We compared eight AI tools for RCM automation by the revenue cycle stage each one takes off your staff: claim resubmission, autonomous coding, denials, patient billing and payer calls, which we cover in more depth in our guide to AI voice agents for healthcare RCM. For every tool, we also noted who finishes the cases its AI can’t, which EHR and PM systems it names, and how it’s priced.
TL; DRThe best AI tools for RCM automation depend on which stage of your revenue cycle uses the most staff hours. Claim resubmission and patient balances inside one payment platform – Waystar Inpatient coding and status checks tuned to a health system’s records – AKASA Agents plus an outsourced team for patient access and accounts receivable – Infinx Payer calls and portals for complex plans, inside your own software – MindK Autonomous coding for physician groups and outpatient volume – Fathom Autonomous coding for large health systems on Epic – CodaMetrix Denials and underpayments for specialty groups – Adonis Patient billing calls, texts, and payments – Cedar |
More than a third of health systems now use generative AI somewhere in the revenue cycle. PayZen and the Healthcare Financial Management Association (HFMA) asked more than 200 revenue leaders about it in May 2026. Among the health systems in that survey, 37% use generative AI in revenue cycle management (RCM), 48% of large systems do, and 45% apply AI to denials (Healthcare Finance News).
In practice, an RCM automation tool might code a chart from the physician’s note, resubmit a denied claim with a corrected field, or explain a balance to a patient on the phone. Each vendor covers some stages of the cycle. Staff or another tool still handle the rest.
The work that stays manual longest involves payers that answer only by phone or portal, such as self-funded employer plans. Billers still wait on hold for their benefits and claim status, and MindK builds its agents for that queue.
How We Compared AI Revenue Cycle Tools
On October 21, 2026, we went through each vendor’s product pages, press releases, and customer stories. For every tool, we recorded the revenue cycle stages it automates, who finishes the cases its AI can’t, which electronic health record (EHR) and practice management (PM) systems it names, and how it’s priced. Figures in this article are the vendors’ own unless we link a different source.
Where Revenue Cycle Work Still Lands on Staff
A revenue cycle runs through six stages. Each one has a manual step, and AI tools target those steps in different ways.
| Step | What staff do today | What tends to go wrong |
|---|---|---|
| 1. Intake and registration | Type demographics and insurance details from forms and cards | A wrong member ID turns into a denial weeks later |
| 2. Eligibility and benefits | Run electronic checks, then call or log in for benefit details | Self-funded plans leave specialty benefits blank, so the call queue grows |
| 3. Prior authorization | Look up payer rules, fill in forms, and check status | A payer asks for more records, and no one sees the request for days |
| 4. Coding and charge capture | Read the visit note and pick procedure (CPT) and diagnosis (ICD-10) codes | Coding backlogs hold claims, and missed charges never reach the payer |
| 5. Claims and denials | Work rejections, call for claim status, and file appeals | Denied claims age past the payer’s filing deadline |
| 6. Patient billing | Mail the statement and take the patient’s call about it | A confusing bill sits unpaid until someone phones the patient |
Take the chief operating officer of a behavioral health and physical therapy group with 30 locations that grew through acquisitions and bills about 40 payers. Her coders keep up with the charts. Her backlog sits in steps 2 and 5: benefit calls for self-funded plans before the first visit and claim status calls for the same plans six weeks later. A tool that only reads charts leaves both queues where they are.
We compared tools for the first three steps in separate guides to patient intake software, insurance eligibility verification software, and prior authorization software. This article covers platforms that span several stages and the tools for payer calls, coding, denials, and patient billing.
Best AI Tools for RCM Automation Compared
We ordered the tools by revenue cycle stage. Platforms that cover several stages come first, followed by payer calls, coding, denials, and patient billing.
| Tool | How it works | Best for | EHR/PM | Pricing |
|---|---|---|---|---|
| Waystar | AltitudeAI agents inside Waystar’s claims and payments platform | Health systems, physician groups, and billing services on Waystar | Waystar platform; supported systems listed on its site | Not published |
| AKASA | Generative AI models tuned to each health system’s records | Hospitals and health systems | EHRs through standards-based integrations | Not published |
| Infinx | AI agents plus RCM specialists who resolve exceptions | Specialty groups, surgery centers, and rural hospitals | 20 named systems, including Epic, athenahealth, and Raintree | From $5,000 a month on annual contracts |
| MindK | Voice and portal agents configured to your payers | Specialty practice networks and hospital systems with complex payers | Works inside your existing EHR and RCM systems | Not published; scoped per project |
| Fathom | Autonomous coding sent straight to billing | Physician groups, health systems, and RCM vendors | Epic Toolbox; athenahealth deployment | Quote on request |
| CodaMetrix | Autonomous coding from a full timeline of care | Large health systems and academic medical centers | Epic Toolbox approved | Not published |
| Adonis | Denial and underpayment detection with agents for payer follow-up | Physician groups and RCM services organizations | Epic, ModMed, NextGen, and payer portals | Not published |
| Cedar | Billing, payments, and Kora agents for patient calls and texts | Health systems and clinician services providers | Modular deployment with major EHRs | Not published |
Platforms That Cover Claims, Coding, and Patient Access
Each of these three sells modules for at least two stages under one contract.
1. Waystar: Altitude AI Agents for Denied Claims
Waystar (Nasdaq: WAY) sells healthcare payment software to more than 30,000 clients. On August 26, 2026, Waystar launched AltitudeAI agents that read the payer’s reason for a rejection or denial and resubmit the claims that qualify.
Waystar reports more than 7.5 billion transactions a year across about 60% of US patients, which gives its AI revenue cycle management agents a long record of how each payer responds. The August release also added agents for clinical documentation review, analytics questions in plain English, and patient balance questions.
| Best for | Health systems, physician groups, and billing services that already send claims through Waystar |
| Automation scope | Claim resubmission, clinical documentation review, analytics questions, and patient balance guidance |
| Integrations | Waystar platform; supported systems listed on its site |
| Pricing | Not published |
The agents work on claims that run through Waystar, so a group on another clearinghouse would need to switch to use them. Waystar calls autonomous claim resubmission an industry first, so ask which payers and denial reasons it covers today. Waystar’s authorization tools appear in our prior authorization guide.
2. AKASA: Generative AI Trained on Each Health System’s Records
AKASA builds generative AI for hospital and health system revenue cycles. It has trained its models on 57 million clinical documents, by its count, and tunes a version for each health system on that system’s own records. An in-house team of RCM experts, with an average of 15+ years in the industry, guides the models and can take whole workflows off a client’s staff.
Its newest product codes inpatient encounters autonomously and shows the evidence behind each code, and the health system sets the threshold for which cases skip a coder. Separate tools check authorization and claim status automatically. That mix places AKASA’s version of AI in RCM in the middle of the cycle, where hospital coding and clinical documentation integrity (CDI) teams work.
| Best for | Hospitals and health systems with large inpatient coding and CDI workloads |
| Automation scope | Autonomous inpatient coding, coding and CDI review, authorization status, and claim status |
| Integrations | EHRs through standards-based integrations |
| Pricing | Not published |
AKASA builds for hospitals. A physician group that bills professional claims and needs payer calls will find more of that work covered by other tools in this list.
3. Infinx: AI Agents Backed by an Outsourced RCM Team
Infinx pairs AI agents with its own RCM specialists. The agents run routine payer and portal steps 24/7, and Infinx specialists pick up the cases the agents flag. The platform connects to 2,800+ payers and 20 named EHR, PM, lab, and radiology systems.
The three case studies Infinx features first come from physical therapy and rehab providers. In one, a physical therapy provider automated 100K+ eligibility cases in 60 days. Among the AI RCM companies in this list, Infinx is the only one that publishes a starting price, $5,000 a month on an annual contract.
| Best for | Physical therapy, rehab, radiology, and lab groups that want software and staff from one vendor |
| Automation scope | Catalog agents for eligibility checks in Availity, eviCore and UnitedHealthcare authorizations, claim status follow-up, and payment posting |
| Integrations | Epic, athenahealth, eClinicalWorks, ModMed, Raintree, and 15 other named systems |
| Pricing | From $5,000 a month on annual contracts |
Infinx also sells full revenue cycle outsourcing, which suits a group short on billers more than one that wants to keep billing in-house. In a pilot, ask for the split between cases the agents closed and cases Infinx staff closed.
Payer Phone and Portal Work
Payer phone and portal work comes up in benefits verification, authorization follow-up, and claim status. Prosper AI, SuperDial, and Infinitus also call payers, and we compared them in our guide to AI voice agents for healthcare RCM.
4. MindK: Payer Communication Automation for Complex Payers
MindK’s agents handle the payer side of benefits, authorization, and claim status work, including self-funded plans and payers with long interactive voice response (IVR) menus. Before launch, MindK sets retry and escalation rules for each payer on the client’s roster. An agent stays on a case until it has an answer and enters the result in your RCM system, where your billers already look for it.
MindK’s verification of benefits (VoB) agent starts about 80% ready, and MindK builds the other 20% around each client’s payers and fields. A completed call through the AI voice agent returns the plan’s network status, deductible balance, and the rep’s reference number. On the patient side, MindK’s Patient Intake agent takes a new patient from the first call to a booked visit. All of it runs as middleware inside your current software.
| Best for | Specialty groups with 10+ locations and community hospital systems; agents adapt to each specialty’s payer rules (physical therapy and rehab, behavioral health, orthopedics and pain management, cardiology, gastroenterology, and others) |
| Automation scope | VoB, eligibility, authorization follow-up, claim status, and patient intake calls; payer portal agents for status checks and retrieval |
| Integrations | Middleware inside your EHR and PM systems; prior work with Epic, Oracle Health, eClinicalWorks, MEDITECH, and Veradigm |
| Pricing | Not published; scoped per project |
MindK runs the same agents in GoodBilling, MindK’s own RCM product for US medical practices, which handles eligibility, benefits verification, and claims for the practices it serves. GoodBilling sends third-party models only depersonalized data. Its anonymizer removes protected health information (PHI) first, and GoodBilling matches the answer back to the patient on its own AWS infrastructure.
MindK automates the communication around a decision. It doesn’t decide medical necessity, and following up on a denial is a different job from writing a clinical appeal. If a packaged product already covers 90–95% of a workflow and the remaining exceptions cost little, MindK’s configuration work won’t pay off. Small practices that need one simple agent, or buyers who want a self-serve subscription, will do better with a packaged product such as Prosper AI.
Autonomous Medical Coding
These two read clinical documentation and send codes to billing without a coder touching every chart.
5. Fathom: Coding Straight to Billing Across Service Lines
Fathom’s homepage lists 3K+ provider sites, 63M+ encounters, and 5K+ providers. Health systems use it for facility and professional coding, and health plans use it for retrospective risk-adjustment coding.
Your Health, a senior-focused care group, switched on Fathom for every service line at once through athenahealth’s Data View. According to Fathom, Your Health reached a 95.5% automation rate at 98.3% accuracy. Buyers comparing AI medical coding software for Epic can also find Fathom in Epic’s Toolbox program.
| Best for | Physician groups and health systems with high outpatient and professional coding volume |
| Coding scope | Facility and professional fee coding, evaluation and management (E/M) levels, audits of coder work, and hierarchical condition category (HCC) capture for health plans |
| Integrations | Epic Toolbox; athenahealth (Your Health deployment) |
| Pricing | Quote on request |
Ask Fathom for its automation rate by specialty on a sample of your own charts, and for how many of those charts would still land with your coders.
6. CodaMetrix: Autonomous Coding From the Full Record of Care
CodaMetrix’s CMX CARE codes for academic health systems, Mayo Clinic and Cedars-Sinai among them. It looks at the whole stay, so a surgery and the visits after it share one coding context.
In February 2026, KLAS gave CodaMetrix its Best in KLAS award for autonomous coding (score 90.7). Epic lists it in Toolbox.
| Best for | Large health systems and academic medical centers on Epic |
| Coding scope | Radiology and pathology reads, endoscopy and surgery cases, inpatient professional fees |
| Integrations | Epic Toolbox; coders keep working in Epic |
| Pricing | Not published |
CodaMetrix builds for enterprise health systems on Epic. A specialty network on athenahealth will find a published deployment on that EHR with Fathom.
Denial and Underpayment Recovery
Denial tools compare what payers paid with what they should have paid and send agents after the difference. Our claim denials guide covers seven frequent causes.
7. Adonis: Denial and Underpayment Agents for Specialty Groups
Adonis estimates what each claim should pay and shows the gap when a payer pays less, denies, or goes quiet. Its agents check appeal status and timely filing with payers and post the answer to the PM system.
Specialty groups appear across its customer stories. Fox Valley Orthopedics cut its denial rate by 25% in year one. ApolloMD’s chief operating officer credits Adonis’s AI denial management agents with 1,000+ staff hours saved a month, and Allied Digestive Health’s chief financial officer cites a 4.5x return in the first year.
| Best for | Orthopedic, gastroenterology, emergency medicine, and behavioral health groups, plus RCM service companies |
| Denial scope | Underpayments, denials, stalled claims, and appeal follow-up |
| Integrations | Epic, ModMed, NextGen, and payer portals |
| Pricing | Not published |
Adonis works after the claim goes out. The front-end errors behind many denials, such as missed benefits or authorizations, need a tool earlier in the cycle.
Patient Billing and Payments
The patient balance comes last in the cycle. This vendor automates statements, payments, and billing conversations.
8. Cedar: Billing Calls and Payments With Kora Agents
Allina Health and Talkiatry send their patient bills through Cedar. Its Kora agents answer billing calls and texts, from a missing insurance card to a Medicaid application.
Kora has taken 600K+ billing calls so far in English and Spanish, by Cedar’s count.
| Best for | Health systems and physician groups with large patient balances |
| Billing scope | Patient statements and payments, plus Medicaid and Affordable Care Act (ACA) enrollment |
| Integrations | Runs next to your EHR and phone system |
| Pricing | Not published |
Cedar works on the patient side of the bill. Kora’s page describes patient conversations only, so payer follow-up stays with another tool.
How to Choose AI Tools for RCM Automation
Log a week of your team’s hours by revenue cycle stage before you book demos. The stage with the most hours tells you which group above to shortlist. Then ask each vendor these questions.
| Question for the vendor | Why it matters |
|---|---|
| Which steps does the AI complete, and which come back to my staff? | Vendors use “autonomous” for anything from a suggested code to a resubmitted claim. |
| Can we run the pilot on our ten highest-volume payers? | A demo on the vendor’s chosen payers says little about a self-funded plan or a delegated review vendor on your roster. |
| Can we see a sample record from a live client? | Any field left empty there is one your team types in later. |
| Does PHI reach an outside AI model? | If it does, ask for a business associate agreement (BAA) that covers each model. A tool that strips PHI before the model call needs fewer of them. |
| How do you price the work? | Convert every quote to cost per completed case before you compare. |
FAQ: AI and the Revenue Cycle
How can AI help the revenue cycle?
It takes over repeat tasks with clear rules. Fathom reports a 95.5% automation rate at Your Health, Waystar’s agents resubmit denied claims that qualify, and Cedar’s Kora has handled 600K+ patient billing calls. In the PayZen and HFMA survey, 45% of health systems used AI on denials.
Is AI replacing medical billing?
No. The vendors in this list keep a human queue. Fathom sends low-confidence charts to coders, and Kora transfers patients who ask for a person. Billers then spend their day on those exceptions and on appeals. A clinical appeal still needs a clinician’s argument.
What are some AI companies that offer revenue cycle management solutions?
Waystar, AKASA, and Infinx sell modules for more than one stage. MindK’s agents call payers and work portals from inside your current software, and MindK also builds custom RCM solutions for groups that want to own the workflow. Fathom and CodaMetrix sell only coding, Adonis goes after denials and short payments, and Cedar collects from patients. Firms that offer RCM software development services appear in a separate comparison.
