Revenue cycle, before submission.
Claims checked and priced before they go out.
01 · Worklist
Every claim, checked first.
Edits, predicted payment and holds, so the team works exceptions.
Release cockpit · before submissionSample data
4471Maya ChenEstablished visit, level 4 · predicted $158–$186Clear
4472Marcus WebbWound debridement · missing units addedFixed
4473Elena ParkBlood draw · bundled with the panelNCCI edit
4474David ColeNew patient · reviewers differ on levelCoder review
Edits checked
NCCI · MUE
Held for a person
2 of 4
Release
Needs approval
02 · Denials
Worked with evidence.
Classified by CARC/RARC. Safe fixes apply; money changes wait for a person.
Denials & appealsSample data
CO-97Bundled serviceRoot cause: NCCI pairRebilled$22.00
CO-16Missing informationRoot cause: referring NPIResubmitted$310.00
CO-50Medical necessityAppeal drafted with evidenceHuman review$1,240.00
Patterns learned from remittances become rule proposals. A person approves them before they change a claim.
03 · Aging
Silent claims, surfaced.
Unanswered claims, oldest first, with follow-up drafted.
Aging worklist · no payer responseSample data
1182Commercial PPO47 days · no acknowledgmentStatus check$410.00
1179Medicare52 days · 276 sentWaiting$186.00
1164Regional HMO61 days · still silentFollow-up letter$725.00
Silent claims are the A/R leak nobody works. They surface here, oldest first, with the next step drafted.
FAQ
About Revenue Cycle.
Is this the real product?
It mirrors the product, redrawn with sample data.
Can we adopt this alone?
Yes. Start here and connect the rest later.
Does it fit our systems?
It uses standard X12 and a FHIR-aligned record, and runs beside your EHR via API.
Can we see it on our data?
Yes. Book a working session.
Get started
See Revenue Cycle on your data.
A working session on your specialty and payers.