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Solution · Revenue Cycle Management

Medical billing automation that makes sure earned revenue arrives.

Simz automates the revenue cycle end to end, verifying eligibility up front, tracking every claim to payment, triaging denials into appeals, prioritizing AR worklists, and running patient balance sequences, with your billing team approving the work.

Verified up front→
Clean claim out→
Status tracked→
Denials worked→
Paid & posted
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Front to backone automation layer across the whole cycle
Zeroclaims left to age silently in a status queue
Every balancefollowed up, payer and patient alike
100%HIPAA-first: BAA, encryption, audit logs

The cost of this bottleneck

Days in AR is just the sum of every follow-up nobody had time for

Claims sit unstatused between touches, denials pile into worklists, and patient balances get one statement and then silence. None of it is hard work, it's just endless work, and endless is exactly what staff don't have time for:

Weeksadded to AR by claims aging silently between manual status checks
Written offthe balances and low-dollar denials that never get a second touch

…while the cash you already earned waits in someone else's system.

Claims age silently

Between submission and payment, claims sit, with status checked only when someone remembers.

Follow-up is all manual

Portals, hold music, and spreadsheets are the definition of work that shouldn't need a human.

Patient balances slip

One statement goes out, then silence, and the balance quietly becomes bad debt.

Denials outpace billers

Worklists grow faster than a team can research, draft, and file appeals.

No cycle-wide visibility

Days in AR, clean-claim rate, and collections by payer live in month-end reports, not in front of you.

BEFORE / AFTER

How it works today vs. with Simz

Front end
TODAY ·

Verified at check-in, if there's time

WITH SIMZ ·

Eligibility and auth automated days ahead, so claims go out clean the first time

Claim status
TODAY ·

Portal checks when someone gets to it

WITH SIMZ ·

Statuses checked automatically on cadence, with stalled claims flagged, not forgotten

Denials
TODAY ·

Worked oldest-first from a growing queue

WITH SIMZ ·

Triaged by value and winnability, appeal packets drafted for biller review, deadlines tracked

AR follow-up
TODAY ·

Spreadsheets and memory

WITH SIMZ ·

Prioritized worklists by payer, value, and age, so billers work the right accounts first

Patient balances
TODAY ·

A statement, then hope

WITH SIMZ ·

Sequenced reminders by text and email with payment links and plan follow-up, respectful and complete

HOW IT WORKS

The automation, step by step

01

Clean claims start at the front door

The eligibility and prior-auth engines verify coverage and authorization before service, preventing the denials and rejections that clog the back end.

02

Claim status on autopilot

Every submitted claim tracked through your clearinghouse on a set cadence, with stalled, rejected, and pended claims surfaced to worklists the day they stall.

03

Denials triaged and drafted

Denials captured with payer reasons, ranked by value and winnability, and turned into draft appeal packets for your billers to review and file.

04

AR worked by priority, not by age alone

Follow-up worklists ranked by dollar value, payer behavior, and deadline risk, so effort goes where recovery is.

05

Patient balances, followed through

Statements and reminders sequenced across text and email with payment links and payment-plan follow-up, ensuring every balance gets a complete, respectful sequence.

WHAT YOU GET

Front-end accuracy engine

Eligibility and auth automation feeding clean claims, because the cheapest denial is a prevented one.

Claim status automation

Claim status automation

Denial management

Capture, triage, draft, and deadline-track, providing the full workflow, biller-reviewed.

Prioritized AR worklists

Value- and risk-ranked follow-up, where recovery per biller-hour goes up.

Patient balance sequences

Multi-channel reminders, payment links, and plan follow-up that remain compliant and complete.

RCM analytics

Days in AR, clean-claim rate, denial trends, and collections by payer delivered live, not month-end.

We power your billers, not replace them: Automation does the status checks, triage, drafting, and outreach; your revenue cycle team, in-house or outsourced, keeps the judgment calls and the submissions. Recovery per biller-hour goes up; headcount pressure goes down.

Why we're confident

This engine is already running in production

The platform behind this solution is live today with a multi-site radiology group in Southern California, featuring a phased engagement covering AI intake, real-time eligibility, authorization tracking, a 24/7 phone agent, and analytics, all under one MSA, one BAA, and one HIPAA framework.

Powered by Simz Conversational, Simz Shift, and Simz Chron, with custom development for everything else.

  • BAA executed before any PHI moves
  • HIPAA-eligible infrastructure end to end
  • Human review on every uncertain AI decision
  • Role-based access with full audit logging
  • Works with your billing system and clearinghouse, not against them

FAQ

Revenue Cycle Management, answered

No, Simz is an automation layer that makes your existing revenue cycle operation faster, whether billing is in-house or outsourced. The automation does the status checks, assembly, prioritization, and outreach, while your billers and your billing system keep doing the judgment work and the submissions.

The follow-up-heavy parts where revenue leaks: front-end eligibility and authorization (so claims go out clean), automated claim status checks through your clearinghouse, denial triage and appeal assembly, prioritized AR worklists by value and age, and sequenced patient balance outreach with payment links.

Days in AR is mostly the sum of waiting: claims aging between status checks, denials sitting unworked, and balances getting one statement then silence. Automation removes the waiting, as statuses are checked on cadence, denials are triaged and drafted the day they arrive, and every balance gets a complete follow-up sequence. The cycle shortens because nothing sits.

Simz automates respectful, compliant patient balance outreach, including sequenced statements and reminders by text and email, payment links, and payment plan follow-up, rather than aggressive collections. It is designed to make paying easy and keep the patient relationship intact, with accounts that need escalation routing to your existing process.

Kill this bottleneck first.

Thirty minutes with your operations lead. We map how revenue cycle management works in your practice today, quantify what it's costing you, and hand you an automation roadmap. Whether or not you build it with us.

Book your auditBook your auditNo pitch deck. No obligation. Just a map of your busywork.