment posting, and AR follow-up, all in one connected system. Typical engagement: 9 to 18 months, $500K to $2.5M+ depending on scope.
AI-Powered Denial Prediction and Prevention
We build machine learning models that predict claim denials before submission and recommend the fix. Trained on historical claim data from your clearinghouse, tuned for your payer mix, and integrated with your coding workflow. Average outcome: 30 to 50 percent reduction in first-pass denials within six months of go-live.
Automated Medical Coding and Charge Capture
We build coding assistance tools that suggest ICD-10, CPT, and HCPCS codes based on clinical documentation. Includes NLP-driven extraction from EHR notes, computer-assisted coding (CAC), audit trails, and human-in-the-loop review for high-risk encounters. Ties directly into claims generation downstream.
Claims Management and Clearinghouse Integration
We build claims generation, scrubbing, submission, and tracking tools that connect to clearinghouses like Waystar, Availity, Change Healthcare, and Office Ally. Supports ANSI X12 837P/I/D claim formats, 835 remittance processing, and direct payer integrations for Medicare, Medicaid, and major commercial payers.
Patient Eligibility and Prior Authorization Automation
We build real-time eligibility verification, benefits checks, and prior authorization workflows that reduce front-desk delays and downstream denials. Connects to 270/271 eligibility transactions, payer portals, and prior auth APIs. RPA-driven for the long tail of payers without modern APIs.
Revenue Analytics and Executive Dashboards
We build BI dashboards that show CFOs and revenue cycle leaders what is actually happening across their book of business. KPI tracking for clean claim rate, days in AR, denial rate, net collection rate, and payer-specific performance. Built on Snowflake, Databricks, or Azure Synapse depending on your stack.
Patient Payment and Self-Service Portals
We build patient-facing payment portals that explain charges, offer payment plans, accept HSA and FSA payments, and tie back into your RCM platform. Includes online estimates, billing transparency tools, and integration with payment processors like Stripe, Square Healthcare, and InstaMed.
EHR and Practice Management Integration
We integrate your Revenue cycle management software with Epic, Cerner Oracle Health, Athenahealth, NextGen, eClinicalWorks, Allscripts, MEDITECH, and dozens of specialty PM systems. HL7 v2, FHIR R4, custom APIs, or hybrid integration patterns based on what the target system supports. See our healthcare interoperability services for deeper integration work.
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Dedicated Developer/Teams
Software Development Outsourcing
Staff Augmentation
