sales@signitysolutions.com USA : +1-619-309-4653

About the AI Solution

As revenue inefficiencies compounded across claims, AR, and payer workflows, the healthcare organization needed a partner offering the best AI healthcare development services to build a unified solution. They chose Signity, and we delivered RCM.ai, transforming revenue cycle management from reactive recovery to proactive optimization.

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Fewer claim denials

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Less manual claim review

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Faster AR turnaround

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Higher claim acceptance

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Quicker denial resolution

What We Delivered?

AI-Driven Revenue Cycle Management Platform

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Automated Claim Prediction

RCM.ai applies AI in revenue cycle management to score claims for rejection risk before submission, enabling teams to fix issues early and improve first-pass acceptance.

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Intelligent Claim Scrubbing

We developed a dynamic claim scrubbing layer that learns from payer responses, continuously reducing preventable errors and improving claim accuracy across billing workflows.

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Claim Denial
Intelligence

RCM.ai identifies denial patterns by payer, procedure, provider, and location, enabling targeted corrective actions and long-term improvements in reimbursement performance.

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AR Optimization
Engine

An AI-based prioritization model ranks accounts receivable by recovery probability, claim value, and aging, ensuring revenue teams focus on the highest-impact follow-ups.

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Revenue Forecast Insights

We delivered intelligence dashboards that transform historical and live billing data into real-time, actionable forecasts, improving visibility for cash flow and reimbursement timelines.

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Workflow Automation Hub

RCM.ai automates repetitive RCM tasks, such as eligibility validation and claim tagging, reducing manual workload while allowing teams to focus on complex exceptions.

1-Feb-18-2026-11-36-48-6134-AM

Denial Risk Prevention

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Challenge

The healthcare organization faced frequent claim denials caused by eligibility gaps, coding mismatches, and late error detection.

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Solution

RCM.ai was designed with a predictive claim risk engine trained on historical denial data and payer-specific billing logic. Each claim was evaluated before submission, highlighting risk indicators and guiding billing teams to resolve issues early.

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Impact

Preventable claim denials dropped by 41% across billing cycles.

Claim Review Optimization

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Challenge

Billing teams spent significant time reviewing low-risk claims, slowing submission velocity and increasing administrative load.

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Solution

We introduced AI-driven scoring to automatically clear clean claims while routing only complex exceptions for manual review. This balanced automation with human oversight without compromising accuracy or compliance.

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Impact

Manual claim review effort was reduced by 52%, improving submission turnaround.

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Proactive Denial Intelligence

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Challenge

Denial trends were identified too late, limiting the organization’s ability to prevent recurring reimbursement issues.

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Solution

RCM.ai continuously analyzed denial signals across payers, providers, and procedures to surface systemic patterns early. The platform enabled revenue teams to act on insights before financial impact escalated.

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Impact

Denial resolution cycles became 36% faster across major payers.

AR Recovery Prioritization

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Challenge

Accounts receivable teams followed static worklists without clarity on recovery probability or revenue impact.

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Solution

We implemented an AI-based prioritization model that ranked claims by aging, value, and likelihood of recovery. Routine follow-ups were automated, while high-impact claims received immediate attention.

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Impact

Days in accounts receivable improved by 21% across locations.

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Technologies

Tech Stack Powering RCM

A focused, healthcare-ready architecture built to support AI-driven revenue cycle management at scale.

Programming Language
Python | TypeScript
Backend Frameworks
FastAPI | Node.js
AI & ML Models
GPT-based orchestration | custom claim-risk prediction models
NLP & RAG
Transformer-based NLP | retrieval-augmented generation for payer rules and denial intelligence
Backend Framework
PostgreSQL | MySQL
Vector Database
Pinecone
Cloud Infrastructure
AWS EC2 | S3 | RDS

Why Choose Us to Build AI Revenue Cycle Management

Healthcare-First AI

We build AI systems grounded in real healthcare revenue workflows, payer rules, and compliance requirements, not generic automation experiments.

RCM Domain Depth

Our teams understand claims, denials, AR, and reimbursements deeply, enabling faster alignment between AI models and real-world billing operations.

Proven AI Engineering

Top-tier AI engineers experienced in building production-grade platforms that handle high-volume healthcare data with accuracy, reliability, and scale.

Compliance-Ready Design

Every solution is built with HIPAA-aligned security, access controls, and auditability to meet expectations for healthcare data protection.

Seamless System Fit

We integrate AI directly into existing EHR, billing, and clearinghouse systems without disrupting established revenue cycle workflows.

Outcome-Led Delivery

Each engagement is measured against tangible RCM outcomes like denial reduction, faster reimbursements, and improved revenue predictability.

Build a Smarter, AI-Driven Revenue Cycle

We partner with healthcare organizations to create intelligent RCM platforms that improve accuracy, efficiency, and financial visibility.

Consult Our AI Healthcare Team

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