AI-Powered Revenue Cycle Management

Every Service Your
Practice Needs to
Get Paid Faster.

From claim submission to credentialing, denial management to prior authorization — MedCods delivers end-to-end RCM services backed by AI coding and AAPC-certified specialists.

98.5%

clean claim rate

1.5%

Avg Denial Rate

<20

Days A/R Average

500+

Practices Served
med

Complete Revenue Cycle Coverage,
Built for Every Practice Size

CORE PLATFORM

Healthcare Billing Software — Powered by MAXIMUS AI

The MAXIMUS AI Engine validates every claim against 3M+ payer-specific rules before submission. ICD-10, CPT, HCPCS, NCCI edits, and modifier validation all run at charge entry — catching errors before they become denials. Paired with real-time analytics, 40+ EHR integrations, and a dedicated AAPC-certified account manager.

3M+

Coding rules per claim

60%

Less documentation time

40+

EHR integrations
Most Popular

Denial Management Software

Stop revenue leaks before they start. The industry averages an 11.8% denial rate — MedCods clients average 1.5%. MAXIMUS AI catches 87% of potential errors pre-submission. Automated ERA/835 detection, one-click appeal workflows, and root-cause heatmaps by payer and code.

denial management
medical billing appeals
claim denial prevention
rcm workflow
denial management
Front-End Fix

Insurance Eligibility Verification & Prior Authorization

24% of all claim denials trace back to eligibility or prior auth issues caught too late. MedCods runs real-time 270/271 eligibility at the point of scheduling and FHIR-based electronic prior authorization that resolves in minutes — not days. CMS-0057-F compliant, eliminating CO-197 denials entirely.

prior authorization software
FHIR prior auth
real-time eligibility
270/271 transactions
insurance eligibility verification
Revenue Gap Fix

Medical Credentialing & Payer Enrollment Services

An uncredentialed provider means zero billing — up to $15,000 per day in unrecoverable revenue for high-billing specialists. MedCods manages CAQH setup, PECOS enrollment, commercial payer applications, and re-credentialing end-to-end. Average completion 40–60 days faster than industry standard.

physician credentialing
payer enrollment
CAQH credentialing
PECOS enrollment
medical credentialing services
Enterprise

Medical Billing Software for Billing Companies

One platform to manage unlimited client practices, specialties, and tax IDs. White-label reporting portal, portfolio-wide denial heatmaps, batch claim corrections, and AI coding across all clients simultaneously. Built for CBOs, independent billing companies, and multi-location physician groups.

medical billing software
multi-client RCM
white label billing
billing company software
revenue cycle management
Specialty

Radiology Billing Software & Imaging RCM

TC/26 component splitting, NCCI edit validation, RBM prior authorization via eviCore/AIM, and automatic modifier application for interventional and teleradiology. Purpose-built for imaging centers, hospital radiology departments, and independent radiologist groups. 98.2% clean claim rate.

radiology billing software
TC/26 billing
imaging RCM
interventional billing
radiology prior auth
98.5%

Clean Claim Rate — industry avg is 85%

1.5%

Average Denial Rate — industry avg is 11.8%

97%

Net Collection Ratio

All specialties combined
35%

A/R Days Reduced

Average client result

Your Revenue Cycle, End-to-End

Five integrated stages — from patient scheduling to payment posting — working as one connected system, not a patchwork of disconnected tools.

Patient Scheduling & Eligibility

Real-time 270/271 eligibility and prior auth run at the moment of scheduling. Coverage gaps flagged before the appointment — not after denial.

Charge Capture & Coding

MAXIMUS AI validates every CPT, ICD-10, HCPCS code and modifier against 3M+ payer rules. AI clinical scribe reduces documentation time by 60%.

Claim Scrubbing & Submission

NCCI edits, LCD/NCD checks, and fee schedule compliance validated. 98.5% of claims submit clean on first pass — no rework, no delays.

Denial Management & Appeals

Automated ERA/835 detection categorizes every denial instantly. AAPC-certified coders file appeals. Root-cause analytics prevent recurrence.

 

Payment Posting & Analytics

Automated ERA payment posting, payer benchmarking, A/R aging drill-downs, and predictive collection forecasting — all in your live dashboard.

Comprehensive RCM — Every Specialty, Every Workflow

MedCods serves 30+ specialties with purpose-built billing modules, each carrying specialty-specific CPT code sets, payer contract rules, and denial workflows.

Cardiology Billing
Radiology Billing
Orthopedics Billing
Oncology Billing
Mental Health Billing
Behavioral Health
OB/GYN Billing
Anesthesiology
Pathology Billing
Dermatology
Family Practice
Emergency Medicine
Revenue Cycle Management
Medical Billing Services
Insurance Eligibility
Insurance Eligibility
Prior Authorization
Claim Scrubbing
A/R Management
A/R Management
MIPS Reporting
Coding Compliance
Multi-Specialty Groups
Independent Physicians
Billing Companies
Central Billing Offices
Imaging Centers
ASCs
Telehealth Practices
Urgent Care Center
Hospital Systems
Behavioral Health Groups

Common Questions

How quickly can MedCods reduce my denial rate?
Most practices reach a denial rate under 2% within 90 days of switching to MedCods. The MAXIMUS AI Engine begins catching pre-submission errors from day one of onboarding. Root-cause analytics then identify systemic issues over the first 30–60 days to prevent recurring denials. The industry average denial rate is 11.8% — our clients average 1.5%.
Yes. MedCods integrates with 40+ EHR systems via HL7, FHIR, and direct APIs — including Epic, Athenahealth, eClinicalWorks, Kareo, DrChrono, and more. There is no rip-and-replace required. We sit on top of what you already use.
MedCods is priced as a percentage of collections — meaning we only earn when you get paid. There are no setup fees, no hardware costs, and no long-term contracts required. This aligns our incentives with yours: maximizing your collections is how we succeed.

MedCods supports 30+ specialties with purpose-built billing modules, including cardiology, radiology, orthopedics, oncology, mental and behavioral health, OB/GYN, anesthesiology, pathology, dermatology, family practice, emergency medicine, and more. Each module includes specialty-specific CPT code sets, payer contract rules, and denial workflows.

Yes. MedCods Enterprise supports unlimited providers, locations, and tax IDs from a single management dashboard. Billing companies can manage multiple client practices — each with white-label reporting — from one platform. CBOs and large physician groups get portfolio-level analytics with drill-down to individual provider and claim level.

MedCods manages the full credentialing lifecycle — CAQH profile setup, primary source verification, PECOS Medicare enrollment, Medicaid enrollment, commercial payer applications, and re-credentialing — with proactive status tracking and deadline management. We complete credentialing 40–60 days faster than the industry standard 120-day average, directly reducing uncollectable revenue during the enrollment gap.

The moment a denial is received via ERA/835, MedCods automatically detects it, categorizes it by reason code, and fires a dashboard alert. The claim is routed to the correct appeal workflow based on denial type and payer. High-dollar or clinically complex denials are escalated to AAPC-certified coders who prepare and file the appeal on your behalf. Every deadline is tracked and every status is visible in your dashboard in real time.

Stop leaving revenue
on the table.

Join 500+ practices that replaced billing headaches with a system that works as hard as they do. No setup fees, no long-term contracts, no risk.