We manage the full revenue cycle — start to finish.

Most denials don't start in billing. They start at the front desk. A wrong subscriber ID, a lapsed policy, a missing auth — by the time your billing team finds out, the claim has already been rejected and you're chasing it.

We verify eligibility in real time, manage prior authorizations, and validate coverage details before the patient is seen. It's the least glamorous part of the revenue cycle, and it's also where the most preventable money gets lost.

Our coders are certified (CPC, CCS) and specialty-trained. They code for accuracy and compliance first, reimbursement optimization second — because a short-term coding bump that triggers an audit isn't worth it.

We handle ICD-10, CPT, and HCPCS across multiple specialties, run regular coding audits, and flag charge capture gaps. If you're under-coding, we'll tell you. If you're over-coding, we'll definitely tell you.

This is where our AI Claims Scrubber earns its keep. Before any claim goes out the door, it gets screened against payer-specific rules, CCI edits, LCD/NCD policies, and — this is the part most clearinghouses can't do — your own historical denial patterns.

The scrubber doesn't just flag problems. It tells your team exactly what's wrong and how to fix it. The result is a clean claim rate that stays above [97]%, which means fewer rejections, faster payment, and a lot less rework.

We post payments from ERA (835) files automatically across all major payers — UHC, Cigna, Aetna, BCBS, Medicare, Medicaid, you name it. Every payment gets reconciled against your expected reimbursement, and variances get flagged immediately.

Underpayments don't slip through. Contractual adjustments get validated. And you don't have to wait until month-end to find out a payer changed their fee schedule.

This is the big one. And honestly, it's where we think the gap between Revware and everyone else is widest.

Most RCM companies treat denials reactively: a claim gets denied, someone looks at it, maybe writes an appeal, maybe doesn't. Our system is different. Our Denial Prediction model scores claims for denial risk before they're submitted — so your team can fix problems proactively. When denials do come through, our Auto-Appeal Agent drafts payer-specific appeal letters, pulls supporting documentation, and gets them out the door in hours instead of weeks.

For providers dealing with No Surprises Act disputes, our IDR Analytics Dashboard handles the entire case lifecycle — from initial filing to final determination — with automated document generation and outcome tracking.

Root cause analysis. Denial trending. Payer-specific appeal strategies. Escalation protocols. We don't just resolve denials — we make them stop happening.

An unpaid claim at 60 days is a problem. At 90 days, it's a crisis. At 120, you're probably not getting paid.

Our AI AR Follow-Up Agent doesn't work first-in-first-out like a traditional worklist. It ranks every outstanding claim by recovery probability and dollar value, so your team always works on whatever will bring in the most money the fastest. Routine follow-up actions — status checks, resubmissions, corrected claims — get automated. Complex cases get escalated to specialists with full context attached.

Patient responsibility keeps growing, and most billing departments aren't set up to collect it effectively. Confusing statements, long hold times, no self-service options — it all adds up to write-offs that shouldn't be write-offs.

Our AI Patient Billing Assistant answers billing questions in plain English, walks patients through their statements, sets up payment plans, and knows when to hand off to a live person. Your patients get a better experience. You get better collection rates. Everyone wins.

IQ RCM Analytics is your window into everything. Denial rates, clean claim rates, A/R aging, net collection rate, payer performance — all live, all drillable, all benchmarked.

We also built in anomaly detection, which means you don't have to go looking for problems. The system tells you when something's off — a payer suddenly denying more claims than usual, a provider's coding pattern shifting, collection velocity slowing down in a specific bucket. You find out in real time, not at the end of the quarter.