AI and Automation for Healthcare Revenue Cycle Management (RCM)

Automate workflows across phone, fax, and web. GenHealth can help providers and health plans automate intake, eligibility verification, prior authorization, and denials management.

Complete RCM automation from intake to payment

Average 95%+ first-pass claim acceptance

Reduce days in accounts receivable by 40%

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EMR SystemFax ServersEMRsHealth PlansProvidersBilling SystemsEmail
Brightree
UnitedHealthcare
Cigna
Aetna
Niko Health
Epic Systems
eClinicalWorks
athenahealth
eMedNY
myCGS DME MAC
Noridian Medicare
CMS
EviCore
Gmail
Outlook
RingCentral
Faxage

AI-Powered Revenue Cycle Automation


Our AI helps healthcare organizations process claims, prior authorizations, and manage the entire revenue cycle faster and more accurately. GenHealth AI will improve your bottom line and reduce administrative burden.

Stand Alone AI

Upload and process patient charts, claims, and documents to extract data for intake and run medical necessity checks, eligibility verification, and prior authorization automatically.
  • AI for documents and data extraction
  • Intake, Eligibility, and Medical Necessity
  • Complete documentation management

Integrated AI Automation

Automatically process incoming faxes, claims, and orders between your billing, EMR, and payer systems. Complete workflows that would take all day while you sleep.
  • AI Agent for fax, phone, and web
  • Intake, PA, Denials, and more
  • Integrations into any EMR, Billing, or Payer system

Human-in-the-Loop

Combine AI automation with human oversight. Our platform allows your team to review and approve AI recommendations, ensuring accuracy while maintaining efficiency.
  • AI-assisted decision making
  • Audit trails and compliance
  • Quality control and oversight

AI Agent that works across Fax, Phone, and Web

Our AI Agent works with people, like people. It can read faxes, make calls and converse, and take actions across various web applications from your billing system to health plan and provider portals. For example, GenHealth's AI can take an incoming fax, extract patient information, open a browser, check the patient's eligibility, come back to your billing system, enter all the information for a claim, and then make a call to a provider to get sign off all without any human interaction.
Fax
Automatically process incoming faxes, extract patient information, medical records, and orders. Convert unstructured fax documents into structured data for seamless workflow integration.
Phone
AI-powered phone agent that can make and receive calls, converse naturally with providers and patients, verify information, and update records in real-time.
Web
Navigate and interact with web portals including EMR systems, billing platforms, and payer websites. Automatically fill forms, retrieve information, and process claims.



GenHealth's AI and full-service RCM handles all of your operations, allowing you to focus on patient care while we maximize your reimbursements.




Workflow

Intake

Turns every referral channel into a structured order. Ingests faxes, e-prescribe, uploads, and email attachments; OCR + extraction produces demographics, primary and secondary insurance, ICD-10s, CPT/HCPCS, products, and ordering provider with NPI — each field cited to its source page. On approval (or auto for high-confidence orders), creates patient, insurance, prescription, and order records in your EMR or billing system.
Learn more about Intake Automation
Workflow

Eligibility

Selects the right path per carrier — API, clearinghouse, or portal RPA — and parses raw responses into structured benefits (deductible, coinsurance, out-of-pocket, plan rules). Writes back to the EMR and attaches the eligibility PDF to the patient record. Runs embedded in intake or standalone: ad-hoc, scheduled, or event-driven.
Learn more about Eligibility Automation
Workflow

Prior Authorization

Assembles payer-specific packets from intake and qualification artifacts and submits via Availity, CareCentrix, Carelon, and direct payer portals. Polls for status; ingests approvals, denials, and documentation requests; routes requests back into intake; notifies the team in Slack/email/EHR; and logs auth numbers and units to the order with a complete audit trail.
Learn more about Prior Authorization Automation
Workflow

Resupplies

For each eligible patient: checks payer-specific resupply policy, re-verifies eligibility and plan changes, reviews CMN status and prior-order history, refreshes required documentation, creates the compliant order with attachments, and flags renewals due before shipment. Keeps a per-cycle trail that proves Medicare and commercial compliance on demand.
Learn more about Resupplies Automation
Workflow

Stock & Bill

For clinics that stock DME and dispense at the point of care: GenHealth reads the handwritten dispense slip, structures the order against your inventory, and files a clean 837P claim — without anyone re-keying anything into Brightree or your billing system.
Learn more about Stock & Bill Automation
Workflow

Medical Billing

GenHealth AI automates medical billing submissions across the RCM continuum between providers and plans within existing EHRs and software.
Learn more about Medical Billing Automation
Workflow

Claim Review

Reviews each outgoing claim against Medicare and commercial requirements: code combinations, modifiers, units, documentation linkage, payer edits, and NPI/supplier integrity. Submits under your supplier number through your designated billing/EMR so reimbursements flow to you. Non-compliant claims route back into the front-end workflow for correction.
Learn more about Claim Review Automation
Workflow

Posting

Ingests remittance feeds and posts payments, adjustments, and denial codes against original claims. Reconciles posted amounts to submitted claims; surfaces variances, underpayments, and unposted balances; and triggers secondary/tertiary follow-up where COB applies. Deposit-posting integrations for Brightree today, with parallel flows for NikoHealth and other systems.
Learn more about Posting Automation
Workflow

Claims Follow-Up

Structured follow-up on outstanding claims using payer-specific aging thresholds: status checks via API or portal, escalations, and resubmissions where appropriate. Cadence is configured per payer to match actual response patterns, not a generic schedule. Every claim reaches paid, written off, or routed to appeal.
Learn more about Claims Follow-Up Automation
Workflow

Denials

Targets 90+ and 120+ aging buckets, Medicaid crossover, and categories surfaced by an A/R diagnostic. Diagnoses the denial reason from the ERA/EOB, regenerates corrective documentation via upstream agents, submits the corrected claim or appeal, and tracks each to terminal resolution. Monthly reporting by payer, bucket, and category.
Learn more about Denials Automation
Workflow

Analytics & Reporting

Monthly performance reporting on clean claim rate, first-pass acceptance, denial rate by payer and category, DSO, A/R aging, recovery on prior-period A/R, audit dispositions, and resupply capture rate. On-demand reporting and executive dashboards so leadership has the same visibility as the ops team.
Learn more about Analytics & Reporting Automation