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RCM Command Center

AI-driven RCM outcomes: fewer denials, more revenue, lower workflow cost, faster cash flow.

Estimated Annual Opportunity

$298,000

Combined annual impact across denials, revenue, workflow, and cash flow.

Denial / Revenue Risk

$212,446

  • Reduced denial value$188,496
  • Recoverable revenue$23,950
Reduced Denials Recoverable Revenue Non-Recoverable Denials

Savings identified out of total denial exposure of $856,800.

Workflow Savings

$77,398

  • Reduced rework$14,566
  • Eligibility admin savings$34,272
  • Prior auth admin savings$28,560
  • Staff hours saved1,850 hrs/year

Cash-Flow Acceleration

$8,592

  • Annual collections$9,800,000
  • Cash-flow factor8%
  • A/R improvement9%
  • Value per day reduced$2,148

Opportunity Waterfall

  • Reduced Denials - $188,496 (63%)
  • Recoverable Revenue - $23,950 (8%)
  • Reduced Rework - $14,566 (5%)
  • Reduced Days in A/R - $8,592 (3%)
  • Eligibility Admin Savings - $34,272 (11%)
  • Prior Auth Admin Savings - $28,560 (10%)

Illustrative estimate based on selected provider profile and editable assumptions. Actual results depend on payer mix, specialty, procedure volume, denial patterns, staffing model, and workflow configuration.

Denial / Revenue Risk

Denials are claims you submitted that the payer rejected — work performed, but no payment received. Most denials trace back to one of three places: eligibility wasn't verified before the visit, the prior authorization wasn't on file, or clinical documentation didn't match the payer's policy.

Our AI helps your team avoid denials at every step of the cycle: it verifies eligibility before the patient walks in, packages prior auth requests the way each payer expects, and drafts strong appeals when a denial does happen — so revenue you've already earned actually reaches the practice.

Key inputs View All
Annual claims 20,400
Avg payment per case $420
Claim denial rate 10%
Expected denial reduction 22%
Appeal success rate 55%

Workflow Savings

A big chunk of the time your front-office and billing team spend on each patient is repetitive: phoning insurers for eligibility, filling prior auth forms, chasing pending authorizations, and reworking rejected claims. Most of that work follows predictable patterns.

Our AI absorbs the bulk of those tasks — verifying coverage automatically, drafting prior auth packets in the format each payer expects, and chasing follow-ups on its own — so the same staff can support more visits without burning out. The savings is the cost of those staff hours your team gets back.

Key inputs View All
Eligibility checks per year 19,200
Prior authorizations per year 2,880
Staff cost per hour $34
Eligibility automation 45%
Prior auth automation 35%

Cash-Flow Acceleration

Even when a claim eventually gets paid, the gap between providing care and receiving the money matters. That gap — your days in A/R — ties up cash you've already earned and forces the practice to float operations on its own.

Cleaner authorizations, fewer rejections, and fewer rework cycles mean payments arrive sooner. The cash-flow value here estimates how much sooner — translated into dollars based on your annual collections. It's timing value, not extra revenue.

Key inputs View All
Annual collections $9,800,000
Current A/R days 43.0
Expected reduction 4.0 days

Customize Your Revenue Estimate

Make changes to baseline assumptions to better fit to specific numbers matching your business.

Selected profileSmall Orthopedic Group
Monthly claims1,700
Average payment per claim$420
Current denial rate10%
Monthly prior auth requests240
Monthly eligibility checks1,600
Staff cost per hour$34
Current days in A/R43.0

Advanced Calculator

Estimated Annual Opportunity: $298,435

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