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HiPaaS RCM AI Platform 

Increase Efficiency with AI Powered HiPaaS RCM Platform

  • Use AI to make RCM process efficient - tasks and workqueues
  • Predict over 10 revenue indicators before submitting claims
  • Use Generative AI to manage denials 
  • Integrated with Epic

Request 30 mins demo to check how AI can help


Savings using AI and Automation

  • Save time in manual work - use AI to make RCM process efficient - tasks and work queues
  • Save time on coding - use AI to predict medical codes and patterns
  • Manage Revenue Smartly - Predict over 10 revenue indicators before submitting claims
  • Gain Insights - Use Generative AI to manage denials 
  • Increase revenue - focus on high performing procedures and insurances
  • Gain revenue - process unpaid claims and retro claims
  • Integrated with Epic and leading EHR/RCM

Effectively optimize your cash flow and revenue.

Our AI model predicts the timing of payments for claims and procedure codes, offering valuable insights into aging across different insurance companies to assist in network planning. Gain a comprehensive understanding of top-quality measures that influence revenue.


Optimize Return on Investment (ROI) in patient care

Our AI models analyze and identify financially high-performing procedures, predicting quicker payments and forecasting revenue from patient payments and self-pays. Additionally, our models pinpoint high-dollar procedures and predict which patients' self-pay contributions will be higher, allowing you to understand and prioritize top patients with the highest Return on Investment (ROI).

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Leverage Generative AI to gain a deeper understanding of denials

Our generative AI model provides detailed explanation about rejections and denials. We also predict denials before they happen. Our model also warns which procedures will need prior authorization before submitting

Enhance revenue by aligning and reconciling invoices, electronic remittance advice (ERA), treasury records, and lockbox transactions.
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Start Results Driven Trial


AI Flat Fee
  • Pay monthly flat feee to use our dashboard and AI analytics

  • Manage your revenue forecasts

  • Continue using your existing RCM service


Medical Billing Service
  • Let us manage your Medical Billing and/or posting

  • Work on US hours

  • We work with insurance companies

  • Any size of practice or Medical Group or small Hospital


RCM / Medical Billing Service
  • Dedicated team and infrastructure

  • Guaranteed operational SLA

  • Custom requirements based on your RCM

  • Complete RCM functionality 

  • Good for Hospitals and large groups

What we (HiPaaS) provide

  • Efficient Operations: HIPAAS provides robust framework comprising of individuals and technology to reduce administrative burdens and allows healthcare providers to focus more on patient care and operational efficiency. Our tools are integrated with EPIC and save cost of resources and operations.

  • Data-driven decision-making: HiPaaS tools analyzed valuable data to identify areas for improvement, cost-saving opportunities, and strategies for enhancing the overall financial performance of the healthcare organization.​

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​​HIPAAS RCM Key Components:

  • Eligibility Verification: Verifying eligibility is a vital step within the healthcare sector, involving the confirmation of a patient's insurance coverage and assessing their qualification for medical treatments or procedures. HIPAAS ensures that healthcare providers receive proper reimbursement for the care they deliver.

  • Prior Authorization: Submitting Prior authorization with all required data and reports is crucial. We follow up with insurance companies on additional queries and requests. Our goal is to get prior auth approvals

  • Accurate Coding and Documentation: The crucial procedures of coding and documentation in healthcare encompass the translating patient encounters, diagnoses, and treatments into standardized codes. These codes are used for various purposes, such as billing, insurance claims, medical research, and quality reporting. HIPAAS proper codification techniques and documentation ensures the healthcare providers are appropriately reimbursed, and the patient care is well-documented.

  • Precise Claims Generation: The generation of claims is a crucial stage. HIPAAS crafts detailed medical claims that outline the services rendered to a patient by a healthcare provider and then submitted to insurance payers for reimbursement.

  • Timely Claims Submission: Submitting claims is a pivotal stage in the healthcare RCM process. ensures precise and prompt claims submission there by guaranteeing that healthcare providers receive appropriate reimbursement.

  • Efficient Denials Management: HIPAAS Denials management is systematic approach of recognizing, resolving, and minimizing claim denials, aiming to secure the maximum reimbursement for healthcare providers' services.

  • Precision and Effectiveness in Patient Billing and Collections: HIPAAS again ensures Precision and effectiveness in patient billing and collections to guarantee that healthcare providers obtain proper compensation for their services, all the while nurturing positive patient connections.

  • Precise Payment Posting and Reconciliation: HIPAAS team makes sure proper documentation of received payments from diverse channels, such as insurance firms and patients and reconciles the same with claims, there by securing healthcare providers receive appropriate reimbursement. We reconcile claims, claims payments, ERA, EOB and even match to Treasury files and Lockbox files. This ensures the A/R Accuracy.

  • Patient Responsibility: As part of payment posting we also assign patient responsibility and communicate to collect the required payments via your payment team or collection team

What problems we (HiPaaS) are trying to solve

Retro and unpaid claims revenue :

We have helped practices to resubmit retro and historical unpaid claims with right fixes to increase revenue.

Billing errors:

Reducing billing errors that can lead to claim denials, delays in payments, and potential compliance issues.

Cash flow challenges:

Our AI tools focus on reconciling claims, ERA and Treasury and help to keep the payments timely. Addresses the issue of delayed or reduced payments, ensuring a steady cash flow to support the ongoing operational and financial needs of the healthcare facility.

Administrative inefficiencies:

To streamline administrative tasks related to billing and reimbursement, reducing the administrative burden.

Compliance risks:

By ensuring that the billing and documentation processes adhere to the constantly evolving regulatory requirements and standards in the healthcare industry.

Patient dissatisfaction:

HIPAAS contributes to a more transparent billing process, leading to improved patient satisfaction and trust in the healthcare provider.


Operational inefficiencies:

HIPAAS helps in identifying and addressing operational inefficiencies, thereby improving the overall financial performance and sustainability of the healthcare organization.

HIPAAS Differentiator

  • Maximizing Revenue: It encompasses various strategies and processes aimed at increasing revenue and minimizing financial losses. It involves timely claims submission, accurate eligibility verification processes, pre-authorization requirements, timely follow up on claims & appeal, implementing a collections & appeal process for outstanding insurance balances, our customer have seen 20-30 % increase in revenue for their outstanding balance.


  • Compliance: HIPAAS proper management of the revenue cycle ensures that the healthcare facility remains compliant with the complex and ever-evolving regulatory requirements related to billing and reimbursement in the healthcare industry.


  • Accurate coding and documentation Techniques:  Accurate coding and documentation is what HiPaaS is different from others.


  • AI Tools: Wherever possible HiPaaS uses AI Tools


  • Working in US Time Zone: HiPaaS supports its clients by working in their time zone.

  • Low cost :  Low cost is another differentiator HiPaaS has to showcase.

We have experience with various specialities domains

  • We support all sizes of medical providers. With our large offshore team, we can scale up or scale in specific areas. We offer services on dedicated hourly billing team or % on paid claims

  • We support various specialty Domains, Internal Medicines, Pediatrics, Obstetrics and Gynecology, Otolaryngology (ENT), Gastroenterology, Allergy and Immunology, Radiology, Dental, Durable medical equipment (DME), Psychiatry and Psychology, eye care and others.

We have experience with various EHR and RCM tools

  • Epic - HiPaaS RCM is integrated with Epic workflows be able to use outside of Epic.

  • eClinicalWorks

  • Change Healthcare

  • CureMD

  • Athenahealth

  • Optum360

  • McKesson

  • Availity / TriZetto

  • Waystar / Glace EMR / Brightree

  • pMD

  • Healthnautica

  • Kareo

  • AdvancedMD

  • ipatientCare

  • Practice Fusion

  • Point Click Care (PCC) and others

Integrated with Epic EHR

  • HiPaaS Payment Posting is integrated with Epic EHR for receiving claims, posting payments and other RCM activities

  • All RCM required Epic interfaces are inbuilt in our tool

  • We use Graph Database to match claims to ERA, claims corrections, claims submission and payment posting

  • HiPaaS tool provides work queues for managing the work load, assignments and manual corrections

  • With our tool the operational staff gets reports and visibility that your hospital needs and not available in Epic

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