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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 Paradigm?

Paradigm Senior Services offers a robust, AI-enabled revenue cycle management solution tailored for home-care agencies that manage billing across various third-party payers, such as the U.S. Department of Veterans Affairs (VA), Medicaid, and numerous managed-care organizations. The platform streamlines and improves every aspect of the billing and claims process, which includes tasks like eligibility verification, authorization management, and handling state or payer-specific enrollment and credentialing. It also ensures the submission of correct claims, addresses any denials that arise, and facilitates payment reconciliation. By integrating smoothly with popular agency management software and electronic visit verification systems, it allows for the effective scrubbing of shifts, weekly authorization checks, and smooth payment reconciliations, ultimately leading to fewer denials and reduced administrative burdens. Furthermore, Paradigm provides a "back-office as a service" model for healthcare providers, meaning that even if agencies have their own billing teams or scheduling tools, Paradigm can still oversee claims processing as if it were a dedicated, knowledgeable billing department. This adaptability empowers agencies to prioritize patient care, alleviating them from the intricacies of billing operations by entrusting those complexities to experts. In doing so, Paradigm not only enhances operational efficiency but also supports better financial outcomes for home-care agencies.

Media

Media

Integrations Supported

Additional information not provided

Integrations Supported

Additional information not provided

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

Documentation Hub
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

Paradigm

Date Founded

2015

Company Location

United States

Company Website

www.paradigmseniors.com

Categories and Features

Categories and Features

Home Care

Not specified

Medical Billing

Not specified

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