Custom AI built inside your home health or hospice revenue cycle
Off-the-shelf software runs the same steps for every agency. Our engineers sit with your billing team, build AI agents for your workflows and payer mix, and run them beside your EMR. You keep the systems and the data.
Book a workflow conversationSee where agencies startWhere building custom AI for your agency starts
Our engineers, in your building
Our engineers sit where the work happens. Our experts set the rules and handle what agents flag.
Built on your systems
Our AI agents read and write back in your EMR. They run beside your systems; your agency keeps its data.
The revenue cycle takes its cut before you see the money
Every 30-day period and election drags hours of checking, chasing and rework through your billing office, and the cost lands on your margins.
A queue that never clears
Claims, follow-ups and appeals wait their turn while the census keeps growing.
Days lost to payer portals
Your best billers spend their day on hold and re-keying what the portals show.
Late notices, paid by you
A late admission notice cuts the 30-day payment one-thirtieth per day.
The check lands before the claim does
Our AI agents check each claim against the assessment and your payer rules before submission; our experts set the rules they check against.
- Edits that match assessment to claim
- Payer-specific rules, yours to set
- Exceptions routed to your billers to decide
Notices filed inside the five-day clock, every time
A late notice of admission costs the period one-thirtieth of its payment per day. Our AI agents hold the clock and file; our experts take the exceptions.
- Admission notices held to the five-day window
- Elections tracked from the effective date
- Late filings flagged the same day
What the payer paid, against what was owed, on every line
Our AI agents post each remittance and compare it to what you expected from that payer; our experts chase the underpayments worth chasing.
- Every remittance line posted individually
- Underpayments flagged against your rates
- Write-offs reviewed before they stand
Each denial lands with whoever can fix it
Our AI agents read each denial, route it to the person who can act, and track it to resolution; our experts handle the appeals that need judgment.
- Denials routed by reason and owner
- Appeal deadlines held in view
- Denial reasons trended back to the source
Our study of 169 home health and hospice workflows ranks claims, notices, remittances, denials
- Notice of admission and notice of election generation and filingThe top pick of 169 workflowsWorth it, ready now
- Expected-payment variance for home health periodsIn the top three of 169 workflowsWorth it, ready now
- Denial, return and review routing and triageIn the top ten of 169 workflowsWorth it, ready now
- Medicare Advantage, Medicaid and private duty contract varianceIn the top ten of 169 workflowsWorth it, ready now
- Certification and face-to-face denialsIn the top 25 of 169 workflowsWorth it, ready now
- Period and per-diem claim assemblyIn the top 25 of 169 workflowsWorth it, ready now
- Medical-necessity, homebound, skilled-need and terminal-prognosis denialsIn the top half of 169 workflows
- Pre-billing editsIn the top half of 169 workflowsWorth it, ready now
- Electronic remittance ingestion and auto-postingIn the top half of 169 workflows
Moative's experts mapped all 112 of our revenue-cycle workflows with our team and chose 29 to build first. The first AI agent checks claim status on payer portals; a check that took 19 minutes now takes 45 seconds.
President, Colorado-based RCM company
Your workflow, observed before it is automated
Before anything is automated, our engineers watch your workflow and fix the data it depends on. What we build comes from your operation.
Your staff make every call
Your team reviews what our AI agents flag and decides. The software makes no clinical decisions. Your billers keep the judgment calls.
Rules your team can read
Every rule is written where your team sees it. Our experts set rules with your staff, who can change them.
- 01
Observe, and fix the data
Our engineers sit with your billing, intake and clinical teams, watch the workflow, and fix the data it depends on.
- 02
Build and ship into the live workflow
Our experts build and release AI agents into your live workflow; your staff see every flag.
- 03
Move to the next workflow
Once the first workflow runs, our engineers take on the next; the gains stack, workflow by workflow.
Where off-the-shelf stops and custom AI starts
You already run one of these. Here is where each is good, and where it stops.
Custom AI made for one agency
Our engineers work inside your operation and build for your workflows, your payer mix, your systems. What one agency gets would not fit another, and that is the point.
- Built around your workflows
- Your staff decide; our agents do the checking
- The price follows workflows automated
Billing and RCM software
Good at organizing the billing you already do. It usually runs the same steps for every agency, so your payer's quirks stay manual work.*
Read the comparisonAn outsourced billing company
Good at taking the pile off your desk, usually per claim. Their people follow their playbook; your workflow moves to their queue.*
Read the comparisonYour EMR's billing module
Good at staying connected to the chart, since it is the chart. It usually covers the standard path; your payer-specific checks ride on workarounds.*
Read the comparisonA management services organization
Good at running the back office under one fixed way of working. Most MSOs standardize your operation onto their model; the flexibility is theirs.*
* These are general descriptions of each category as commonly sold; no vendor is named. Terms, pricing and coverage vary by contract. What you get depends on your agency and payer mix.
Where agencies and hospices start
Six areas of the revenue cycle, in the order the money moves. Your first workflow is one of these; our experts help you pick.
Referral intake and patient access
Referrals captured and admitted faster, with fewer steps lost between intake and scheduling.
Prior authorization and utilization review
Authorizations filed before the visit starts, ahead of the payer's clock.
Diagnosis coding and OASIS
Codes checked against the assessment before billing, by our AI agents.
Claim assembly and submission
Clean claims out the door first pass, checked against your payer rules.
Payment posting and remittance
Every remittance posted same day, underpayments flagged against contract.
Denials, ADRs and appeals
Each denial routed to whoever can fix it, appeals tracked to deadline.
Clean claims, held clocks, posted payments, answered denials
The first conversation is about one workflow: where it hurts, what it costs, what our AI agents would take over and what your team would keep. No patient data needed, no commitment.
Questions
Do we have to replace our EMR?
No. Our AI agents run beside your EMR, clearinghouse and payer portals, reading and writing back. You keep the systems you have, and your data stays yours.
How is it priced?
A fee plus an outcome-based part, metered by workflows automated. Adding users costs nothing; adding workflows is what changes the number.
What does forward-deployed mean, day to day?
Our engineers and revenue-cycle specialists sit inside your operation, with your billing, intake and clinical teams. They observe the workflow, set the rules, and handle what our AI agents flag.
Which workflow should we start with?
The one where your agency loses the most today. We rank candidates against our study of 169 home health and hospice workflows, then our experts walk your numbers with you and pick the first.
Who decides what gets sent?
Your staff. Our AI agents check and flag; your team reviews and makes the call. The software makes no clinical decisions.
The full study, PDF · 636 KB
The winner is the dullest job in the building
Claim editing and cash posting beat every clever idea in the study, and they beat it every single time we re-ran the numbers.