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What is RCM Edge?

RCM Edge is a cutting-edge revenue cycle management solution that utilizes artificial intelligence to optimize medical billing processes for various entities, including clinics, physician practices, hospitals, and larger health systems. The platform enhances the billing workflow, starting from eligibility checks all the way to ensuring reimbursements, and is designed to work seamlessly with existing electronic health record (EHR) and practice management tools. With Edge Verify, users can instantly validate insurance eligibility and benefits through a network of 566 payer connections. Additionally, Edge Claims provides real-time monitoring of claim statuses across 468 payer connections, standardizes the responses received from payers, and organizes claims requiring follow-up into designated queues, allowing staff to focus on more complex cases. By incorporating robotic process automation (RPA), predictive analytics, and providing real-time insights, this platform significantly reduces the manual effort required by staff. Although features like prior authorization, denial management, and accounts receivable follow-up are currently in the development phase and not yet live, RCM Edge is committed to continually advancing its capabilities. This ongoing evolution aims to further optimize the effectiveness and efficiency of revenue cycle management in the ever-changing healthcare landscape.

What is Availity?

Successful teamwork in patient care relies heavily on ongoing connectivity and access to current information. It is becoming ever more important to facilitate the flow of this information with insurance companies. Availity streamlines the collaboration with payers, assisting providers from the initial step of confirming a patient's eligibility all the way to resolving reimbursements. Healthcare professionals seek quick and easy access to details regarding health plans. With Availity Essentials, a free service supported by health plans, providers can take advantage of real-time data exchanges with many of the payers they regularly interact with. Moreover, Availity offers a premium service called Availity Essentials Pro that is designed to enhance revenue cycle performance, reduce claim denials, and secure patient payments more efficiently. By utilizing Availity as your reliable source for payer information, you can concentrate your efforts on providing high-quality patient care. Their electronic data interchange (EDI) clearinghouse and API solutions allow providers to seamlessly incorporate HIPAA transactions and other vital functions into their practice management systems, leading to improved operational efficiency. This holistic method not only supports healthcare providers in their operational tasks but also reinforces their ultimate goal of prioritizing patient well-being and satisfaction.

Media

Media

Integrations Supported

Integrations Supported

AI Answering
AbbaDox
Bridger Insight XG
Cohere Unify
ElderSuite
InMyTeam
InvisaClaim
Juris
Lexis Advance Quicklaw
Lexis Omni
Lexis PSL
Motileo
Motivity
Nexis Data+
Nexis Diligence
Nexis Dossier
Nexis Social Analytics
VerifyRX
Vetriq
Visualfiles

API Availability

API Availability

Pricing Information

$200/month
The Professional plan starts at $200 per month. A free 30-day trial is offered. Enterprise pricing is customized.
Free Version

Pricing Information

Pricing not provided

Supported Platforms

SaaS
On-Prem

Supported Platforms

SaaS

Customer Service / Support

Standard Support
24 Hour Support
Web-Based Support

Customer Service / Support

Web-Based Support

Training Options

Documentation Hub
Online Training

Training Options

Webinars
Online Training

Company Facts

Organization Name

ISpectra Technologies Global

Date Founded

2023

Company Location

United States

Company Website

rcmedge.ai/

Company Facts

Organization Name

Availity

Company Location

United States

Company Website

www.availity.com

Categories and Features

Categories and Features

API Marketplaces

Not specified

Healthcare

Not specified

Hospital Management

Accounting Integration
Appointment Scheduling
Billing & Invoicing
Claims Management
In-Patient Management
Medical Billing
Out-Patient Management

Medical Billing

Not specified

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