Medical Billing & RCM

Care gets delivered in minutes. Getting paid for it takes months.

Our goal in this sector

Get providers paid faster with fewer denials and less manual keying.

// 01 — State of Play

Where the
sector stands.

Revenue cycle management is the largest back-office function in healthcare and still the least automated. A single encounter passes through eligibility checks, coding, charge capture, claim scrubbing, submission, remittance posting, denial work, and patient billing — often across four vendors that do not share a database.

The economics are brutal: a meaningful share of claims are denied on first pass, and a large portion of those are never reworked because nobody has time. Every percentage point of clean-claim rate is direct margin, which is why billing is one of the highest-ROI places to put engineering effort.

// 02 — The Shifts

What technology is changing right now.

The forces reshaping this industry — and why they turn into engineering problems.

Shift 01

Payer rules changed faster than software

Edits, modifiers, and prior-auth requirements shift constantly. Static rule engines rot. Systems now need rules as data, versioned and updatable without a release.

Shift 02

Coding assistance became practical

Documentation-to-code suggestion is accurate enough to shorten coder time — provided a human signs off and the audit trail records who accepted what.

Shift 03

Price transparency became law

Published rates and good-faith estimates force machine-readable pricing data out of systems that were never designed to expose it.

Shift 04

Patients became the third payer

High-deductible plans mean a growing share of the bill comes from the patient. That requires consumer-grade statements, payment plans, and self-service — not a paper invoice.

// 03 — Friction

Where it breaks today

  • Denials worked in spreadsheets with no root-cause tracking
  • Eligibility checked manually or not at all before the visit
  • Charge capture that misses procedures performed but never billed
  • ERA / remittance posting done by hand line by line
  • No visibility into days-in-AR by payer, provider, or code
// 04 — What We Build

Systems that fix it

Claim scrubbing and rules engines

Configurable pre-submission validation with payer-specific rule sets, versioned so a policy change is a data edit rather than a deployment.

Denial analytics and worklists

Automatic categorization of denials by reason code, routing to the right worker, and root-cause reporting that closes the loop upstream.

Clearinghouse and payer integrations

837 / 835 / 270-271 pipelines, remittance auto-posting, and reconciliation that flags variance instead of hiding it.

Patient financial experience

Estimates, statements, payment plans, and card-on-file flows that reduce the cost of collecting the patient portion.

// 05 — Ground Rules

How we engineer here

HIPAA

PHI encrypted in transit and at rest, least-privilege access, and immutable audit logs on every read and write.

X12 EDI

Claims and remittances move as 837/835 transactions. Parsers must be tolerant of payer-specific quirks without silently dropping data.

PCI DSS

Card data is tokenized through a compliant processor. Raw PANs never touch application infrastructure.

Auditability

Every code change, write-off, and adjustment must be attributable to a user with a timestamp and reason.

// 06 — Glossary

The language of the sector

Plain-English definitions, so nobody has to pretend they know what an acronym means.

RCM
Revenue Cycle Management — everything from patient registration to final payment posting.
837 / 835
The EDI formats for submitting a claim (837) and receiving the payer's remittance advice (835).
Clean claim rate
The percentage of claims accepted on first submission with no rework.
Days in A/R
Average number of days between service and payment. The headline health metric of a billing operation.
CARC / RARC
Standardized reason codes explaining why a payer adjusted or denied a line item.
// 07 — Questions

Straight answers.

Can you work alongside our existing billing system?

Usually yes. Most engagements start as a layer on top — analytics, worklists, or an integration bridge — rather than a rip-and-replace.

Do you handle clearinghouse connections?

Yes. We build and maintain the EDI pipelines, including per-payer quirks and retry handling.

How do you handle PHI?

Encrypted, access-controlled, logged, and kept to the minimum necessary. Security is designed in, not added after.

Running one of these
operations?

Describe your setup to our AI Strategist and get an architecture sketch back in seconds — or go straight to a human.