Agentic AI Medical Billing

Billing that fights back

Over 50% of denied claims are never resubmitted. SignalRCM runs billing end-to-end, challenges every denial, and feeds each payer outcome into the next claim so revenue stops leaking.

Reads directly from the EHR you already use

DrChrono athenahealth eClinicalWorks NextGen Health Veradigm Epic Centricity
Revenue Leakage

Where billing operations break down

For specialty practices and medical groups, manual handoffs and payer-specific details can turn into denials, payment delays, and write-offs.

01 / TIMING

Manual claims leave too late

When coding, charge entry, and review sit in manual queues, the payment clock starts days after the visit. Revenue is delayed before the payer even sees the claim.

Mon: Visit → Fri: Claim
02 / FIRST PASS

Claims fail first submission

Small claim issues create long payment delays. One missing modifier, expired authorization, or unsupported code can turn a payable visit into weeks of delay.

Payable Visit → Delayed Payment
03 / RECOVERY

Denials get abandoned

Every appeal takes staff time, small underpayments are written off, and complex denials require expertise. Over time, leakage compounds.

Payer Denial → Write-off
Practice Results

Revenue recovered. Rollout handled

Specialty practices and medical groups switch to SignalRCM to recover revenue without adding work to their team.

Recovered revenue
We had thousands tied up in complex, aged denials that our old biller completely gave up on. SignalRCM stepped in, dug through the history, and identified claims we can recover that had been sitting dead for over six months.
Sam Kalioundji, MD
KAL Heart Cardiovascular Specialists
Hands-off rollout
I was dreading the transition because our last software switch felt like a second job. This rollout was entirely hands-off for us — it plugged in smoothly and worked from day one without a single hitch.
Shalini Chalana, RD
Lexington Nutrition Services
The system

Billing that learns from payer outcomes

SignalRCM connects billing from EHR access to reconciliation, so denials, payments, and payer fixes improve the next claim.

SignalRCM plugs into your EHR and reads patient, documentation, and and visit data at the source. No chart exports, uploads, or manual handoffs from your team.

SignalRCM checks eligibility, benefits, and prior authorization before the visit, so payer requirements and patient responsibility are known up front.

SignalRCM checks that documentation, diagnosis codes, and procedure codes support the service being billed — catching missing evidence before it becomes a denial.

SignalRCM checks each claim against payer-specific edits, modifiers, authorization status, documentation support, and specialty rules before submission.

SignalRCM reviews the denial, matches it to the claim evidence, drafts the right response, and tracks follow-up until the claim is resolved.

SignalRCM posts ERAs, confirms payment against the remit, and uses every payer outcome to improve the next claim.

EHR

FILLED
PATIENT MRN 94832051
VISIT Follow-up
PLAN Aetna PPO
NOTE mrn-94832051.txt

SignalRCM

SYNCED
PATIENT MRN 94832051
VISIT Follow-up
PLAN Aetna PPO
NOTE mrn-94832051.txt
Visit in 2 days Mon 9:30
MRN 94832051 Aetna PPO
Time Mon 9:30
Provider Dr. Patel
Service 99214 follow-up
Payer Aetna PPO

Pre-visit checklist

Eligibility, auth, benefits

Ready
Eligibility Active · ID 4182
Benefits $25 copay · met
Prior auth No auth · 99214
Referral On file · Jun 30
Patient due $25 estimate
MRN 94832051 note Signed follow-up
Chart

Patient returns with a moderate asthma exacerbation during an established patient follow-up. She reports daily rescue inhaler use and nighttime symptoms; exam shows diffuse wheeze without distress. Plan is to start prednisone burst and adjust controller inhaler, with recheck in two weeks.

Code support

Evidence from note

Supported
ICD-10 J45.41 Asthma exacerbation
CPT 99214 Follow-up visit
MDM Moderate Daily rescue use
Risk Rx mgmt Prednisone burst
Claim #A7735 · Jun 22 $342.00
MRN 94832051 Aetna PPO · 99214-25
Scrubbing
Member
MRN 94832051
DOB 03/18/82
Member ID W26104830
Provider
Name Dr. Patel
NPI 1841290016
Taxonomy 207Q00000X
Billing
Payer ID 60054
TIN 91-127652
Entity Taiga Medical
Service
CPT 99214-25
Attachment Signed note
POS 11
Claim #A7734 99214 · Aetna PPO
MRN 94832051 Follow-up · Jun 22
Denied
Voice agent Autonomous
Denial flagged Missing modifier, per payer
Calling Aetna Ref #8837291
Presenting documentation Note + original claim evidence
Overturned Payment posted to claim
Recovered $212.40
ERA reconciled Balanced
MRN 94832051 Claim #A7735 · Aetna PPO
ERA received $342.00
Posted to ledger $342.00
Difference $0.00
Payer coverage

Works across your payer mix

From national carriers to regional plans, Medicare, Medicaid, TRICARE, and specialty networks, SignalRCM handles the payers your practice already bills.

Aetna Cigna UnitedHealthcare Humana Anthem Medicaid Reclamation ERA Blue Cross and Blue Shield of Texas Kaiser Foundation Health Plan Georgia National Centers for Medicare & Medicaid Services Medicaid California Medi-Cal TRICARE East Molina Healthcare Centene (Medical) Wellcare Oscar Health Carelon Behavioral Health EmblemHealth Plan Horizon Blue Cross and Blue Shield of New Jersey
Practice Control

Full-service billing in your control

Physician oversight

SignalRCM surfaces suggested diagnosis and procedure codes in a single approval queue, so physicians can review and approve billing before claims go out.

Denials challenged

SignalRCM challenges every denial, reviews the evidence, prepares the appeal or correction, follows up with the payer, and tracks the claim through resolution.

Revenue dashboard

SignalRCM gives you real-time visibility into collections, denials, payer delays, code-level trends, and recovery activity from one dashboard.

Patient statements

SignalRCM sends clear statements, automates follow-up, and handles patient billing questions so your front desk is not stuck explaining balances.

Revenue cycle specialists

SignalRCM automation handles repetitive claim work while experienced revenue cycle specialists review complex denials, underpayments, and escalations.

Claim ownership

SignalRCM follows through to resolution. Every claim, appeal, patient balance, and payer follow-up has a clear status, next step, and owner.

Support

Questions we hear most

SignalRCM handles coding review, claim scrubbing, claim submission, denials, appeals, payment posting, reconciliation, patient statements, and billing follow-up. Your team stays focused on patient care while we manage the revenue cycle work.

Every denial is reviewed and challenged. SignalRCM checks the evidence, prepares the appeal or correction, follows up with the payer, and tracks the claim through resolution.

You get physician code review, real-time revenue dashboards, claim-level status, and a named account lead. Your practice keeps visibility into what is happening without having to manage the billing work day to day.

Our team handles the EHR connection, payer setup, clearinghouse routing, workflow mapping, and open-claims review where needed. Most practices can go live in weeks without pulling staff away from patient care.

No. SignalRCM connects with systems like Epic, athenahealth, eClinicalWorks, AdvancedMD, Tebra, NextGen, and DrChrono. Your team keeps charting the same way while SignalRCM runs the billing workflow around your existing systems.

Ready to close the loop?

See what your practice is leaving on the table — and how much of it SignalRCM recovers before it becomes a write-off.

Book a demo