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Revenue Cycle Management
Automation

Decrease AR days, denial rate, and cost‑to‑collect with an interoperable RCM module. MindK offers audit‑ready revenue cycle management automation that integrates with your EHR/PM and clearinghouse.

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Results you can defend to finance

Reduce denials at the source, accelerate cash flow, lower cost‑to‑collect, and give patients a cleaner financial experience with automated RCM.

Higher clean‑claim rate

Catch issues upstream of 837 creation to raise the clean‑claim rate by 5–15%, depending on payer mix and existing edits.

Fewer A/R days

Streamline prior‑auth and reduce rework to raise first‑pass yield and shorten time to cash.

Lower cost‑to‑collect

Eliminate swivel‑chair tasks and route only valid exceptions to staff to lower the cost per claim.

Decreased write‑offs

Enforce payer contracts and attach medical‑necessity evidence to prevent avoidable losses.

Modular RCM automation

MindK aids healthcare companies in adopting modular automation, one capability at a time.

Eligibility and benefits verification

The cheapest denial is the one you never file. Verify eligibility and benefits before the visit, shifting coverage checks from day‑of‑service to pre‑service. We apply secondary‑coverage logic and cache benefits to reduce phone calls and last‑minute reschedules.

Real‑time 270/271 checks
Eligibility precheck
Benefits caching
Automatic coordination‑of‑benefits capture
Pre‑service financial estimates
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Charge capture, coding, and claim scrubbing

Stop sending fixable errors to payers. During claim creation, we apply CPT/HCPCS/ICD‑10 edits and payer‑specific logic. Our software uses NCCI, LCD, and NCD guidance to catch mismatches early. It increases first‑pass approvals and reduces resubmits, so coders spend time on true exceptions.

NCCI edit library
Context‑aware modifier logic
LCD/NCD coverage checks
Code‑set versioning
Pre‑submission 837P/837I validation
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Prior authorization automation

Decrease manual follow‑ups, speed up authorizations, and get fewer downstream denials. We normalize intake, check criteria, package the required documentation, and track status automatically. Whenever applicable, the team connects your software to payer APIs in line with CMS‑0057‑F.

Standardized PA intake
Auto‑assembly of clinical docs
Status polling via 276/277 and ePA/API
Prior‑auth work queues
Audit trail
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Denial & appeal management

Recover revenue with less effort per claim. MindK helps you ingest 835s, cluster denials by root cause, assemble medical‑necessity evidence from clinical notes, and generate payer‑specific appeal packages with clear SLAs. Your team spends less time per denial, while recoveries speed up.

835 parsing
Denial clustering
Auto‑drafted appeal letters
Deadline tracking with ticklers
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Patient financial experience

Make it easy for patients to understand and pay their bills. Eligibility‑informed estimates, friendly reminders, payment plans, and multiple payment rails decrease customer friction. You get higher patient‑pay conversion without pressuring the front‑desk staff.

Estimate generation
SMS/email reminders
Payment plans with autopay and retry logic
Multiple payment rails
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Payer contract compliance

Don’t leave money on the table. We model your contracts to calculate the expected allowed amount on each claim, flag underpayments, and assemble dispute packages automatically while keeping fees and edits centralized. That turns revenue leakage into predictable collections.

Contract modeling
Batch EOB reconciliation
Centralized fee schedule
Edit governance with version control
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Success stories

Explore recent case studies in healthcare RCM automation.

  • Background for

    Cloud-native application

    RCM module for a specialty EHR

    USA

    MindK developed a specialty EHR system with a built-in RCM module. The chart auto-suggests CPT/HCPCS codes and ICD-10s. The module cross-checks codes, modifiers, POS, and payer contract rules to ensure claim information is consistent with the care plan and clinical notes. After the final sign-off, clean 837P and a PDF are submitted to the clearinghouse in real time. Claim status updates feed back into the EMR dashboard, allowing users to track the claim status and reasons for denial.

    • AI-based denial appeal optimization.
    • Payer eligibility check.
    • Automated charge capture and coding.
    • Claim scrubbing and real-time submission.
  • Background for

    Covered

    Eligibility checks for private practices

    USA

    We developed a web platform that allows dieticians and mental health professionals to go in-network. The system handles patient intake, checks eligibility/benefits, credentialing, billing, and claim processing.

    • Patient portal integrated with EHR.
    • Visit scheduling automation.
    • 120+ health plans supported.
    • 1
    • 2

    Healthcare revenue cycle automation in 5 steps

    Get a pragmatic, auditable path from baseline to pilot and full-scale rollout with measurable Service-Level Objectives (SLO) and rollback plans.

    Discovery (1–3 weeks)

    MindK team maps your current KPIs, systems, payer mix, edits, and queues. We also sit with work queue owners to see the clicks between systems.

    What you get: KPI baseline, systems map, risk register to share with compliance.

    01

    Preparation (3–6 weeks)

    The next step covers workflow decomposition, data integration, security, and compliance. We design rules-based automation for deterministic payer edits. Meanwhile, machine learning can focus on denials clustering, intake normalization, and evidence assembly.

    What you get: integration spec, interface catalog, schema contracts, security plan, BAA‑ready controls, BPMN diagrams, automation backlog.

    02

    Pilot (6–10 weeks)

    We ship an RCM module with one or two end‑to‑end automations and dashboards. The team runs shadow mode on claims to validate scrubbing/edits and uses de-identified or synthetic PHI in non-prod. We compare pre-deployment baseline metrics to the pilot results for maximum transparency.

    What you get: A running pilot, SLOs, and measurable results (A/B or pre/post).

    03

    Scale‑out and hardening

    The team extends the revenue management solution to adjacent steps, specialties, and payers. They add observability, retries, idempotency, and cost controls as well as enforce backward-compatible schemas.

    What you get: production runbooks and on‑call playbooks that your team can own.

    04

    Continuous improvement

    Our team provides ongoing support and quarterly tune‑ups for as long as needed. These may include new rules and features, ML retraining, and guardrail refresh.

    What you get: Training assets, SOPs, RACI, a living roadmap, savings roll‑ups, and updated SLOs.

    05

    Compliance and security

    We build controls into day‑one architecture and tackle common risks of automated revenue cycle management.

    Data protection

    We minimize PHI, encrypt data in transit and at rest, and enforce least‑privilege IAM to keep exposure risk low.

    Audit logging

    MindK team maintains immutable audit trails and implements e‑signatures for regulated changes, so auditors get evidence without extra work.

    PHI de-identification

    Our company uses de‑identified or synthetic data in non‑production and review access regularly. This way, non‑prod remains safe by default.

    BAAs

    MindK operates under Business Associate Agreements and supports 42 CFR Part 2 (where applicable) to ensure the proper handling of your sensitive data.

    AI in RCM vs
    rules-based automation

    ML/Gen AI shines at high‑friction, unstructured work. We deploy AI where it demonstrably reduces denials, shortens time‑to‑cash, or lowers cost‑to‑collect, while keeping deterministic payer rules as your source of truth.

    Intake & document understanding

    AI classifies and extracts key fields from faxes/PNs, redacts PHI where needed, and routes low‑confidence items to humans.

    Prior authentication

    LLMs are great at summarizing clinical notes against payer criteria, assembling checklists and document packets, and calling ePA/API when available.

    Claim scrubbing

    The assistant suggests likely modifiers and coverage notes while learning from prior denials.

    Anomaly detection

    ML can spot short‑pays and outliers against modeled contracts, as well as surface dispute packages.

    Patient financial engagement

    AI can predict the best channel/timing and offer plans that increase payment likelihood without extra front‑desk load.

    Coding QA & audit

    The agent cross‑checks codes against clinical documentation and care plans, as well as flags contradictions before submission.

    Why MindK

    Get audit‑ready, payer‑savvy RCM automation that slots into your EHR/clearinghouse and proves ROI within the first pilot.

    Compliance by design

    Benefit from PHI minimization, least‑privilege IAM, encryption in transit/at rest, immutable audit trails, and e‑signed changes.

    01

    FHIR interoperable

    Our team is fluent in X12 (270/271/276/277/278/835/837), EHR/PM APIs, and clearinghouses.

    02

    Proof, not promises

    Get baselines and SLOs up front. Run a pilot in shadow mode behind feature flags and receive pre/post deltas you can take to finance.

    03

    Senior hands‑on, end‑to‑end

    MindK uses founder‑level oversight and senior engineers on every engagement with transparent communication.

    04

    What
    our
    clients
    say

    • Allison Erickson

      Allison Erickson

      Director of Product, The Lactation Network

      Allison Erickson

      Incredibly impressed by their ability to deliver such quality work in such efficient timing

      «I have nothing but great things to say about our partnership with MindK and the solid work they have done and continue to do for the growth of our company. Professionally, they are amazingly lovely people to work with. Our rapport is strong which is a reflection of their professionalism, hard work, and great outputs.»

    • Al Hariri

      Al Hariri

      Co-Founder, Vitagene
      USA

      Al Hariri

      Results-oriented and
      outcome-driven

      «I can tell you confidently that they are different from your regular agency that just wants to charge as much money for their work as they can get away with. MindK is completely results-oriented and outcome-driven.»

    • Jason Lutton

      Jason Lutton

      CEO, International Surrogacy Center

      Jason Lutton

      Impressed with their team's ability to understand our industry

      «MindK reduced the time a surrogate takes to complete an online application, increased the number of completed applications, and streamlined our intake process, resulting in fewer staff man hours needed to complete the backend processes for finalizing an applicant.»

      Our approach

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        Book a free 30-minute assessment

        We’ll identify 2–3 RCM automations worth piloting and deliver a budgetary plan in 5 business days.

        Complimentary services

        Explore the full range of services MindK provides to healthcare companies.

        FAQ

        • How is automation different from “adding AI”?

          Automation is the goal, AI is one of the tools. MindK uses rules for deterministic payer edits and apply ML/LLMs where the variance justifies it (e.g., denials clustering, document assembly).

        • What guardrails do you apply to AI in RCM?

          Our RCM automation company uses the following design principles as the guardrails:

          • Rules first, ML where it pays. Deterministic edits remain authoritative; LLM outputs require human approval for regulated changes.
          • Ground the model (RAG). Retrieve payer policies, contracts, LCD/NCDs, and SOPs to ground responses; no free‑text hallucinations.
          • Protect PHI. Use HIPAA‑eligible deployments under BAAs; encrypt in transit/at rest; use de‑identified/synthetic data in non‑prod.
          • Human‑in‑the‑loop. Confidence thresholds, exception queues, and e‑signature checkpoints for accountability.
          • Observe and control. Log prompts/responses, track accuracy/latency/cost, monitor drift, and keep rollback paths for every AI feature.

          Close the loop. Feed denial and appeal outcomes back into upstream rules and features to continuously improve.

        • Can you integrate with our EHR/PM and clearinghouse?

          Yes. We work with vendor APIs, X12/FHIR interfaces, and secure file exchanges. Write‑back depends on vendor permissions; we scope read‑only vs write early.

        • What about HIPAA, SOC 2, and BAAs?

          To comply with HIPAA, MindK builds PHI‑safe pipelines, uses least‑privilege IAM, encryption at rest/in transit, immutable logs, and e‑signatures on regulated changes. We provide a controls matrix suitable for BAAs.

        • How fast can we see results?

          Many teams see the first moved metric within the pilot window (6–10 weeks), often in clean‑claim rate or time‑to‑auth. Results depend on payer mix, data quality, and baseline edits.

        • What data do you need to start?

          Automation in revenue cycle management requires minimal exports, limited API access, and a sample set of claims/denials/appeals. We supply a secure import checklist.

        • How do you measure ROI of RCM automation?

          We agree on baselines and SLOs up front, then show pre/post deltas in dashboards. Savings roll‑ups are part of the deliverables.

          Book a free assessment

          Schedule a 30-minute meeting with our RCM team. We’ll map 2–3 high‑impact automations and a budgetary plan you can take to finance.

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