Facility-specific answers for revenue cycle teams
RCI brings payer rules, payment estimates, denial guidance, coding checks, and facility context into one workspace. Use the web tools, have us manage your payer base, or connect the same intelligence to your own systems through API access.
Building software? Start with the developer API.
RCI Workspace
Facility and payer context
Current question
Workspace output
Estimated payment
$80.78
Source-linked Medicare calculation
- Expected payment with source files
- Filing and appeal windows by payer
- Billing form, modifier, and POS guidance
For the teams that own revenue cycle performance
Workspace modules
One place for facility, payer, payment, and denial answers
RCI puts the knowledge revenue cycle teams rely on in one place. Work in the modules directly, let us manage your payer base, or connect the same answers to your own systems.
Payment Calculator
Estimate Medicare and Medi-Cal reimbursement by facility, payer, CPT, HCPCS, MS-DRG, or APR-DRG with source-linked detail.
Use nowFacility Context
Resolve site-specific billing context from provider identifiers: location, facility type, payment system, billing form, and setting.
View workspacePayer Rules
Centralize filing limits, appeal levels, prior auth rules, payer policy details, and operational guidance for your teams.
View workspaceDenial Resolution
Turn CARC/RARC denial data into plain-English explanations, root cause categories, documentation needs, and appeal next steps.
View demosCoding Safety
Support coding and billing review with NCCI, MUE, modifier, documentation, medical necessity, and code research workflows.
View demosRule Change Feed
Track policy, fee schedule, and edit changes so teams can adapt before old rules create avoidable denials.
View workspaceManaged payer-base modeling
We build and manage your payer base in RCI
For teams that need more than public tools, RCI can become a managed workspace for your facilities, payer mix, policy priorities, reimbursement questions, and denial workflows.
Load your facilities and sites
We map CCNs, service locations, billing settings, payment systems, and site-specific rules into a workspace your team can use.
Model the payer base
We organize the commercial, Medicare, Medicaid, managed care, and specialty payer rules that matter for your actual claims.
Maintain the knowledge layer
Policy, filing, fee schedule, and edit changes are tracked and kept current for you — no more scattered PDFs and spreadsheets.
Roll out to teams and systems
Teams can work in the web tools, and product teams can connect the same managed model through the existing developer access path.
Public tools and API examples
Answer reimbursement, payer, facility, coding, and denial questions with the public calculator and API examples — no account needed.
Payment Calculator
Enter a procedure and facility and see expected payment broken down by component.
Public tool: reimbursement
Denial Inspector
Paste denial codes and get a plain-English explanation, root cause, and next action.
API example: denial follow-up
Billing Rules Network
Search payer rules, filing deadlines, modifier requirements, and revenue codes.
API example: payer rules
CCN Resolver
Paste any CCN and see facility location, type, payment system, billing form, and setting.
API example: facility context
Code Crosswalk
Map between code systems for coding review, policy research, and billing QA.
API example: coding safety
Audit & Compliance Feed
Track payer rule changes, CMS fee schedule updates, and NCCI edit changes in real time.
API example: change governance
Developer access
Same workspace intelligence, available programmatically
Everything in the workspace is also available through the API, so product, engineering, and data teams can embed RCI directly into their own systems.
Who uses RCI
Leaders, operators, delivery teams, and builders all draw on the same billing knowledge — as web tools, managed payer models, or APIs, depending on how each team works.
Prevent avoidable denials before claims reach payers
Revenue Cycle Leaders
Use RCI to check claims earlier, resolve payer rules faster, and turn denial data into clear next steps for your teams.
Estimate reimbursement and reduce revenue leakage
Healthcare CFOs
Benchmark expected payment, flag variance, and quantify the value of replacing manual lookups and internal rules engines.
Resolve coding, billing, and follow-up questions
HIM, Coding, Billing & AR Teams
Give coders, billers, and AR teams sourced rules, edit checks, payer context, and next-step guidance for daily work.
Make every client rollout more repeatable
Implementation & Client Delivery Teams
Use a managed payer-base model so implementation teams can answer site, payer, and billing questions consistently across clients.
Integrate billing intelligence without building the rules
Product & Engineering Teams
Call RCI through REST APIs, SDKs, MCP, sandbox workflows, and authenticated docs built for product teams.
Designed to plug into
Secure, reliable, and traceable
Facility, payer, and reimbursement work needs clear governance. Every answer in RCI links back to its source, whether your team reaches it through the workspace or the API.
Security & Compliance
- HIPAA-aligned infrastructure and processes
- Multi-tenant data isolation
- Workspace and API access controls
- Full audit logging
- SOC 2 Type II (in progress)
Reliability & Scale
- Cloud-native architecture
- Rate limiting and abuse protection
- Real-time monitoring and alerting
- CMS data updated as it changes
- Dedicated support for enterprise
HIPAA
Aligned infrastructure
SOC 2
In progress
Build your revenue cycle workspace around your sites and payers.
Tell us about your facilities, payer mix, reimbursement questions, and denial workflows. We can help map the right workspace, managed payer model, and developer access path for your team.
Embedding RCI into your own product? Start with the developer docs.