The RCM Engine prices and predicts professional, outpatient and inpatient claims against official CMS rules, through an API.
Priced under IPPS, with payment range and denial risk, before submission.
An inpatient claim, grouped and priced. 1. An inpatient claim arrives through the API beside your EHR. 2. The official CMS grouper assigns the DRG, versioned by discharge date. 3. MS-DRG 291, Medicare-exact, in a few milliseconds. Deterministic every time. 4. Priced under IPPS, with payment range and denial risk, before submission. Illustrative, synthetic data.
Revenue teams learn the payer’s answer weeks after submission. Inpatient grouping often needs yet another licensed system.
The engine runs the CMS MS-DRG grouper, prices against IPPS and OPPS, and predicts payment and denial risk per line, beside your EHR.
The CMS reference grouper, versioned by discharge date, at about 7,800 claims a second.
IPPS and OPPS / APC, with national edits per claim type.
X12 files or an API and SDK. FHIR R4 read tested in the Epic sandbox.
A record separating what VAERION proves from approvals only you, payers or vendors can give.
Measured on a single 2-vCPU container running the CMS MS-DRG reference grouper.
Every capability, labelled plainly.
A working session mapped to your organization.