TrueRCM runs the full revenue cycle for physician groups and medical billing companies — scheduling and eligibility, clean-claim scrubbing, dual-rail 837 submission, ERA posting, denial routing, guardrailed AI appeals, patient statements, and the reporting to prove it.
Built for US physician groups and billing companies · Multi-tenant with per-client scoping
Every hand-off in the revenue cycle is a place money leaks. TrueRCM closes them by running the whole cycle in one place.
Scheduling with month, week, and day views. Check-in creates the billing visit automatically, and 270/271 eligibility runs before the patient is seen.
CPT/ICD charge entry with NCCI and MUE edits, fee schedules, and a box-level CMS-1500 editor with diagnosis pointers.
Blocking edits stop bad claims before submission. Every claim gets a 0–100 denial-risk score with cited reasons; overrides are audited.
Redundant clearinghouse rails with idempotent de-duplication. If the primary rail is down, claims fail over automatically.
Remits auto-post to matched claims with line-level allocation. Manual posting, lockbox import, reversals, and refunds are first-class.
Denials route by CARC/RARC code into resubmit, appeal, or remediate lanes — ranked by recoverable dollars so billers work the highest-value first.
AI drafts the narrative; every factual assertion is pulled from source records and citation-verified. A human attests before anything is sent, and overturns are tracked.
Statements with line detail, a configurable dunning ladder, payment plans, per-patient ledgers, and a bad-debt workflow.
The GA-18 report set with Excel/CSV/PDF export, scheduled email delivery, and KPI threshold alerts that page you before the trend becomes a problem.
Five stops from booked appointment to reconciled dollar.
The revenue cycle starts before the visit. TrueRCM verifies eligibility up front so ineligible visits never become denials.
Charges become claims, claims get scrubbed against blocking edits, scored for denial risk, and transmitted on redundant rails.
Every denial routes by CARC/RARC into the right lane. Appeal-eligible denials are ranked by recoverable value, drafted by AI, verified against source records, and attested by a human.
ERAs auto-post to matched claims; what doesn't match lands in a review queue instead of a black hole. Patient balances flow to statements, plans, and dunning automatically.
Eighteen reports cover A/R, denials, collections, payer mix, and productivity. Schedule any of them for email delivery, and set KPI alerts on the metrics you watch.
Healthcare billing is no place for a chatbot with write access. Every AI surface in TrueRCM is bounded, audited, and backed by a deterministic fallback — so automation never blocks your revenue.
AI writes the appeal prose under a signed BAA with zero data retention. Codes, amounts, and dates are pulled from your records — never generated — and a citation verifier blocks any mismatch before a human attests and sends.
"Check eligibility for tomorrow's visits." "How many claims are outstanding?" Velox parses trusted instructions only — content inside records can never become a command — and every action re-checks your permissions.
Agents run on tiered models with default-deny tool access and approval gates for anything irreversible. If the required model tier isn't available, the task routes to a human — it never silently downgrades.
HIPAA-aligned controls enforced in the database, not just the UI.
Tenant isolation enforced by PostgreSQL RLS — the app connects as a non-superuser role that physically cannot cross tenants.
Billing companies manage many client practices with per-client scoping inside each tenant.
TOTP, email, or SMS with recovery codes. Secrets stored encrypted; setup enforced at first login.
Granular permissions checked on every route and re-checked on every copilot action.
Logins, overrides, attestations, approvals, and admin changes land in an append-only audit log.
The only live AI vendor operates under a signed BAA with zero data retention, and prompts carry minimum-necessary facts.
The full cycle: claims, denials, appeals, payments, statements, reports, and the copilot.
Providers see their schedule, their patients, and their profile — without the billing noise.
Patients view appointments, visits, statements, and balances in one place.
Guided walkthroughs of every workflow — from first login to appeal attestations — that play like videos, captioned, with progress tracking. Free and public, so staff can train before their first login.
▶ Open the Training CenterBring one month of remits and we'll show you where the dollars are leaking — and how TrueRCM closes the gaps.