21 Feb Hello World.
An inside look into RCM Brain by John Williamson, Founder and CEO
RCM Brain is using artificial intelligence and bot automation to create a healthcare payments industry that is accurate, transparent, and dramatically simpler than it is today.
We are building the world’s most advanced AI-enabled rules engine for revenue cycle management. To bring our vision to life, we’ve pulled together experts from every part of the industry – the provider revenue cycle side and the payer payment integrity side – and assembled an engineering team with a background in AI applications and healthcare data processing.
Our platform, also know as Beth, will house every known coding and billing rule alongside every payers’ guidelines and a complete pricing engine. Beth will use our self-learning rules engine to reverse engineer denial scenarios from historical billing patterns. All of which come together to predict and prevent future denials, as well as, prioritize and fix prior historical denials, and ultimately ensure accurate, transparent payment for everyone.
For providers this means the capability to bill a claim optimized with payer-specific coding, then validate accurate payment, then prioritized denial opportunities for your staff. At the same time, you’ll also receive a 360-degree perspective on your financial data and the root cause insights in that data – regardless of how many systems the data is spread across.
For payers, RCM Brain becomes your new front door before the adjudication process begins, allowing you to pre-scrub against every known rule, including your own internal guidelines, contract terms and fee schedule terms set with any given provider. This allows you to immediately identify predicted denials that can be returned to the provider for claim correction and resubmission, completely bypassing the adjudication life cycle.
At this stage, we’re rapidly developing partner relationships. Partners for us include clearinghouses, provider software vendors and payers committed to reducing friction with their provider network. Let’s connect and discuss your options for better revenue cycle management. If you’re a large healthcare provider or a large third-party RCM company, our solution can help you regain margin and increase market share without increasing staff.
RCM Brain, Inc.
Founder and CEO