Autonomous AI Agent for Revenue Cycle

The Revenue Your Practice Has Already Earned — But Never Collected

AI service autonomously monitors denied claims, navigates payer portals, files appeals, and tracks every dollar to resolution. No new headcount. No manual review.

HIPAA-Safe IntegrationNo EMR DisruptionPerformance-Based Pricing
The Denial Gap
60%of denied claims are never resubmitted
54%of appeals overturned when filed
$25average cost to rework a denial manually
11.8%average initial denial rate across U.S. payers

Source: AHA, MGMA, CMS claims data

The Opportunity

Billions in revenue sits in denied-claim queues — unworked.

$0B+Annual denial-driven revenue loss (AHA)
0%Denied claims never resubmitted
0.3%Appeal overturn rate when pursued
0.8%Average U.S. payer denial rate
HIPAA-Compliant Process
Secure EMR Integration
Audit Trail on Every Appeal

Source: American Hospital Association, MGMA, CMS data

How it works

From Denied to Paid — Automatically

The agent handles the full post-denial workflow. Your billing staff focuses on what only humans can do.

01

Connect & Monitor

AI service connects directly to your EMR billing data and monitors for denied claims in real time — no manual export, no CSV uploads.

02

Analyze & Appeal

For each denial, the agent determines the correct appeal pathway, assembles supporting documentation, drafts the appeal letter, and submits through the payer portal.

03

Track to Resolution

Every appeal is tracked until paid or exhausted. You see exactly what was denied, what was appealed, and what came back — all logged with zero manual intervention.

Why Practices Switch from Waystar to AI service

Existing RCM platforms stop at initial submission. The denial queue is where revenue dies — and where we start.

The Old Way

Manual / Waystar

AI service

Autonomous agent

Post-denial workflow
Manual staff queues, often abandoned
Fully autonomous agent execution
Appeal filing
Human must review, draft, submit
Agent drafts + submits automatically
Payer portal navigation
Staff logs in manually
Agent navigates portals autonomously
Denial tracking
Spreadsheets or no tracking
Live status on every open appeal
Scalability
Limited by headcount
Handles any volume without new hires
Pricing model
Monthly software fee
Performance-based — pay on recovery
Platform Capabilities

Built for the Denied-Claim Gap Nobody Else Owns

Real-Time Denial Monitoring

Connects to your EMR and watches billing data 24/7. The moment a claim is denied, the agent is already working the appeal — before your billing staff even sees it.

Always OnZero Latency Trigger

Autonomous Portal Navigation

Logs into payer portals, navigates appeal workflows, and submits documentation without a human touching a keyboard.

Intelligent Appeal Assembly

Parses CARC/RARC codes, CPT/ICD combinations, and payer-specific requirements to build the strongest possible appeal packet automatically.

Full Audit Trail

Every action logged — appeal submitted, status checked, payment confirmed. Compliance-ready documentation on every recovered claim.

Zero Workflow Disruption

Plugs into existing EMR systems (athenahealth, eClinicalWorks, Epic). No change to how your team submits initial claims.

Pricing

Recovery-Based Pricing. You Only Pay When We Win.

No monthly seat fees. No upfront cost. AI service earns when your practice earns — aligning our success with yours.

Starter PracticeIndependent & small practices
12%/of recovered claims
  • Up to 200 denied claims/month
  • EMR read integration (1 system)
  • Autonomous appeal filing
  • Monthly recovery report
  • Email support
Growth ClinicMost Popular
Multi-provider specialty practices
10%/of recovered claims
  • Up to 800 denied claims/month
  • EMR integration (up to 3 systems)
  • Autonomous portal navigation
  • Real-time denial dashboard
  • Priority appeal queue
  • Dedicated account manager
  • Quarterly business review
Surgical GroupHigh-volume multi-location groups
Custom
  • Unlimited denied claims
  • Multi-EMR full integration
  • Custom payer portal coverage
  • White-glove onboarding
  • SLA-backed turnaround
  • API access
  • Dedicated engineering support

Percentages applied to actual recovered revenue only. No recovery = no charge.

Practices Recovering Revenue They'd Given Up On

Riverside Orthopedics

8-provider group

$47K recovered in 90 days
We were writing off 18% of denied claims every month — there just wasn't bandwidth to chase them. AI service recovered $47,000 in the first 90 days without a single new hire.

Sarah M., Billing Director

Clearwater Behavioral Health

4-provider clinic

5× more appeals filed
Behavioral health has the highest denial rates in the industry. We used to appeal maybe 20% of denials manually. Now every single denial gets reviewed and filed automatically.

James T., Practice Administrator

(Illustrative case studies)

“The ROI conversation was simple — if you recover revenue you'd already written off, the percentage fee is pure upside.”

— Dr. Patricia K., Physical Therapy Group

Questions Practices Ask Before Signing On

Start Recovering Revenue You've Already Written Off

Book a 20-minute demo. We'll show you exactly what your denial queue looks like — and what a recovery rate looks like in practice.

Book a Demo

No commitment. No setup fee. First 90 days on performance terms.

HIPAA-Safe
No EMR Disruption
Performance-Based
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