Revenue Cycle Management Services Powered by AI, Backed by Expertise, Built for Predictable Revenue
Most revenue cycle partners tell you what happened last month. Neolytix tells you what’s coming — 30, 60, and 90 days out. InCredibly AI combines real-time claim intelligence with 13+ years of specialty expertise to deliver the one thing healthcare finance has always lacked: predictable revenue.
270+
14+
>96%
40%+
The Revenue That Never Arrives
First-pass clean rate
Avg. contract leakage indenfied
Typical collections lift
The leak is predictable. So is the fix.
Trusted by 270+ healthcare organizations nationwide
Two Kinds of Revenue Leaks. Most Vendors Only Fix One.
Every RCM company talks about clean claims and denial management. Almost none of them look at the contracts those claims are paid against.
Tier 1 · Operational Leaks
The Problems Everyone Knows About
These are the failures every billing vendor promises to fix. Important, but table stakes.
Front-end registration and eligibility errors
Missed insurance verifications, incomplete prior authorizations, and data entry mistakes that trigger avoidable denials before a patient is ever seen.
Undercoding that never shows up on a denial report
Without specialty-specific coding expertise, practices routinely bill at lower complexity levels than the documentation supports. The revenue loss is invisible.
Reactive denial management
Most billing vendors appeal the biggest denials and write off the rest. Without root-cause analytics, the same patterns repeat month after month.
No forward-looking visibility
Monthly PDF reports tell you what already happened. They cannot tell you what is coming. Finance planning becomes guesswork.
Tier 2 · Structural Leaks
The Leaks Nobody Audits
These are baked into your payer contracts. No amount of clean claims will fix a rate that was set too low.
Rates negotiated without market data
Your payer knew what they were paying every other provider in your market when they set your rates. You did not have that information at the table.
Clawback provisions with no cap
Payers recovering payments 24 to 36 months retroactively with automatic offsets and no appeal pathway required.
Timely filing windows under 120 days
Practices lose clean, payable claims because the window was never negotiated. Payers default to 90 days. Windows of 180 to 365 days are achievable.
Hidden payment processing fees
Two-thirds of practices unknowingly absorb electronic payment fees that can be pushed back contractually.
Why Does Revenue Cycle Management Fail?
step to fixing it permanently.
Execution gaps at the front end
The majority of claim denials originate before a patient is even seen. Missed eligibility checks, incomplete prior authorizations, and registration errors create a denial backlog that billing teams spend months chasing — instead of preventing.
Coding that leaves money on the table
Undercoding is as costly as denied claims — it just doesn't show up on a denial report. Without specialty-specific coding expertise, practices routinely bill at lower complexity levels than the documentation supports.
Reactive denial management
Most billing vendors appeal the largest denials and write off the rest. Without root-cause analytics, the same denial patterns repeat month after month — eroding net revenue with no visibility into which payers are driving it.
No visibility into what's coming
Monthly PDF reports tell you what happened. They don't tell you what's coming. Without forward-looking revenue intelligence, finance planning in healthcare becomes guesswork.
One Operating Model. Five Pillars. A Published 100-Day Playbook.
Most RCM vendors describe what they do. We publish how we do it — and the milestones we hold ourselves to. The Neolytix Operating Model is how we deliver 95%+ clean
Specialty-Specialized Delivery
Coding teams are organized as sub-specialty pods, not generalist queues. AAPC- and AHIMA-certified coders trained in the modifier discipline, payer-specific policies, and procedure-coding nuance of the specialties they cover. Coding accuracy audited monthly against a 95% threshold per coder.
KPI-Bound Performance Standards
We track outcomes against published thresholds, reviewed weekly with the account manager and benchmarked monthly against HFMA MAP Keys.
- Clean claim rate : 95%+ vs 85–92%
- Denial rate : <5% vs 12–15%
- AR > 90 days : <10% vs 17.7%
- Days in AR :<30 vs 45–60
- Net collection rate : 97%+
Incredibly AI: Revenue Intelligence With Forecasting
Most RCM platforms report what already happened. Incredibly AI forecasts what’s about to happen — 30/60/90-day revenue projections built from live claims, payer behavior, and AR data. Pattern detection on denial codes, modifier errors, and underpayment variance surfaces issues at submission, not after the denial.
Diligence-Grade Compliance Posture
HIPAA-compliant operations with ISO 27001-certified information security as the baseline. HITRUST certification on our published roadmap, target Q3 2026. The compliance frame that holds up under PE sponsor diligence, lender reporting, and Joint Commission scrutiny — not just a HIPAA badge.
Dual-Shore Operating Model
Domestic accountability with offshore scale. US-based RCM leads own outcomes and report to your team. Offshore coding and AR-recovery teams provide the operational throughput that keeps engagement economics aligned with mid-market collection volumes. The combination is what sustains 95%+ clean claim rate at competitive cost-to-collect.
A 100-Day Roadmap to Predictable Revenue.
Day 30
Clean claim rate at 95%+; baseline diagnostic delivered to CFO.
Day 60
AR over 90 days held under 15%; payer-specific denial trends mapped.
Day 90
Denial rate reduced 40%+ from baseline.
Day 100
Full Incredibly AI dashboards live; first quarterly business review delivered.
Day 30
Clean claim rate at 95%+; baseline diagnostic delivered to CFO.
Day 60
AR over 90 days held under 15%; payer-specific denial trends mapped.
Day 90
Denial rate reduced 40%+ from baseline.
Day 100
Full Incredibly AI dashboards live; first quarterly business review delivered.
Choose Full-Service RCM or Select Targeted Solutions — On Your Terms
Select individual service offerings from within the revenue cycle to gain access to specific expertise to complement your non-clinical growth goals.
Patient Access
- Innovative data-driven solutions for hospitals, ambulatory care centers, clinics, etc.
- Reducing cost, minimizing errors, and improving patient experience
Credentialing And Enrollment Services
- For credentials verification, aligning with state compliance requirements, and delivering non-disruptive patient care.
- Medical Licensing, PSV, Credentialing & Enrollment & Privileging Management services
Medical Billing & Coding
- Insurance benefit verification, medical coding, claim submissions & follow-up, denial management, accounts receivable management, reporting & analytics.
- Reduction in AR, improved clean claims %, and process transparency.
Payor Contract Negotiation
- Optimizing reimbursement rates through contract negotiations and get paid what your healthcare organization deserves
- Fixed-Fee Structure & Incentive-Based Fee Structure available.
Your RCM Includes Payer Contract Intelligence
Your payers negotiate your contract armed with data showing exactly what they pay every competitor in your market, down to the CPT code. Most practices never see that data before signing. They renew contracts without knowing whether their rates are competitive, below average, or leaving hundreds of thousands on the table.
Neolytix changes that equation through three connected capabilities — CPT-level market rate benchmarking, structured operational review of every material contract term, and active renegotiation when the rate gap is material. All three are bundled into your RCM relationship. One team. One fee structure. No separate consulting engagement.
Three Capability Pillars
Contract Readability Report
Plain-language review of every key contract term delivered as a green/yellow/red scorecard. Covers fee schedules, timely filing, prior auth scope, recoupment windows, tier classification, payment terms, and exit provisions. Best for practices entering new payer networks or those who have never systematically reviewed their contracts.
$341K
Average revenue opportunity identified per payer audit engagement
Rate Gap Analysis
Everything in Tier 1, plus a CPT-level rate comparison against market benchmarks for your specialty and region. Identifies exactly which codes are underpaid, by how much, and which payer contracts have the highest recovery potential. The output is a prioritized action plan, not a generic report.
$3.27M
Largest single-client opportunity identified to date
Full Renegotiation Support
Everything in Tiers 1 and 2, plus active renegotiation execution. Our team serves as your operational advocate at the table, armed with market data and payer-specific negotiation playbooks. Fee structure is gain-share — we earn our fee only from the rate improvement we deliver.
18-23%
Typical gap below market median on top payer contracts
Payer Contract Intelligence — Where Others Stop, We Start
Your payers negotiated your last contract armed with CMS Transparency in Coverage data — two trillion data points showing exactly what they pay every competitor in your market. Only 18% of practices currently use that same intelligence at the negotiation table. The other 82% sign renewals blind. We bring the data, the operational contract review, and the active renegotiation to the table — bundled with your RCM, not sold as a separate consulting engagement.
Three Capability Pillars
Know What They're Hiding
CMS Transparency in Coverage data parsed to CPT level — showing exactly what your payers pay competitors in your market for every code you bill. Every rate. Every plan. Every modifier combination. The same data payers use against you, now working for you.
Three Layers. No Gaps.
Three-layer analysis that no legal review catches: rate schedules against market median, code-scope architecture for bundling and carve-out gaps, and contract terms — clawback windows, timely filing, prior auth, payment methods, exit clauses. Lawyers review legal risk. We review revenue impact.
We Go to the Table for You
Our Enrollment Ops team executes the renegotiation — armed with benchmarking data, payer relationship history, and a gain-share engagement model where we only get paid when your rates go up. No other RCM partner bundles this at this price point.
From First Appointment to Final Payment — Every Stage Covered
One integrated RCM model across six service areas — each stage staffed by specialists, tracked in real-time through InCredibly, and held to the same performance standard across every provider you operate.
PATIENT ACCESS
Patient Access & Eligibility
- Insurance verification before every visit
- Prior authorization management, all payer types
- Registration error identification
- CAQH profile setup & payer enrollment
CODING
Charge Capture & Coding
- CPT, ICD-10-CM, HCPCS across 31 specialties
- AAPC/AHIMA-certified coders
- HCC coding for value-based care
- Payer-specific audits to protect clawbacks
CLAIMS
Claims Submission & Scrubbing
- Rules-based claim scrubbing via clearinghouse
- >96% first-pass acceptance rate target
- Electronic and paper submission, all payers
- Timely filing management
DENIALS
Denial Management & Appeals
- Same-day denial identification & root-cause
- Multi-level appeals with clinical documentation
- Payer escalation for complex denials
- 40%+ denial reduction in 90 days
AR MANAGEMENT
AR Management & Collections
- Aged AR analysis by payer and value
- Target: <60-day net AR days
- Multi-channel patient statement delivery
- Payment plan setup & hardship screening
REPORTING
Reporting & Revenue Intelligence
- Real-time InCredibly AI dashboards
- TiC rate benchmarking
- 30/60/90-day revenue forecasting
- Weekly account manager review
Revenue Cycle at Portfolio Scale
what that looks like across the Neolytix client portfolio.
Incredible RCM. Revenue That Doesn't Wait.
InCredibly™ is Neolytix’s purpose-built revenue intelligence platform — turning your billing cycle from an administrative holding pattern into a forecastable revenue pipeline.
Sankey Pipeline Visualization
Identifies revenue-blocking bottlenecks across all active payer workflows.
30/60/90-Day Revenue Forecasting
Projected collections by payer and provider, updated in real time.
Stakeholder Dashboards
COO, Finance, and Operations views with role-specific reporting.
Payer Intelligence Engine
Verified submission contacts, current requirements updated daily.
Case Studies
Real challenges. Measurable outcomes. Proven results across healthcare operations.
Prime Healthcare's Path to 98.5% First-Pass Enrollment
98.5%
First-Pass Approval
70%
Denial Reduction
40%
Faster Enrollment
50%
Revenue Increase
“Enrollment used to be a reactive, manual process that tied up significant resources. Neolytix gave us visibility and predictability. We can now flag problems early and prevent denials rather than chase them after they happen.”
— Operations Director, Prime Healthcare · 45+ hospitals · 300+ providers
Why Healthcare Leaders Choose Neolytix Over Conventional RCM
Not all revenue cycle partners are built the same. Here is how Neolytix compares to the typical billing company or in-house billing department.
| Neolytix | Typical Billing Company | |
|---|---|---|
| Specialty Coverage | 31 specialties with dedicated coding teams | Generalist billing, 5–10 specialties |
| Technology | InCredibly AI — live dashboards, TiC benchmarking | Monthly PDF or Excel reports |
| Revenue Forecasting | 30/60/90-day projected collections | Not available |
| AR Days Target | <60 days net AR | Often 75–120+ days |
| Clean Claim Rate | >96% first-pass acceptance | Industry average 85–92% |
| Denial Management | 40%+ reduction; root-cause analytics | Reactive appeals only |
| Certifications | ISO 27001, HIPAA, SOC 2, AAPC | HIPAA compliant (self-reported) |
| Onboarding Time | Go-live in 2–4 weeks | 4–12 weeks |
RCM Built for the Full Spectrum of Healthcare
From solo practitioners to 45-hospital networks — Neolytix scales to your complexity. Our model is built around your specialty mix, payer contracts, and operational structure.
Multi-Specialty Group Practices
Orthopedics & Spine Surgery
Behavioral Health & Psychiatry
Cardiology & Vascular Surgery
Neurology & Neurosurgery
Physical & Rehab Therapy
Telehealth & Hybrid Care
Hospital-Employed & ACO Groups
40
US states
2x
languages
RCM Built for the Full Spectrum of Healthcare
From solo practitioners to 45-hospital networks — Neolytix scales to your complexity. Our model is built around your specialty mix, payer contracts, and operational structure.
WEEK 1
Free Revenue Audit
We analyze your current billing data, denial trends, and payer mix — at no cost — and deliver a clear picture of where your revenue is leaking and how much is recoverable.
WEEK 1–2
Custom RCM Blueprint
Your dedicated account lead builds a tailored RCM workflow for your practice — mapping your specialties, payers, and operational requirements to the Neolytix delivery model.
WEEK 2–4
Go-Live & Optimization
We integrate with your existing EHR/PM system, train your staff, and go live. From day one you have InCredibly dashboards and a weekly performance cadence.
Security-First. At Every Step.
Built for Compliance. Designed for Confidence.
Every service we deliver is built on a foundation of strict data governance and regulatory compliance. HIPAA safeguards and ISO 27001-certified security practices are embedded into how we work, not added after the fact.
Built for Compliance. Designed for Confidence.
FAQs
Frequently Asked Questions About Neolytix RCM
What types of healthcare organizations does Neolytix serve?
Neolytix serves a wide range of healthcare providers — from solo practitioners and small group practices to large multi-specialty groups, telehealth platforms, and hospital-based organizations. We support 31 specialties across 40 US states.
How quickly can Neolytix take over our billing?
Most practices go live within 2–4 weeks. We handle system integration with your EHR/PM, staff onboarding, and data migration. Complex multi-location setups may take 4–6 weeks.
Do we have to sign a long-term contract?
No. Neolytix does not require multi-year lock-in contracts. We earn your business through results. Typical engagements run month-to-month or on an annual basis, depending on your preference.
What is your fee structure — percentage of collections or flat fee?
Our standard model is a percentage of net collections, which aligns our incentives directly with yours. We also offer flat-fee arrangements for practices above a certain volume.
Which EHR and practice management systems do you integrate with?
We integrate with 20+ major EHR and PM platforms including Epic, Athenahealth, eClinicalWorks, Kareo, DrChrono, Practice Fusion, Greenway, and others.
Is Neolytix HIPAA compliant?
Yes. Neolytix is HIPAA compliant and ISO 27001 certified. All data is encrypted in transit and at rest. We sign a Business Associate Agreement (BAA) at the start of every engagement.
How do you handle denied claims?
Our denial management workflow begins with same-day identification and root-cause categorization. Appeals are worked by specialists assigned to the specific denial type — eligibility, coding, clinical documentation, or payer behavior. We track appeal outcomes by payer and use that data to reduce future denial rates proactively.
What does the free revenue audit include?
The free audit covers: a review of your last 90 days of claims data, denial rate and root-cause analysis, AR aging breakdown, clean claim rate assessment, and a benchmark comparison against specialty-specific TiC rates. You receive a written report with prioritized recommendations within 5 business days.
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Response within 1 business day · HIPAA-compliant onboarding · No long-term contracts required