Modern Healthcare Claims and Risk Management Solutions
Modernize your healthcare claims management workflows with automation that prevents denials, reduces risk, and accelerates reimbursement.
Trusted by the best in the industry
Proactive Claim Validation at the Source
- Validates all submitted data against CMS and payer-specific rules
- Applies built-in edits to flag invalid insurance details, provider IDs, and service codes
- Aligns every claim with eligibility, authorization, and modifier policies in real time
Risk Management Built Into the Claim Lifecycle
- Flags high-risk claims using AI-based denial prediction and historical trends
- Auto-escalates documentation gaps or coding issues for resolution before submission
- Minimizes audit exposure and clawbacks with compliance-first validation logic
Automated Claim Workflows That Scale
- Auto-generates claims directly from EHR notes and charge entries
- Syncs in real time with clearinghouses and payer systems for seamless submission
- Reduces manual work between coding, billing, and compliance teams
End-to-End Claim Lifecycle Optimization
Unified Claims Engine for Submission, Validation, and Tracking
RapidClaims transforms provider documentation into fully validated, payer-ready claims. Every submission is scrubbed against CMS and commercial payer rules before it hits the clearinghouse.
- Applies charge-level validation during claim generation
- Supports both institutional (837I) and professional (837P) formats
- Eliminates manual bottlenecks between coding, billing, and compliance teams
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Smart Telehealth and Multi-Channel Billing Compliance
Stay audit-ready across in-person, virtual, and hybrid encounters with real-time billing logic and edit intelligence.
- Validates telehealth-specific time codes, POS modifiers, and service limitations
- Flags unsupported services or missing documentation at the point of coding
- Automatically applies CMS, NCCI, and payer-specific edits before submission
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Real-Time Claim Monitoring and Bottleneck Detection
Gain real-time visibility into claim progress, payment delays, and operational risks—before they affect revenue.
- Tracks each claim’s progression across systems and clearinghouses
- Detects TFL slowdowns and escalation points across departments
- Surfaces high-risk claims using denial trend analytics and AI scoring
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What Sets Us Apart
Built for Claims Management in Healthcare, Not Just Billing
- Handles high-volume, multi-location provider claims with ease
- Aligns with all CMS edits, payer requirements, and LCD or NCD logic
- Enables real-time edits, cross-checks, and validation before clearinghouse submission
Proven Performance Across the Revenue Cycle
- 99.4% clean claim rate on average within 30 days
- Up to 48% faster claim resolution
- Cuts denial rework effort by up to 60%
Enterprise-Grade Security and Connectivity
- HIPAA and SOC 2 Type II certified
- Seamless integrations with Epic, Cerner, Athena, and eClinicalWorks via HL7 or FHIR
- Role-based access, full audit logs, and end-to-end encryption ensure compliance and traceability
Results You Can Trust
RapidClaims delivered what other vendors only promised. We've seen a 30% reduction in AR days within one quarter, unlocking $2.5M in accelerated cash flow. Their platform adapts to our specific workflows instead of forcing us to change our processes.
CFO, Major Health System
$2.5M
Accelerated cash flow
30%
Reduction in AR days
"With RapidClaims, we're maximizing our limited resources while improving revenue capture by 5%. Our team now spends more time on patient care and less on administrative tasks."
Director HIM, Federally Qualified Health Center
5%
↑ increased revenue
40%
Reduction in coding and billing costs
RapidRisk transformed our value-based care documentation, improving RAF by 15% and reducing documentation gaps by 22%. This directly impacts our shared savings and quality metrics.
Medical Director, Leading Accountable Care Organization
15%
↑ RAF
45%
New conditions identified
Our clean claim rate jumped from 92% to 99% with a 96% first pass yield rate. With RapidClaims, we improved the productivity of our coding staff by 100%. Our team only focuses on complex cases that require human expertise.
VP Revenue Cycle, Multi-Specialty Physician Group
27%
Reduction in claim denials
70%
Reduction in cost to collect
Take Control of Claim Accuracy, Timelines, and Reimbursement Risk — Without Manual Chasing.
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Transform Your Revenue Cycle in 30 Days or Less
Join leading healthcare organizations already seeing results with RapidClaims.
