AI Agents for Medical Billing Automation | Achieve 100% Clean Claims
Transcure steps into the future of RCM automation with intelligent AI agents. They handle prior authorizations, denials, and other repetitive billing tasks, driving up collections by 20%.
- AI-Powered Claim Submissions.
- Minimal Errors.
- Maximum Reimbursements.
Which AI Agents Has Transcure Built to Automate Every Step of RCM?
Our developers, in collaboration with medical billing experts, have built 7 AI agents to automate repetitive RCM tasks. With these agents, we improve accuracy and maximize revenue while your team focuses on patient care.
ELIXA
This AI agent instantly verifies patient eligibility and insurance coverage in real time, eliminating manual checks. It reduces claim rejections and ensures every claim is submitted with accurate patient data.
PRIA
It accelerates prior-authorization approvals by automating submissions and payer follow-ups. This automation tool minimizes delay and facilitates faster patient care through its authorization tracking.
CODIN
Our team uses this AI agent to ensure coding accuracy using AI-driven algorithms and compliance rules. It uses up-to-date CPT/ICD-10 usage and optimizes payments through precise code selection.
CLAIR
Transcure has built this RCM automation tool to handle claim scrubbing, creation, and submission. This AI agent detects errors before submission and delivers cleaner claims for faster reimbursements.
DEXA
With this billing AI agent, identify denial trends, automate appeal generation, and prevent repeat denials. It learns from past payer responses to improve future claim success rates and revenue recovery.
ARIS
Using this AI healthcare solution, automate A/R follow-up communication with payers to handle claims. This AI RCM agent shortens payment cycles and prevents revenue leakage effortlessly.
REMITA
This AI agent automates payment posting, reconciles remittances, and detects discrepancies instantly. With this medical billing automation tool, you can get real-time financial visibility for your practice.
Why Do Practices Need AI RCM Agents to Automate Billing?
Healthcare professionals need an automated billing system to bypass manual tasks and delayed payments. Here is why you need our AI agents:
Claim Denials and Rejections
Up to 30% of claims face denial due to manual errors. AI agents provide real-time verification and clean submissions for faster collection.
Time-Consuming Prior Authorizations
Staff spend over 14 hours weekly on authorizations. Automation will cut approval times by 60% and improve patient satisfaction.
Coding Errors and Compliance Issues
Manual coding causes 63% of denials. With AI agents, we assign accurate CPT codes, improving coding precision by 99%.
Inefficient Denial Management
Practices recover only 70% of denials. RCM automation helps in denial tracking and appeals, helping recover lost revenue.
Tired of Denials and Delays? Let Our AI Agents Handle Billing for Your Practice.
How Transcure’s AI Agent Can Help You Automate Medical Billing?
ELIXA – AI Eligibility Verification Agent
ELIXA transforms eligibility verification with intelligent medical billing automation. It connects to EHRs and payer systems via EDI, APIs, and AI-driven calls to interpret coverage data in real time. It even shows the number of eligibility checks that required prior authorization.
On its dashboard, you can see Live AI Activity to analyze the eligibility verification status happening through billing automation. It even tracks claim details and verification trends.
PRIA – Prior Authorization AI Agent
PRIA automates case detection and payer follow-ups with over 97% accuracy. Its Predictive Risk Heatmaps identify high-risk denials before they happen. Moreover, the AI Call Center automates payer calls to drastically reduce manual phone time spent on getting status updates or submitting verbal PAs.
Within the dashboard, you can track its integration performance with different payer portals or authorization vendors. Most importantly, this agent gives AI confidence in its decision to show it has selected the correct payer, form, CPT, and documentation.
CODIN – AI Coding and Compliance Agent
CODIN automates medical coding with AI that reads clinical notes, extracts diagnoses, and procedures. After extracting data points with its OCR technology, this AI billing agent matches them to the correct CPT and ICD codes. It audits every claim, detecting NCCI or MUE violations and flagging missing documentation.
Moreover, this medical billing automation agent analyzes prepared claims to suggest the right codes for higher reimbursements.. It even assigns a risk severity score, so teams can prioritize review of the most critical claims first.
CLAIR - AI Claim Scrubbing and Creation Agent
CLAIR is your intelligent claim scrubbing AI agent designed to eliminate denials before they happen. It analyzes claim line items (codes, modifiers, coverage, provider info) using AI and payer rules. The dashboard even displays live clean rates, denial trends, and system accuracy.
Surprisingly, this AI agent auto-fixes minor issues like modifier errors or code mismatches using trained models. Moreover, this billing automation tool compares each claim against historical denial patterns and payer-specific edits (NCCI, MUE, and LCD).
DEXA - Denial Experience and Analytics Agent
DEXA revolutionizes denial management by turning payer rejections into revenue opportunities. This AI agent detects, analyzes, and resolves denials in real time. DEXA documents each call outcome in real time and updates claim statuses automatically in the EHR or billing software.
More importantly, this AI RCM tool auto-categorizes critical denials, generates appeal letters, and even calls payers to verify claim details. With live analytics on recovery rates and financial risk, you will always have eyes on your collection status.
ARIS - Accounts Receivable Intelligent System
ARIS intelligently tracks outstanding claims and auto-drafts appeals using payer-specific rules. Its predictive engine scores recovery probability, prioritizing the highest-value accounts for faster action. Moreover, Voice AI handles patient payment calls to improve payment collection.
With real-time payer performance insights, ARIS empowers teams to make smarter recovery decisions. Most of the appeals and billing-related escalations are fully automated, cutting delays and manual workload.
REMITA - Reconciliation and Autonomous Posting Agent
REMITA is an AI automation tool for payment reconciliation and exception management in the healthcare RCM. This AI billing agent auto-reconciles remittance data (ERAs and EOBs) with expected payments and posts payments automatically to patient and insurance accounts.
Plus, this agent detects and flags exceptions, such as underpayments, denials, or missing info. Overall, it reduces manual intervention by continuously learning payer patterns.
Why Should You Choose Transcure AI RCM Agents for Billing Automation?
Practices should choose our AI Agents to take a step into billing automation. These AI tools empower healthcare practitioners in the following ways:
Near-Perfect Claim Accuracy
Your practice can achieve around 99.99% claim accuracy after completely adopting all of these AI agents into your workflow. Our AI claim scrubbing detects coding, modifier, and NCCI errors before claim submission.
Faster Eligibility Verification
Our ELIXA AI Agent for Medical Billing verifies patient eligibility in just 4 seconds, replacing weeks of manual work. It accelerates front-end billing, reduces claim delays, and empowers your team to deliver more efficient patient care.
Cost and Time Savings
By automating verification, coding, claim scrubbing, and payment posting, Transcure’s AI agents reduce manual effort by up to 70%. In this way, you can save resources and money required to be spent on the human workforce.
Auto-Resolution of Claims
With the involvement of advanced AI, agents like DEXA and ARIS do their job to resolve every stuck claim automatically. You can expect an auto-resolution rate of over 80%, without needing any human intervention.
Revenue Improvement
After fully implementing AI agents for medical billing automation, you can see improvements in collections. Most of our clients see revenue growth of around 10 to 15% within a few months of automating the billing cycle of their practice.
Real-Time Financial Visibility
On our main dashboard, you will get insights about eligibility scores, revenue collected, appeal success, and many other factors. Practices gain financial insights and monitor areas of concern through the module health dashboard.
What You Can Achieve Through Our AI Agents for Medical Billing?
Actionable Insights from Your AI RCM Agents
Our Master Command Dashboard gives you a data-driven view of how these AI agents are performing across every stage of the revenue cycle. You get the following insights:
- Predictive Analytics: Our AI predicts revenue trends, denial spikes, and coding accuracy so you can act early and strengthen financial performance.
- Performance Tracking: Using this dashboard, track first-pass rates, collections, and A/R days to measure automation success and maximize profitability.
- Health Monitoring: Instantly spot which RCM modules excel and which need tuning to make sure that your AI agents run at peak efficiency every day.
- AI Predictive Insights: You will get AI-powered alerts on denials, delays, or underpayments before they impact revenue, so your team stays financially confident.
What Our Clients Are Saying About AI-Powered RCM Agents?
Jackie Judd
Practice Manager
Wilson Creek Internal Medicine
As a practice manager, I needed a smarter way to handle billing without all the complexity. Transcure’s AI Agents completely transformed our workflow by automating tasks and saving hours every week. It’s efficient, accurate, and truly built around our needs.
Amber Vaughan
Office Manager
Idaho Kidney & Hypertension Institute
We’re a large practice with 15 providers, and Transcure’s AI Agents have been game-changing for our billing operations. After 5 years of partnership, their automation and seamless support continue to exceed expectations. A truly reliable, innovative team to work with.
Ashlee Rose
Practice Manager
Harding Memorial Healthcare
We’ve partnered with Transcure for 8 years, and after the introduction of their AI Agents, our billing has been revolutionized. Their team responds instantly, and their AI RCM agents automate payments effortlessly, helping us generate millions in revenue.
Frequently Asked Questions (FAQs)
Will AI replace medical billers?
AI won’t completely replace medical billers, but it’s transforming their role. Tools like Transcure’s AI RCM agents automate repetitive billing tasks such as eligibility verification, coding, and payment posting. This eliminates manual errors and saves up to 70% of billing time.
However, human expertise remains essential for oversight and strategic decision-making. In short, AI isn’t replacing billers, but it’s empowering them to work smarter.
Are AI Agents compatible with my EHR system?
Yes, Transcure’s AI Agents integrate with most EHRs and payer systems through EDI and API connections for smooth data exchange and real-time updates.
What is medical billing automation?
Medical billing automation uses advanced technologies like AI and machine learning to accelerate the entire RCM. Through such a process, you can automate eligibility checks, coding, claim submissions, denials, and payments. It minimizes manual effort, reduces errors, and helps healthcare practices maintain financial accuracy.
How secure is patient data with AI automation?
All Transcure AI Agents are HIPAA-compliant for end-to-end encryption and full protection of sensitive patient and financial data.
