Applied AI for the parts of the revenue cycle that cost you the most.
We don't sell a generic platform. We apply AI to specific, high-value problems, with human review built in.
0%
of healthcare leaders cite data privacy and security as the biggest barrier to AI adoption.
0%
say it is difficult to fully trust AI's results.
Providers are right to be careful. Our approach is designed around both concerns. Source: Experian Health
Solution areas
Denial prevention
- Pre-submission denial risk scoring to catch claims likely to deny before they go out.
- Automated root-cause classification by CARC/RARC, payer, provider, and service line.
- Pattern detection to fix upstream issues at registration, authorization, and coding.
Appeals automation
- AI-drafted appeal letters using payer policy, clinical documentation, and prior successful appeals.
- Appeal prioritization by recoverable dollar value and likelihood of overturn.
- Deadline tracking so timely filing windows are not missed.
FQHC revenue
- PPS/APM encounter billing accuracy and wrap-around payment tracking.
- Sliding fee scale and eligibility workflow support.
- Visit-to-encounter reconciliation and UDS reporting data quality.
- Multi-payer complexity across Medicaid, Medicare, and managed care.
Pain management
- Prior authorization support for interventional procedures such as epidural injections, facet procedures, and radiofrequency ablation.
- Medical necessity and LCD documentation checks before submission.
- Urine drug testing billing compliance and frequency edits.
- Denial pattern analysis for high-scrutiny procedure codes.
Prior auth and eligibility
- Auto-detection of authorization requirements.
- Status tracking across payers and portals.
- Expiry alerts before a valid authorization lapses.
Why BigLeap for AI in RCM
Our AI is built by people who have worked denials, not just modeled them.
- Human-in-the-loop controls on every decision that touches revenue.
- Audit trails for every AI output.
- A measured baseline before launch, so you can see the ROI.
Pick one expensive problem. We will start there.
Denials, appeals, FQHC encounters, or pain management authorizations. Bring the one that costs you most.
Explore a use case