We build automation platforms that handle eligibility checks, prior authorization, coding, claims submission, denial management, and payment posting — cutting manual work out of your revenue cycle and getting you paid faster.
For hospitals, ASCs, multi-specialty groups, medical billing companies, and healthcare SaaS teams building or modernizing RCM software.
🔒 HIPAA & PCI DSS-ready architecture · BAA available · NDA on request
Trusted by health systems, ASCs & medical billing companies
Every manual eligibility check, every re-keyed charge, every claim that gets denied for a fixable reason and never resubmitted — it all adds up. Most of it never shows up as a single line item on a P&L. It just shows up as slower cash flow, an overworked billing team, and a "days in A/R" number that keeps creeping up.
Across the industry, initial claim denial rates now average 11.8% — climbing past 15–19% for Medicare Advantage, Medicaid, and ACA marketplace plans. Nearly two-thirds of denied claims are never even resubmitted, which means that revenue isn't delayed — it's gone. Workflow automation doesn't just speed up billing; it closes the specific leaks costing you the most.
Find out where your revenue cycle is leakingSources: Aptarro, Enjoin, Advisement.com, RapidClaims — 2026 healthcare denial & reimbursement statistics
Revenue Cycle Management (RCM) covers everything between a patient booking an appointment and your organization actually getting paid: eligibility verification, prior authorization, charge capture, medical coding, claims submission, denial management, payment posting, and reporting. Healthcare workflow automation is the broader discipline of using software — rules engines, RPA, OCR, and AI/NLP — to remove manual, repetitive steps from that process and from adjacent operational workflows like scheduling, intake, and provider credentialing.
Done well, this isn't "replace your billing team with a bot." It's giving your team software that checks eligibility instantly instead of by phone, flags a claim likely to be denied before it's submitted, drafts the appeal language automatically when a denial does come through, and gives your CFO real-time visibility into days-in-A/R instead of a monthly spreadsheet. The staff you have get more done; the errors you were bleeding money on stop happening.
Automation isn't a nice-to-have layered on top of billing operations anymore — it's becoming the baseline that hospitals, ASCs, and billing companies are competing on. Here's what a well-built platform actually delivers, beyond the marketing language.
Catching eligibility and coding issues before submission stops denials at the source instead of fighting them after the fact.
Every claim that doesn't need manual rework saves $25–$181 in staff time — that adds up fast at volume.
Billing teams stop re-keying data between systems and spend their time on the claims that actually need human judgment.
CFOs get live days-in-A/R and denial-rate dashboards instead of waiting for month-end reports to find out something's wrong.
AI-assisted coding checks against payer rules before a claim goes out, reducing both denials and audit exposure.
Standardized, automated workflows let multi-site groups add locations without proportionally growing back-office staff.
Billing and revenue cycle software is unforgiving — a bug in a claims workflow doesn't just break a feature, it costs a real client real money. We've built healthcare and fintech-adjacent software long enough to know that EDI formatting quirks, payer-specific denial codes, and clearinghouse edge cases are where most RCM projects actually go wrong — and we've already solved most of them.
Across clinical, RCM, fintech, and enterprise automation products
A real claims/eligibility workflow live, not a slide deck
Scope slippage is on us, not billed back to you
Same engineers from architecture through post-launch support
We know the difference between a CO-197 and a CO-45 denial code, and why that matters to how the workflow is built.
HIPAA, PCI DSS, and payer-specific rules are built into the architecture from sprint one, not retrofitted before launch.
We've already built against the major EHR/PM systems and clearinghouses — we're not learning X12 EDI on your project.
Coding automation, RPA, dashboards, and integrations — one accountable team, not three subcontractors passing blame.
A number you can take to your board or investors — and we own the risk of hitting it, not you.
Payer rules change constantly — SLA-backed support and ongoing rule updates keep the platform accurate after launch.
No sales deck, no generic pitch — a 30-minute call with someone who can speak to your specific EHR/PM, clearinghouse, and payer mix.
Book Your Free Strategy CallRising claim complexity, payer rule changes, and chronic staffing shortages are pushing hospitals, ASCs, and billing companies toward automation faster than almost any other back-office category in healthcare — and the market numbers reflect it.
Range across major research firms for the RCM software category
Compound annual growth through 2030–2034 across most forecasts
Total value of denied claims across the US healthcare system each year
Industry-wide average initial claim denial rate in 2026
Sources: Grand View Research, Mordor Intelligence, Fortune Business Insights, Aptarro (2026 industry forecasts)
From a single automated workflow to a full RCM platform for a billing company's clients — we build the whole stack, in-house, with your billing and compliance teams involved from week one.
End-to-end claim creation, scrubbing, and submission workflows that catch errors before they reach the payer.
Automated auth requests and status tracking that cut days off the pre-visit workflow.
Real-time eligibility checks against payer systems instead of manual phone calls.
Automatic denial categorization, root-cause tracking, and AI-drafted appeal letters.
ICD-10/CPT coding suggestions grounded in the encounter, reviewed and confirmed by your coders.
Structured charge capture directly from clinical documentation, reducing missed and duplicate charges.
Self-service patient statements, payment plans, and online payment collection.
Automated tracking of licenses, payer enrollment, and re-credentialing deadlines.
Digital intake forms, insurance capture, and scheduling workflows that feed clean data downstream.
Automated referral tracking and leakage reporting across your provider network.
Automated ERA/EOB posting and reconciliation against expected reimbursement.
Real-time KPIs — days in A/R, denial rate, clean claim rate — built for finance leadership.
Robotic process automation for the repetitive back-office tasks that don't need a human judgment call.
HL7/FHIR and X12 EDI integration work connecting your automation layer to existing systems.
Upfront, payer-aware cost estimates that reduce billing surprises and speed up patient collections.
Track negotiated rates by payer and flag underpayments automatically during reconciliation.
HIPAA and PCI DSS-aligned architecture built in from day one, not retrofitted before launch.
SLA-backed monitoring, payer-rule updates, and continuous feature delivery post-launch.
A production RCM platform is really three connected products: the worklist your billing staff live in, the dashboard finance leadership checks daily, and the integrations that make it invisible to IT.
The day-to-day worklist your billing and coding team actually uses to move claims through the cycle.
What a CFO, practice administrator, or RCM operations lead needs to see the health of the revenue cycle at a glance.
The plumbing that lets IT and security sign off — deep integration, identity, and infrastructure controls.
Whether you're running the revenue cycle for one hospital or a hundred client practices, the workflows, payer mix, and reporting needs are different — we tailor the build accordingly.
From the moment a patient books an appointment to the moment payment lands in reconciled cash — here's the automated pipeline we build under the hood.
Digital intake captures insurance info; eligibility is verified automatically in real time.
System flags services requiring authorization and initiates the request automatically.
Encounter data is structured into charges with AI-suggested ICD-10/CPT codes.
Claims are checked against payer rules before being submitted through the clearinghouse.
Denials are categorized automatically, with appeal drafts generated for common reasons.
ERA/EOB data posts automatically and rolls up into real-time finance dashboards.
Most RCM projects don't fail because the automation logic is wrong — they fail because the data never reliably flows between the EHR, the practice management system, and the clearinghouse. We build against HL7 v2, FHIR R4, and X12 EDI (837 claims, 835 remittance, 270/271 eligibility, 276/277 claim status) as the standard backbone, with custom interface work wherever a client's specific instance or clearinghouse relationship needs it.
For medical billing companies managing dozens of client practices across different EHR/PM systems, we design integration layers that normalize incoming data into a single automation pipeline — so one denial-management workflow can serve every client, regardless of what system they run underneath.
Ask us about your specific EHR/PM & clearinghouse setupRCM software touches real money and real payer relationships — a broken claims workflow doesn't just annoy a user, it delays cash. Our process is built around validating against real claims data early, not after go-live.
Current workflows, EHR/PM/clearinghouse environment, payer mix, and compliance requirements.
System design, integration approach, automation scope, compliance roadmap.
Billing-staff and finance-dashboard UI designed with real users in usability sessions.
Agile sprints across claims workflows, integrations, dashboards, and automation logic in parallel.
Testing against real (de-identified) claims data, EDI validation, security testing.
Cloud provisioning on compliant infrastructure, CI/CD setup, phased rollout.
SLA-backed maintenance and ongoing payer-rule updates as regulations and policies change.
We pair proven web/cloud infrastructure with automation and AI components tuned specifically to claims data and payer rules — not a generic workflow tool repackaged for healthcare.
RCM software fails in production for one of two reasons: the automation wasn't built by people who understand payer rules and EDI, or the compliance work was an afterthought. We treat both as first-class requirements from day one.
| Criteria | Freelancers | Generic Agencies | Our Company |
|---|---|---|---|
| RCM & Payer Rules Expertise | ✕ | Partial | ✓ Deep |
| HIPAA & PCI DSS Compliance | ✕ | Partial | ✓ Built-in |
| EHR/PM & Clearinghouse Integration | ✕ | Partial | ✓ Epic / Cerner / athena / Availity |
| X12 EDI Experience | Varies | ✕ | ✓ In-house |
| Security Architecture | Partial | Partial | ✓ Enterprise |
| 24/7 Support | ✕ | Partial | ✓ SLA-backed |
| Dedicated Team | ✕ | Shared | ✓ Ring-fenced |
RCM software touches protected health information (PHI) and payment card data at the same time — patient demographics, claims, remittance, and billing. We architect for HIPAA, HITECH, and PCI DSS from the first sprint, and we'll sign a Business Associate Agreement (BAA) before any PHI touches our systems.
Card and payment data flow through PCI-compliant gateways — we don't store raw payment credentials in the application layer.
For billing companies managing multiple client practices, data is logically isolated per-tenant with strict access boundaries.
Every automated decision — a denial classification, a coding suggestion — is logged and traceable back to the rule that produced it.
Healthcare RCM has some pricing norms software elsewhere doesn't — including percentage-of-collections, which is worth designing for from day one if you're a billing company or considering becoming one.
Fee tied to a percentage of what's actually collected — the dominant model among RCM/billing service providers.
Standard for RCM vendorsFlat monthly fee per licensed user of the platform.
Predictable SaaS revenueUsage-based pricing tied to claim volume, scaling naturally with practice size.
Good for variable volumeFlat annual licensing for health systems deploying across multiple facilities.
Best for hospital systemsLicense the platform to billing companies or EHR vendors under their own brand.
B2B2C distributionCore claims automation vs. full denial-management and analytics tiers at different price points.
Higher ARPU ceilingOne-time setup, data migration, and staff training packages.
Services revenue layerPremium reporting and benchmarking sold as an upsell to core automation.
Upsell for finance teamsA revenue cycle platform that lives outside your existing systems just becomes another tab someone forgets to check. We build integrations so automation runs inside the workflows your team already trusts.
Problem: A 12-location ASC group had a denial rate above 18% and a billing team drowning in manual rework.
Solution: Automated eligibility verification, claim scrubbing, and denial categorization integrated directly into their PM system.
Problem: A medical billing company needed a single platform to serve 40+ client practices running different EHR/PM systems.
Solution: Multi-tenant automation platform with a normalized data layer across EHR/PM systems, white-labeled for their brand.
Problem: A regional hospital system's manual prior-auth process was delaying procedures and frustrating both patients and surgeons.
Solution: Automated auth requests with real-time status tracking integrated into their Epic instance.
Our denial rate dropped by more than half within two quarters. The Epic integration was the part I worried about most, and it was the part that just worked.
We onboard client practices faster now because the platform normalizes data across whatever EHR they're running. That used to be our biggest bottleneck.
They understood PCI and HIPAA well enough that our compliance review took days instead of months. That's rare for a dev partner in this space.
From a single automated workflow to a full RCM platform — let's scope your project in a free 30-minute strategy call.
🔒 BAA available · ⚡ Response within 24 hours · 🏥 Built for regulated healthcare finance
Cost depends on scope — a focused automation (e.g. eligibility checks or denial management) costs less than a full RCM platform with EHR/PM/clearinghouse integration. We provide a fixed-scope quote after a discovery call.
A focused automation module typically takes 10–14 weeks; a full multi-tenant RCM platform takes 4–7 months.
We build on compliant infrastructure with encryption, audit logging, and access controls throughout, route payment data through PCI-compliant gateways, and sign a BAA before any PHI touches our systems. Final compliance sign-off is your organization's responsibility with counsel.
Epic, Cerner/Oracle Health, athenahealth, eClinicalWorks, Kareo/Tebra, and AdvancedMD are common EHR/PM integrations; Availity, Waystar, Change Healthcare, and TriZetto are common clearinghouse integrations. We also build custom HL7/FHIR/X12 interfaces for less common systems.
Yes, this is one of our most common builds — a multi-tenant platform with normalized data across different client EHR/PM systems, white-labeled under your brand.
Accuracy depends on model tuning and specialty. We benchmark against real (de-identified) claims during development and keep certified coders in the review loop — the AI suggests, it doesn't submit codes autonomously.
Yes, we design billing and reporting logic to support percentage-of-collections, per-claim, per-seat, or hybrid pricing models depending on how you go to market.
Yes, X12 EDI is core to how claims, remittance, and eligibility data move through the platform — this is standard infrastructure in every RCM build we do.
Yes, we handle data migration and run legacy and new systems in parallel during transition to avoid disrupting active claims and cash flow.
Most clients see measurable denial-rate and A/R improvements within the first 1–2 quarters after rollout, though this varies by current process maturity and payer mix.
Yes, via SLA-backed maintenance packages covering monitoring, payer-rule updates, and continuous feature delivery — payer rules change often enough that this matters.
Yes, NDAs are available on request before any detailed technical or business discussion.
Ed-Tech
We developed an innovative exam preparation app, equipped with features including a Content Management System (CMS) and robust user authentication. Our user-friendly design simplifies content search and filtering, enabling seamless progress tracking and interaction with interactive learning tools. With scalability and reliability at its core, the app ensures a secure learning environment through encryption and regular audits.
Downloads
Blockchain Trading Platform
Downloads
Gym Membership App
Downloads
Booking App
Ticketbox is developed with user convenience in mind, boasting an intuitive interface and seamless functionalities for effortless booking management, ticket viewing, and tracking of booking history. Our integration of secure payment gateways ensures peace of mind, while real-time updates keep users informed every step of the way.
CEO | Carpooll
CEO | Deluxe Days
CEO | LogiTrac
CEO | ElecGlide
CEO | RhythmoReunion
CEO | Gemstone Gallery
CEO | SoulSingles
CEO | Allayya
CEO | Vezita
“The team was great to work with, stayed on track, and exceeded our expectations.”
“They demonstrated a thorough understanding of our project requirements and provided innovativ…
Talk to our experts and get the best solutions
Talk To our Experts
Congratulations on taking the first step towards taking your business to new heights!
We are ready to take you there.
We will soon contact you for more details.
