Revenue cycle management leaders know that the battle for financial performance is increasingly being fought at the intersection of clinical accuracy and operational speed. As denials rise and margins tighten, traditional documentation and coding processes, built for a different era, are struggling to keep up.
The idea of RapidClaims, the NY-based award-winning AI RCM company, was conceived with the thought that sustainable gains in RCM require more than automation. Providers demand real-time clinical intelligence embedded directly into the workflows of providers and coders. This requirement is even more relevant for specialty groups, yet healthcare technology companies haven’t been able to traditionally manage this requirement across multiple specialty types. This is exactly what is being championed at RapidClaims.
With our latest expansion, RapidClaims now supports 25+ medical specialties, helping hospitals, IDNs, and specialty groups unify their documentation and coding infrastructure under a single AI-powered platform.
Why Specialty-Driven RCM Matters
Every specialty brings its own documentation patterns, coding nuances, and audit risks. Gaps in coding or HCC capture are rarely the result of negligence, they stem from inconsistent data, fragmented workflows, and the overwhelming complexity of evolving regulations.
Industry data shows that up to 30% of chronic conditions never reach the final claim. Moreover, 1 in 2 physicians are unsure about which diagnoses count under CMS’s updated V-28 HCC model. These silent gaps don’t just affect compliance, they cost health systems millions in value-based revenue.
RapidCDI™: Closing the Loop in Real Time
RapidCDI™ addresses these issues head-on by integrating seamlessly into the EHR to deliver real-time prompts that surface missing, undercoded, or resolved diagnoses. By ingesting clinical data across 50+ document types and stitching together longitudinal patient records, RapidCDI™ empowers physicians with point-of-care nudges, no extra clicks required.
Each prompt includes context, such as the lab result or phrase that triggered the suggestion, allowing clinicians to quickly accept or reject with confidence. On average, users see a 24% lift in HCC capture and reclaim 30 minutes per physician per day, contributing to lower burnout and better documentation quality.
At a San Diego FQHC handling 600,000 charts per year, RapidCDI™ lifted RAF scores by 24% and cleared the entire documentation backlog within a month. In a 5-hospital IDN in the Midwest, improvements in evaluation and management (E&M) leveling translated into a $4.6 million annual revenue lift and reduced A/R days by five.
RapidCode™: AI Coding at Clinical Speed
On the coding front, RapidCode™ delivers autonomous ICD-10, CPT, and E&M coding with98%+ audited accuracy. It processes over 1,000 charts per minute, identifies coding opportunities in real time, and pushes high-confidence claims straight to bill, with hover-card explanations for every code selected.
Coders retain full control with the ability to review, edit, or annotate any AI-suggested output, but no longer spend hours manually digging through documentation. At a major southern health system, coding backlogs were cut in half within 30 days and eliminated entirely by day 60. First-pass denials dropped by 28%, accelerating collections and easing overtime costs.
A Dallas-based nephrology group saw E&M accuracy improve by 30%, gaining nearly 2 hours per day per physician for direct patient care and achieving an 8X ROI in just the first quarter.
RapidScrub™ and RapidRecovery™: Closing the Denial Loop
RapidScrub™: Real-Time Claim Scrubbing
Positioned upstream of submission, RapidScrub applies predictive denial scoring, contract-underpayment alerts, and eligibility guardrails to every claim before it leaves your door. Hospitals running RapidScrub have cut first-pass denials by up to 70% and shaved a full week off average A/R days, giving finance teams faster cash while easing staff workload.
RapidRecovery™: Automated Denial Resolution
Even best-in-class prevention cannot stop every payer rejection. RapidRecovery picks up where RapidScrub ends, triaging denials by root cause and automating appeal packages with payer-specific rule sets. Revenue teams recover lost dollars sooner, reduce rework hours, and lift overall net collections.
Together, RapidScrub and RapidRecovery ensure end-to-end control of the denial life cycle, complementing RapidCDI™ and RapidCode™ so health systems capture every allowable dollar across 25+ specialties.
Designed for Fast Deployment and Long-Term Value
What sets RapidClaims apart is its ability to go live in less than three weeks. Both RapidCDI™ and RapidCode™ require only 500 historical charts to deploy, thanks to our few-shot learning framework. Our SMART-on-FHIR and HL7 integrations allow for rapid onboarding across Epic, Cerner, Athena, and other major EHR platforms, without disrupting existing workflows.
Each implementation includes a shared ROI dashboard to quantify savings from Day 1, and our AI models continue to improve weekly through feedback from denials, coder annotations, and payer adjudication patterns.
Built for Security, Compliance, and Scale
Whether working with large IDNs or lean specialty groups, security and compliance remain foundational. RapidClaims is fully HIPAA, SOC 2, and ISO 27001 certified, and its models are aligned with AHIMA, OIG, LCD/NCD, and HCC guidelines.
With confidence-based human-in-loop safeguards and a federated learning architecture that keeps PHI within your cloud, RapidClaims ensures both data security and continual model refinement.
The Road Ahead
RapidClaims’ mission stays the same: make RCM smarter, faster, and clinically aware. RapidClaims is not just a coding engine or a documentation assistant, it is a platform that transforms how organizations capture revenue at scale without compromising care quality or clinician time.
About RapidClaims
RapidClaims is an AI-powered platform transforming healthcare revenue cycle management for health systems and provider groups nationwide. The NY-based, Accel-backed company automates medical coding and documentation in the mid and e-revenue cycle, addressing inefficiencies leading to revenue loss and clinician fatigue. Utilizing proprietary LLMs and domain-trained AI, RapidClaims achieves 98%+ accuracy and 100% compliance, reduces denials by up to 70%, and accelerates reimbursements. Its products deliver 1-2% net revenue gains (RVUs), up to 170% coder productivity increases, and 5 days faster A/R. Integrating seamlessly with over 20 major EHR systems via FHIR/HL7, it ensures rapid deployment. For more information, visit rapidclaims.ai.
