Revenue cycle management
From patient encounter to payment.
We build revenue cycle software for practices and medical billing organizations — eligibility, charge capture, coding, claims, remittance, denials, A/R, patient balances and financial reporting — with AI where it genuinely helps.
The problem
What makes this hard
01
Denials worked from spreadsheets
Root causes never get fixed, so the same denials come back every month.
02
A/R worked oldest-first
Instead of by money at risk, payer behaviour and filing deadlines.
03
Manual posting and status checks
ERAs keyed by hand; claim status checked one portal at a time.
What we build
Capabilities
Eligibility & registration
Automated 270/271 with exception handling before the visit.
Charge capture & coding
Encounter-to-charge reconciliation and coding review queues.
Claims engine
837 creation with payer-specific scrubber rules and acknowledgement tracking.
Remittance posting
835 parsing, auto-posting and deposit reconciliation.
Denial management
CARC/RARC categorization, routing, correction and appeal workflows.
A/R follow-up
Configurable prioritization and automated 276/277 status checks.
Patient balances
Clear statements, payment links and plans.
Financial reporting
Collections, denial trends, days in A/R and payer performance.
Interactive demo
Follow one claim through the whole cycle.
A $1,250 claim: partial payment, AI-triaged denial, staff correction, final payment.
Morales, Evan · DOS 09/12 · Dr. Daniel Reyes
Crestline BCBS
| Code | Service | Charge | Paid | Status |
|---|---|---|---|---|
| No charges yet — the visit hasn’t happened. | ||||
- Charged
- $0.00
- Paid
- $0.00
- Adjusted
- $0.00
- Patient
- $0.00
- Open
- $0.00
Claim history · event 1/14
- System · Sep 11 · 16:02
Eligibility verified
270/271 returned active coverage. Copay $40 collected at check-in.
AI + medical billing
Practical AI for the billing office.
Specific capabilities — not a promise of higher collections.
pre-submission review · CLM-24-08817
Intelligent claim review
Flags potentially incomplete or inconsistent claim information before submission, so it's fixed once rather than reworked after a denial.
sample distribution · fictional
Denial intelligence
Groups denials by likely cause using CARC/RARC codes and claim context, and surfaces patterns by payer and service.
- 1CLM-24-07702$2,140— 12 days to filing limit
- 2CLM-24-07415$1,380— payer usually pays by day 30
- 3CLM-24-06988$960— no response since submission
- rule: $ at risk × days to limit × payer lag
A/R prioritization
Orders open accounts by configurable rules — balance, age, payer behaviour, filing deadlines — using the data you have.
- Document
- EOB
- Payer
- Crestline BCBS
- Claim #
- CLM-24-08817
- Paid
- $540.00
- Remark
- M119
Document processing
Extracts relevant fields from EOBs, referrals, authorizations and correspondence, and routes them into the right workflow.
Automated workflows
Predefined actions triggered by operational events: an ERA posts, a denial arrives, a claim ages past a threshold.
Why was Morales’ claim partially paid?
Staff copilot
Helps billing staff find information, summarize account history and navigate workflows — with sources shown.
weekly summary · Collections trended up across the quarter. Most new denials this month were CO-16 on drug lines for one payer; a scrubber rule was added on Sep 27.
Reporting intelligence
Turns large operational datasets into readable summaries and trends leaders can question.
Questions
Common questions
Do you work with billing companies as well as practices?
Yes. Multi-client billing organizations need tenancy, per-client payer rules, staff productivity views and client reporting — we design for that from the start.
Will AI increase our collections?
We don't promise that. AI can reduce repetitive work, surface issues before submission and put the right accounts in front of staff first. The impact depends on your payer mix, data quality and processes, and we measure against your baseline.
Which clearinghouses can you connect to?
We integrate through the clearinghouse's supported interfaces — typically APIs or SFTP exchange of X12 files. We confirm the specifics for your clearinghouse during discovery.
Technical consultation
Have a complex problem?
Tell us what you’re trying to build, automate or improve. We’ll help you map the technology, architecture and execution path.
hello@revotechlabs.org01
You tell us the problem
A few sentences about what you're building, automating or fixing.
02
We map the system
A working session on workflows, data, integrations and constraints.
03
You get an execution path
Architecture, phased scope and a realistic estimate — yours to keep.