Stop losing revenueto preventableclaim denials
End-to-end revenue cycle automation — from real-time eligibility verification through payment collection. Custom-built to your payer mix, your specialty, your denial patterns. Not a generic billing tool.
Every day you run manual
revenue cycle, you're losing
money
Healthcare organizations with manual RCM processes don't just lose revenue on denials — they pay staff to rework them, wait 65–75 days to collect, and can't see where the leaks are happening until it's too late.
The organizations that adopt custom AI revenue cycle automation recover $300K–$600K annually — not from billing more, but from finally collecting what they were already owed.
Average days in AR for behavioral health — money sitting uncollected
Of all claims denied — the majority due to preventable errors
Cost to rework every single denied claim manually
Of denials caused by simple data entry errors — fully preventable
Five stages. Fully automated.
End-to-end.
Each stage is where revenue leaks happen. Our custom AI system plugs each leak — from the moment a patient schedules an appointment to the moment payment is posted.
Eligibility Verification
Real-time insurance checks run automatically at scheduling and again 24 hours before the appointment. Catches coverage gaps before the patient arrives — not after.
Prior Authorization
Automated auth submission directly to payer portals. Real-time status tracking. Expiry alerts prevent lapses. Reduces PA processing from 13 hours per week to under 2 hours.
AI Claim Scrubbing
Every claim is run through an AI model trained on your historical denial patterns before submission. Catches coding errors, missing modifiers, and payer-specific rule violations in real time.
Triple Check Automation
Simultaneous clinical, coding, and billing validation before every claim leaves your system. Flags mismatches between clinical documentation and billing codes that would trigger denial.
Denial Management
AI analyzes every denial, identifies patterns by payer, code, and clinician, and generates appeal letters automatically. Dashboard shows denial root causes so you eliminate them at the source.
Every capability your
revenue cycle team needs
Real-time eligibility checks
Automated insurance verification at scheduling and 24 hours before each appointment. Alerts staff to coverage gaps before they become denials.
Automated prior authorization
Submits auth requests directly to payer portals, tracks status in real time, and alerts before authorizations expire. Reduces PA work by 85%.
AI-powered claim scrubbing
Trained on your organization's historical denial patterns. Catches payer-specific rule violations, missing modifiers, and coding mismatches before submission.
Triple check validation
Simultaneous clinical, coding, and billing validation. Flags mismatches between clinical documentation and billing codes that would trigger denial or audit.
Denial pattern analytics
Cross-payer, cross-location, cross-clinician denial analytics. Shows exactly where revenue is leaking and why — so you eliminate root causes, not just rework claims.
Automated appeal letters
AI generates payer-specific appeal letters automatically on denial. Pulls clinical documentation, payer policy, and denial reason to build the strongest possible appeal.
AR aging dashboard
Real-time view of accounts receivable by age bucket, payer, location, and provider. Prioritized worklists for your billing team — highest-value, highest-risk claims first.
Payment posting automation
Automatic ERA/EOB posting, contractual adjustment calculation, and patient balance generation. Eliminates manual payment posting entirely for most payers.
PM & EHR integration
Deep integration with your existing practice management and EHR systems. No rip-and-replace — we add intelligence on top of what you already have.
86–90% of denials are
preventable. We prevent them.
Most organizations treat denials as a billing problem to fix after the fact. The right approach is to eliminate them before they happen — by training AI on your specific denial history and catching every error pre-submission.
For the denials that do come through, automated appeal letter generation means your billing team spends minutes per appeal instead of hours — with higher success rates because every letter is built on the exact payer policy language.
All five categories are addressed by Metricoid's pre-submission AI layer
Trained on your exact payer mix —
not generic rules
Every payer has different rules, different documentation requirements, and different denial patterns. Generic billing tools apply the same rules to every payer. We train your AI on your actual payer contracts and denial history.
Medicaid (State-specific)
Medicare (Part B & Advantage)
BlueCross BlueShield
Aetna / CVS Health
United Healthcare
Your Payer Mix
See what revenue cycle automation
means for your organization
Adjust the sliders to match your organization — see a realistic estimate of what Metricoid's RCM automation could recover.
Revenue cycle automation in action
Days in AR from 71 to 29 — $520K recovered annually
Days in AR had climbed to 71. Claim denials hovered at 14% — with the billing team spending 3 full days per week on rework. Multiple payers, multiple specialties, and no unified denial visibility across locations meant no one could identify where the leaks were coming from.
What Metricoid Built
“Our cash flow had become a real problem. The Metricoid system started catching errors before claims even left our office. Within 90 days, we were collecting faster than we ever had.”
— CFO, MULTI-SPECIALTY PHYSICIAN GROUP, NORTHEAST USDays in AR — sustained improvement after month 3
Claim denial rate — across all 8 locations and specialties
Annual revenue recovered from denial reduction and faster collection
Faster claim resolution — billing team freed for higher-value work
Live in 10 weeks.
Cash flow improving by week 6.
We start with the highest-volume denial category in your current claims data and prove ROI there before expanding to the full pipeline.
Revenue Cycle Audit
We analyze 12+ months of your claims data — denial reasons, payer patterns, AR aging, coding accuracy. We map where every revenue leak is happening.
Build & Integrate
Custom AI models trained on your denial history. Integrations built with your PM system and payer portals. Full eligibility and PA automation configured.
Parallel Run & Prove
Run automation alongside your existing process. Measure denial rate reduction and AR improvement in real numbers. You see ROI before full cutover.
Optimize & Expand
AI learns from every new denial, improving accuracy monthly. Quarterly business reviews. Expand to new payers, locations, or specialties as you grow.
Built for the regulatory complexity
of US healthcare billing
HIPAA
Full Privacy & Security Rule
HITECH
Breach notification compliance
BAA Available
Signed before work begins
SOC 2 Aligned
Security & availability controls
EDI 837/835
ANSI X12 claim formats
FHIR R4
Payer API interoperability
CMS Mandates
Prior auth API compliance 2026
US-Hosted Only
AWS/Azure US regions, AES-256
Find out exactly how much
revenue you're leaving on the table
We'll audit your current claims data — denial rates, AR aging, payer patterns — and show you in real numbers what automation would recover. 15 minutes, no commitment.
- Free claims data audit
- ROI quantified before you commit
- BAA signed before any work begins
- Works with your existing PM system
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