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Full-Spectrum RCM

Services for Every
RCM Challenge

Whether you need full outsourcing or targeted help, RevMaxPro delivers specialist services backed by AI intelligence and measurable outcomes.

Healthcare AR Management & Small Balance RecoveryUnderpayment & Payment Variance RecoveryMedical Coding, CDI & Coding AuditsDenial Management & Prior AuthorizationsInsurance Discovery & Eligibility Verification
AR & Collections

AR Management &
Small Balance Recovery

AI-prioritized worklists surface the right accounts at the right time. Automated follow-up handles the volume; experts handle the complexity.

βœ“AI-driven account prioritization and worklist management
βœ“Automated payer follow-up via AI call agents and web bots
βœ“EDI 276/277 claim status & 835 remittance processing
βœ“Small balance automation β€” fully touchless recovery
βœ“Underpayment identification and appeal management
βœ“Real-time AR aging dashboards and trend analytics
AR Performance Metrics
28dAvg AR Days
94%Collection Rate
$1B+Total Revenue Recovered for Clients
Payment Variance Recovery

Zero Balance, Underpayments
& ED Downgrades

Many hospitals leave significant revenue on the table through contractual underpayments, incorrectly zeroed accounts, and emergency department payment downgrades. RevMaxPro recovers what you've already earned.

βœ“Zero balance account review β€” identify incorrectly written-off claims
βœ“Systematic contractual underpayment identification and appeal
βœ“ED payment downgrade analysis β€” recover improperly reduced E&M levels
βœ“Payer contract compliance auditing against actual remittances
βœ“AI-driven variance detection across thousands of accounts simultaneously
βœ“Retroactive recovery with root cause prevention going forward
Payment Variance Results
$2M+Avg Annual Recovery Per Client
AIAutomated Variance Detection
3 TypesZero Balance Β· Underpayments Β· ED Downgrades
Coding & CDI Performance
97%Coding Accuracy
48hrAvg Turnaround
100%AHIMA / AAPC Certified Coders
Coding & CDI

Medical Coding, CDI &
Coding Audits

Certified coders for all specialties, concurrent CDI programs, and comprehensive audits that capture proper APRDRG, SOI, and ROM assignment.

βœ“Inpatient, outpatient, ED and professional coding
βœ“APRDRG, ICD-10, CPT, HCPCS expertise
βœ“Concurrent CDI with physician query management
βœ“Retrospective audits with variance analysis & education
βœ“HCC risk adjustment coding for value-based care
Denials & Auth

Denials Management &
Prior Authorizations

End-to-end denial prevention and resolution β€” including clinical denials β€” plus AI-powered authorization management to stop revenue leakage before it starts.

βœ“Clinical denial management with physician advisor support
βœ“Medical necessity appeals and peer-to-peer coordination
βœ“Root cause analytics to prevent recurring denials
βœ“AI call agents for real-time auth submission and tracking
βœ“Payer portal automation via AI web bots
βœ“EDI 278 auth transaction processing
Denials & Auth Results
65%Auth Denial Reduction
72hrDenial Turnaround
3.2%Average Client Denial Rate
Insurance Discovery Results
40%Self-Pay Conversion
EDI270/271 Eligibility
AIPowered Discovery Engine
Insurance Discovery

Insurance Discovery &
Eligibility Verification

Convert self-pay accounts to billable revenue using AI-powered discovery β€” and eliminate eligibility denials with real-time verification.

βœ“AI-driven hidden coverage discovery on self-pay accounts
βœ“Real-time eligibility verification via EDI 270/271
βœ“Benefits investigation and plan detail verification
βœ“Medicaid eligibility screening and enrollment support
βœ“Coordination of benefits verification

Let's Build Your Custom RCM Strategy