Recover More Revenue with AI Powered RCM Intelligence
Apex RCM AI helps medical billers, billing companies, and healthcare providers reduce denials, detect claim errors, generate appeal letters, and optimize revenue cycle performance through intelligent automation.
Revenue Recovered
$1.28M
+18.2%
Denial Rate
9.4%
−2.1%
Avg Days in A/R
28.4
−11%
Revenue Recovered
YTDA/R Aging
Missing prior authorization
Filing deadline in 8 days
Generate Level 1 appeal
Claim Scrubber
2 CRITICALMedicare
UnitedHealthcare
BCBS
Built for the systems revenue teams already run on
Reduce claim denials
Catch missing authorizations, coding conflicts, and eligibility gaps while the claim is still in your queue, not after it bounces.
Recover underpaid revenue
Every remittance is checked against contracted rates, so underpayments surface instead of quietly slipping through.
Automate appeal workflows
Payer ready appeal letters draft in seconds, route for approval, and stay tracked all the way to recovery.
The problem
Revenue leaks at every step of the cycle
Data is scattered across clearinghouses, EMRs, and spreadsheets, and the gaps between them are exactly where revenue disappears.
$262B
in claims are denied annually across U.S. healthcare.
Most are preventable, lost to missing data and manual review, not to legitimate payer disputes.
65%
of denied claims are never reworked or resubmitted.
8+ hrs
per biller each week lost to manual appeal letters.
The revenue cycle today
LeakingEligibility & auth
Coverage unverified before the visit
Coding & scrubbing
Conflicts caught only after submission
Submission
Missing data bounces the claim
Remittance
Underpayments go undetected
Appeals
65% are never reworked
Every gap between systems is revenue that never gets collected.
The solution
The intelligent operating layer for revenue cycle teams
Apex RCM AI unifies your claims, denials, payments, and appeals into one secure workspace, with AI working alongside your billers at every step.
Integration ready, modular architecture
Ingest
837 claims, 835 ERA, 270/271 eligibility
Scrub & score
AI flags risk before submission
Work & appeal
Queues route, AI drafts appeals
Recover & report
Track recovered revenue end to end
The platform
Every module your revenue team needs
One cohesive platform, not a patchwork of point tools. Each module shares data, security, and AI.
Active claims
First pass clean
Open denials
Recovered · 90d
Your modules
View all →Claims Management
Full lifecycle from draft to closed, with bulk actions.
Claim Scrubber
Checks for codes, auth & payer rules before submission.
Denials
Reason codes, root causes & recovery by payer.
Appeals
AI drafted letters and approval workflows.
Payments / ERA
Parse 835s, automatically post payments, flag underpayments.
AI Center
Risk scoring, appeal drafting & payer rule explainers.
AI Intelligence
AI Built for Revenue Cycle Workflows
This isn't a chatbot bolted on. It's a controlled, auditable intelligence layer built for claims, denials, and appeals. Every output is reviewable before action.
Missing prior authorization. Aetna requires PA for procedure 29881.
Filing deadline alert: 8 days remaining to submit.
Suggested next action: secure retro authorization before submission.
Appeal recommendation
Generate Level 1 appeal, estimated 84% recovery likelihood.
PHI redacted before model processing
Security & compliance
Designed for secure, compliance conscious healthcare operations
Security isn't a feature bolted on at the end. It's the foundation Apex RCM AI is built on.
Role based access control
Six built in roles with least privilege permissions.
Organization level isolation
Tenant data is partitioned with Row Level Security.
PHI redaction before AI
Known identifiers are tokenized server side. The model receives tokens.
Audit logging
Sign in, AI, and change events recorded with actor, time, and IP.
Encrypted data workflows
Encryption in transit and at rest by default.
No PHI in notifications
Alerts carry counts and links, never patient detail.
Interoperability
Built for healthcare interoperability
Connect the clearinghouses and EMRs you already run on. Apex normalizes and secures every message, then exchanges data in the standards payers expect.
Clearinghouses
EMR / Practice management
Apex RCM AI
normalize · validate · secure
Claims & remittance
Eligibility & status
Standards & files
Executive RCM Report
LAST 90 DAYS$1.28M
Recovered
96.4%
Net collection
72%
Appeal win
Reporting & analytics
See exactly where revenue is won and lost
Boardroom ready dashboards and exportable reports give every stakeholder the metrics that matter, from the C suite to the biller.
Pricing
Plans that scale with your revenue
Start small and grow into enterprise, with AI credits, claim volume, and seats sized to your team.
Starter
For solo billers and small practices
- Seats
- 5
- Claims / mo
- 1,000
- AI credits / mo
- 500
- EDI / mo
- 2,000
- Locations
- 1
- Data retention
- 90 days
What's included
- Claims capture, scrubbing, and eligibility
- Payment posting and ERA review
- Standard dashboards and reports
- Email support
Growth
For small groups and scaling billing teams
- Seats
- 25
- Claims / mo
- 7,500
- AI credits / mo
- 5,000
- EDI / mo
- 15,000
- Locations
- 3
- Data retention
- 365 days
What's included
- Everything in Starter
- AI denial prevention and appeal generation
- Custom payer rules
- Work-queue and SLA routing
- Priority support
Professional
For mid-size groups and managed RCM operations
- Seats
- 50
- Claims / mo
- 25,000
- AI credits / mo
- 10,000
- EDI / mo
- 50,000
- Locations
- 10
- Data retention
- 2,555 days
What's included
- Everything in Growth
- Advanced analytics and audit exports
- Clearinghouse and EHR integrations
- Sales-managed overages
- Optional 2-3% of collections pricing
Enterprise
For health systems and large RCM firms
- Seats
- Custom
- Claims / mo
- Custom
- AI credits / mo
- 25,000
- EDI / mo
- Custom
- Locations
- Custom
- Data retention
- 3,650 days
What's included
- Everything in Professional
- SSO / SAML and SCIM
- Dedicated success manager
- HIPAA BAA included
- Custom SLAs and private AI quota
Contact
Talk with an Apex RCM AI revenue specialist
Share your workflow, claim volume, current systems, and timeline. The right team member will follow up with a practical implementation path.
Verified domain communication
Transactional replies come from authenticated apexrcmai.com sender addresses.
Compliance-conscious intake
Do not include PHI in public forms. We will route sensitive data through secure channels.
Sales and support routing
Contact inquiries, quote requests, and general questions enter separate typed email flows.
Best for product fit, partnerships, or implementation questions.
Start Recovering More Revenue with Apex RCM AI
Join the billing teams using AI to reduce denials, recover underpayments, and get paid faster, without adding headcount.