Automation and Rules Powered by Your Expertise

Every healthcare organization is unique, and no one knows your organization better than you. We collect and transfer your knowledge into rules. Rules that are highly-tailored to address your payer requirements, specialties, value-based contracts, and more.  Rules can be set to automatically correct billing and coding errors so your staff is only working the most important issues. 

See Custom Rule Examples

Welcome to Better

 

 

Unprecedented Customization

We work closely with you to create custom rules to meet your organization's unique needs and to ensure coding compliance. We then help you determine which rules can be set up to automatically correct routine billing errors, freeing up your team’s valuable time to focus on more important issues.   

Custom Rule Examples

The Challenge

A charge coming from the EMR into the RCM System consists solely of the professional component, but this medical group is able to bill for the technical component, as well.

The Solution

A custom rule to automatically add the technical component to a claim. The rule knows which charges require the technical component based on the location/CPT data.  

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Integrates with Systems You Already Use

Working on the front-end of your process, RCxRules reviews all charges for coding completeness and accuracy right after entry into your EMR, before a claim is created. 

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Optimize Productivity, Maximize Reimbursement

4X ROI Through the capture of missed revenue, decreased denial rate and increased coder productivity
75% Automation rate, no longer spend time on tedious manual tasks
Infinite custom rules based on your organization, specialty, and payers
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“One of the biggest things I like about the product is the auto-fixes that are embedded within the core functionality of the product, that certainly has allowed our staff to be able to focus on the more difficult edits rather than to having to simply work on simple claim fixes and simple charge corrections.”
Chad Barringer Director of Revenue Cycle Management, OrthoCarolina

How the RCxRules Software Works

A modern take on a claim scrubber, RCxRules reviews all charges for coding completeness and accuracy right after entry in your EMR against a robust set of industry standard and custom rules. If no coding discrepancies are detected, the charge passes through to your RCM system in real-time. If a coding error is identified, two things can happen:

  1. Autocorrect- If the error is a routine data quality issue, the rules engine can automatically correct the error
  2. Tasked to coder- If the error needs a more in-depth review, the charge is automatically sent to a biller/coder for resolution

“Now, out of 3,000 tasks a day, we probably have to manually review about 100. Everything else automatically posts. Clean claims go out the first time without the need to review them.”

 

Christi GarriottSenior Vice President of Business Intelligence and Revenue Peak Vista Community Health Centers

World Class SupportWe Always Go the Extra Mile

Your success is our success. We pride ourselves on the quality of our implementations and support services. But don't take our word for it. Hear what our valued customers have to say about us.

Hear From Our Customers

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Frequently Asked Revenue Cycle Rules Questions

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