Say goodbye to manual RCM cycles. Our multi-agentic system automates every step from patient intake to claims submission.
Agentic RCM deploys a coordinated system of specialized AI agents that work in parallel across the complete revenue cycle — from the moment a patient is registered to the moment a claim is adjudicated. Each agent is purpose-built for its task, eliminating the handoff errors and manual touchpoints that drive denials and revenue leakage.
The system handles both referred and direct-visit patient paths, adapting automatically to payer-specific requirements, prior authorization rules, and documentation standards — giving billing teams real-time visibility into the pipeline without the burden of managing it.
Watch the Agentic RCM pipeline process a claim in real time — each AI agent completing its task before passing to the next, with full audit trail.
Automate the full RCM cycle across multiple facilities and departments — reducing FTE cost without sacrificing accuracy or compliance.
Handle complex prior authorization requirements and payer-specific documentation standards without dedicated billing staff for each specialty.
Accelerate time-to-payment for high-volume, lower-complexity procedures with automated clean claim generation.
Manage the complexity of GCC insurance landscapes — multiple payer formats, eligibility rules, and PA requirements — through a single automated layer.
We recovered AED 7.8 million in previously denied claims in the first six months. The Prior Auth Agent alone eliminated the largest single bottleneck in our billing cycle. Our clean claims rate went from 71% to 96% in twelve weeks.
Our billing team was spending 60% of their time on prior authorizations. Agentic RCM now handles 94% of PAs without human touchpoints. The team has been redeployed to complex denials and patient relations — work that actually requires human judgment.
Every implementation is different. These are the questions we hear most often — answered directly, without the sales wrapper.
Agentic RCM is pre-configured for all major GCC insurers — Daman, AXA Gulf, MetLife, Bupa Arabia, Tawuniya, Nextcare, and all direct-billing payers across the UAE, Saudi Arabia, Bahrain, Kuwait, and Qatar. The system also connects to all major international payers and clearinghouses for cross-border billing. New payer configurations are typically added within 5 business days upon request.
The Denial Management Agent automatically analyses every denial, classifies the root cause (medical necessity, eligibility gap, incorrect code, documentation missing), and generates the appropriate resubmission or appeal package. For denials that require clinical documentation, the system drafts a clinical justification letter based on the parsed EHR notes for physician review before submission. Average denial overturn rate across our client base is 68%.
Every agent has a defined confidence threshold. When a case falls below that threshold — typically due to incomplete data, payer-specific rules not in the training set, or a novel denial type — the case is flagged and routed to a human reviewer with a full context summary. The case is never dropped or silently failed. All escalations are tracked in the audit log, and the reviewer's resolution feeds back into the agent's improvement cycle.
Standard implementations with Epic or Cerner integrations are complete in 6–8 weeks: 2 weeks for EHR integration and data mapping, 2 weeks for payer credential configuration and sandbox testing, 2 weeks for parallel running alongside existing workflows, and go-live. Implementations with legacy or non-standard billing systems are scoped individually but typically run 10–14 weeks.
Yes — and this is how most clients start. Agentic RCM is designed as an augmentation layer, not a replacement system. Your billing team retains full oversight through the dashboard and handles the escalated cases the agents flag. Over time, as the system learns your payer mix and documentation patterns, the volume of manual touchpoints decreases. Most clients see 60–80% reduction in manual billing steps within the first 90 days.