Revenue Cycle Management Software That Automates Your Billing
RCM Edge is revenue cycle management software that automates manual billing workflows in real time through end-to-end RCM automation — reducing AR days, preventing denials, and accelerating cash flow for healthcare organizations.
Interface imagery uses illustrative sample data.
Introducing the RCM Edge Platform
A unified revenue automation suite designed to optimize every stage of the billing lifecycle.
Introducing the RCM Edge Platform
A unified revenue automation suite designed to optimize every stage of the billing lifecycle.
Edge Claims
Monitor claim status across 468 payer connections, normalize payer responses, and route unresolved claims to the right follow-up queue.
Edge Verify
Verify eligibility and benefits across 566 payer connections before service, then route inactive coverage and missing responses for review.
Edge DenialsIQ
Denial-intelligence workflows are in development to help teams identify patterns, prioritize exceptions, and prepare follow-up actions.
Edge PA
Prior authorization automation is in development to support submission tracking, status monitoring, and exception routing.
Edge AR
AR follow-up automation is in development to help prioritize accounts and route payer follow-up work.
Intelligent RCM for every scale
Tailored automation workflows designed to meet the unique demands of billing companies, health systems, and specialty groups.
Replace repetitive eligibility checks and claim-status follow-up with an exception-focused workflow. This can help billing teams expand capacity without tying every new client to proportional staffing growth.
Verify eligibility before service, monitor claims after submission, and route exceptions to staff without replacing the EHR or PM system your team already uses.
Coordinate high-volume eligibility and claim-status workflows across tax IDs, locations, and payer connections through a unified operational view. Confirm FHIR, HL7, or X12 requirements during implementation planning.
Eligibility Payer Connections
Claim Status Payer Connections
Guided Product Demo
Unified RCM Platform
Model an illustrative RCM ROI scenario
Adjust the sliders to model an illustrative planning scenario for your team.
Your current setup
Adjust to match your billing team
Illustrative value scenario
Uses transparent planning assumptions — not customer outcome data
Validate the assumptions
Book a 30-minute demo using your workflow data
Illustrative planning model. Actual results depend on payer mix, workflow coverage, staffing, integration, and implementation. Not a forecast or guarantee.
Automate Every Step of Your Revenue Cycle
RCM Edge combines smart automation and real-time data intelligence to streamline every stage of the healthcare revenue cycle — reducing manual work while improving financial outcomes.
- Real-time Claim Tracking
- Eligibility & Benefits Verification
- AI Denial Prediction
- Prior Authorization Automation
- Revenue Intelligence Dashboards
- Workflow Automation Engine
Predict denials, recover every dollar
Move from reactive billing to proactive revenue management. Our prediction engine identifies denial patterns and root causes before they impact your cash flow.
- Denial Prediction & Analysis
- Root-Cause Identification
- Payer Performance Benchmarking
- AR Aging Optimization
- Smart Appeal Pathways
- Real-time Risk Scoring
See where your revenue is moving and where it's getting stuck
RCM Edge brings payments, claims, denials, payer performance, and AR activity into one real-time view. Spot revenue trends, identify problem payers, and prioritize the accounts that need attention — without digging through spreadsheets or disconnected systems.
Interactive interface with illustrative sample data. Prior authorization, denial-management, and AR automation capabilities are in development.
Every open account is scored by dollars at risk and likelihood to resolve, then ranked so staff touch the highest-value claims first — not simply the oldest.
- Priority score blends balance, aging, payer behavior & timely-filing risk
- Queues rebuild automatically as statuses change
- One-click filters by payer, provider, or denial reason
Live connection health across separate payer networks (468 claim-status connections and 566 eligibility connections). When a route degrades, work is flagged and re-routed so nothing quietly stalls in the clearinghouse.
- Real-time claim & eligibility connection status per payer
- Outage-aware routing keeps submissions moving
- Connection issues surface as tasks, not silent failures
Work is auto-assigned and load-balanced across the team by skill, payer, and SLA. Aging accounts escalate automatically before they breach a filing or follow-up deadline.
- Skill- and payer-based routing to the right specialist
- Even workload distribution with live capacity tracking
- SLA countdowns with automatic escalation
AI flags claims likely to deny before they go out and routes them to the right specialist with the probable reason — shifting your team from rework to prevention.
- Pre-submission risk scoring on every claim
- Predicted denial reason with a recommended fix
- At-risk claims routed before submission, not after rejection
Supporting Two Payer Networks
Nationwide
RCM Edge supports claim-status workflows across 468 payer connections and eligibility workflows across 566 payer connections through one unified platform.
Flexible pricing plans. Any scale.
Whether you are an independent clinic, a growing billing company, or a national health system, we have a plan that aligns perfectly with your revenue goals.
