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RCM Operations Simplified

End-to-end claims management powered by AI

From fixing pre-submission errors to denial management and enhance your entire revenue cycle workflow with intelligent automation that catches issues before they become lost revenue.

Regional Health System

40%
Reduction in Denials
60%
Faster Appeal Processing
95%
First-Pass Acceptance
$2.1M
Avg. Annual Recovery

Platform + Partnership

Choose the model that fits your organization — self-service SaaS or fully managed service.

SaaS Platform

Self-Service
  • Full platform access for your team
  • Real-time dashboards & reporting
  • AI-powered work queues
  • Training & onboarding included
  • Email & chat support

Hybrid

Flexible
  • Platform access + partial managed support
  • CareEco handles overflow or complex cases
  • Scale support up or down as needed
  • Shared responsibility model
  • Dedicated success manager
Analytics Dashboard
$1.2M
Recovered YTD
↑ 12%
94.2%
Clean Claim Rate
↑ 3%
4.2%
Denial Rate
↓ 1.5%
Denial Trends by Payer
AetnaBCBSCignaUHCHumanaOther
Recovery Trend (12 mo)
Learn

Drill-Down Dashboards

Multi-year analysis of all claims to identify trends. Track KPI targets, analyze denial trends with payer response details, and uncover areas for margin improvement and revenue recapture.

Work Queue Dashboard
Denial Work Queue
All PayersThis Week
PriorityClaim IDPatientPayerAmountAction
CLM-4521 Johnson, M. BCBS $2,450 Appeal
CLM-4518 Smith, R. Aetna $1,890 Appeal
CLM-4515 Davis, K. UHC $980 Review
CLM-4512 Wilson, J. Cigna $1,250 Rebill
AI Recommendation: Appeal CO-16 denials first — 87% success rate
Enhance

AI-Powered Work Queues

Work queues with AI-powered recommendations. Prioritized tasks guide your team to the highest-value actions first based on historical success rates and recovery potential.

Action Tracker
Recent Actions
My TeamToday
Appeal submitted for CLM-4521 by CareEco Team • 10 min ago
$2,450
Payment received for CLM-4498 Auto-posted • 25 min ago
$1,680
📝
Note added to CLM-4502 by CareEco Team • 1 hr ago
$890
Claim rebilled CLM-4489 by CareEco Team • 2 hrs ago
$3,200
24 Actions Today
$18.4K Value Worked
92% SLA Met
Act

Follow-Up Actions & Notes

Performance-based solution ensures aligned incentives. Follow-up actions and notes taken by CareEco team removes burden from your existing staff while maintaining full visibility.

Complete Claims Lifecycle Management

Work Queue Management

Prioritized work queues with actionable next steps. Your team knows exactly what to work on and when, maximizing productivity and recovery.

  • AI-prioritized task lists
  • Role-based queue assignment
  • Productivity tracking
  • SLA monitoring

Claim Submission & Tracking

Submit claims electronically and track their status from submission through payment. Real-time visibility into your entire A/R.

  • Electronic claim submission (837P/837I)
  • Real-time status tracking
  • ERA/EOB auto-posting
  • Payment reconciliation

Denial Management

AI-powered denial classification and routing. Automatically parse denial codes, identify root causes, and route to the right team for resolution.

  • Auto-parse CARC/RARC codes
  • Root cause categorization
  • Appealable vs. preventable classification
  • Trend analysis and reporting

Appeal Automation

Generate appeals with supporting documentation automatically. Our AI drafts persuasive appeals based on denial reason and clinical documentation.

  • AI-generated appeals
  • Auto-attach supporting documentation
  • Payer-specific formatting
  • Appeal success tracking

Timely Filing Tracking

Never miss a filing deadline again. Automated alerts based on payer-specific timely filing limits ensure claims are submitted and appealed on time.

  • Payer-specific deadline tracking
  • Automated priority alerts
  • Aging bucket management
  • At-risk claim identification

Pre-Check AI

Validates claims against payer-specific rules before submission. Catches coding errors, missing information, and compliance issues that would result in denials.

  • Payer-specific edit validation
  • Medical necessity checks
  • Authorization verification
  • Duplicate claim detection

Who RCM Operations Is For

Health Systems

Standardize RCM operations across facilities, reduce denial rates, and improve cash flow with centralized visibility and automated workflows.

Physician Groups

Get claims paid faster with pre-submission validation and automated denial follow-up. Focus on patient care, not paperwork.

Billing Companies

Scale your operations without adding headcount. Process more claims with higher accuracy and demonstrate ROI to your clients.

Consulting Organizations

Quickly uncover crucial insights for clients with their own data. Leverage ongoing reporting for continued connection to clients post-engagement.

Ready to Transform Your Claims Operations?

See how RCM Operations can reduce denials, accelerate payments, and recover more revenue.

Request Demo