Module

Medical Billing & RCM

Charge capture from a locked PCR all the way through to the last dollar collected.

Charge capture happens automatically when a crew locks a PCR. Codes surface with evidence citations, modifiers, PCS tracking, and ABN capture. Claims scrub against payer rules before submission. 837P goes out through Change Healthcare / Optum; 835s auto-post. Denials route into a work queue with AI-drafted appeal letters. Patient billing is HIPAA-compliant, multilingual, and integrates Stripe under BAA.

Interactive prototype

Click around — these are real HTML, not screenshots

AR aging — aged-AR bars, dense claim table, payer/age/status filters, bulk-action bar

Design prototypes rendered in isolated frames — interaction patterns only, not yet a live product surface.

What's inside

Charge capture from locked PCR with HCPCS + ICD-10 + CPT assist
AI coding with evidence citations; upcoding/downcoding risk detector
270/271 eligibility, 837P submission, 835 ERA auto-post
Change Healthcare / Optum (first-class), Availity, Waystar, Trizetto adapters
AI appeal letter generator, denial pattern learner, PCS/ABN gap detector
Patient portal, payment plans, Stripe (BAA), ACH, HSA/FSA
Print-mail statements (OSG / Lob / Billtrust / built-in)
Full RCM analytics: days-in-A/R, cost-per-claim, collections velocity

Feature catalog for this module

17 numbered features · ranges F1200–F1291, F1300–F1319, F1330–F1336, F1340–F1350, F1360–F1362

F1210

AI chart-to-code with PCR evidence citations

F1211

AI up/downcoding risk detector

F1212

AI medical-necessity narrative generator

F1213

AI denial pattern learner

F1214

AI PCS / ABN / signature gap detector

F1215

AI payer-rule engine

F1216

AI audit explainer

F1217

AI output carries confidence + model version + human sign-off required

F1250

ClearinghouseAdapter interface

F1251

Change Healthcare / Optum (first-class)

F1252

Availity

F1253

Waystar

F1254

Trizetto

F1255

Direct-payer EDI (Medicare MAC DDE/EMC)

F1256

Batching, throttling, idempotent retry

F1257

277CA acknowledgment parsing

F1258

Clearinghouse health dashboard

→ View every feature across all modules

Want this module in your operation?

Registration opens soon for the 2027 pilot — design partners shape priority.

Check back later to register interest

Other modules

HRIS & Credentialing Scheduling & Payroll ePCR & Medical Direction Fleet & Ops Readiness Dispatch (911 + NEMT CAD)Purchasing & Accounting Status Boards & Paging Safety, Wellness & Knowledge