INCISE AI — Revenue Cycle Intelligence for Surgical Practices

Why Control Matters

You didn't outsource your billing.
You outsourced knowing what's going on.

Revenue cycle management is a labor business — people working your claims in someone else's building, billed as a percentage of everything you collect. When it lives over there, you lose more than margin: you lose visibility, speed, and the ability to fix what's broken. Revenue cycle intelligence puts the work back on your side of the wall.

You can't see the leak

Missed modifiers, coding gaps, denials worked late or never. By the time it shows up in a monthly report, the money is gone and the pattern has repeated a hundred times.

You pay for headcount, not results

Legacy RCM firms solve revenue problems by adding people, then bill 5–8% of everything you collect to cover them — forever, whether they perform or not.

⌛

You wait on someone else's queue

Your claims sit behind other practices' claims. Your appeals wait for a person with a stack. Your questions get answered next week.

⇆

You can't leave easily

Your data lives in their system, in their format. Switching means starting over — which is exactly why nothing ever improves.

The Platform

Five AI agents. Your office runs them.

Software does the reading, checking, coding, and computing on every claim. Your team stays in control of the work — and sees all of it, live.

Pre-Claim Intelligence

Coverage, eligibility, and authorization verified before the case happens. Problems surface while they can still be fixed.

Specialty Claim Scrubber

Surgical and assist coding logic — modifiers, unit rules, payer edits — applied to every charge before it becomes a claim.

Denial Classifier

Every denial triaged and root-caused in minutes, appeals drafted automatically, and the pattern fixed upstream so it stops repeating.

AR Aging Monitor

Every payer bucket watched continuously. Escalations trigger on thresholds — not on someone remembering to run a report.

Payment & Outcome Intelligence

A payer- and procedure-level benchmark built from real results, so underpayments are identified the day they arrive.

The Human Layer

Where judgment carries legal weight — formal disputes and arbitration — US-based analysts review and sign every filing.

One Pipeline

Referral to payment — one system owns the whole line

Integrated with the EHR and clearinghouse you already use. Nothing gets re-keyed, nothing falls between systems.

Referral Intake

eFax, email, and electronic referrals captured and structured automatically — no re-keying, no queue.

Benefits & Eligibility

Coverage, eligibility, and authorization verified at intake — problems caught pre-op, not post-denial.

Appointment Booked

Scheduling triggered from the cleared referral.

Care Team & Patient Comms

Both sides informed automatically — HIPAA-compliant, consent-tracked.

AI Coding Check

Specialty CPT logic and modifier rules applied to every charge before it becomes a claim.

Claims Drop

Clean claims direct to the clearinghouse — hours, not days.

Adjudication Tracking

Status polled continuously. Nobody waits on payer mail.

Denials & AR

Triaged, appealed, escalated, and collected — with the root cause fixed upstream.

Reporting You Actually Own

One live dashboard: every claim, every dollar, every payer — in your hands, not in a monthly PDF.

How The Economics Change

Software does the work legacy billers charge you for

This is the difference between revenue cycle management and revenue cycle intelligence: automation replaces the labor, so the pricing changes shape entirely — and so does who holds the leverage.

1 platform

Your whole book

Every payer, every claim — in-network and out. Not a bolt-on for one slice of your revenue.

9 stages

Referral to payment

One system owns the line, so nothing falls between your front office and your back office.

5 agents

Working every claim

AI handles the reading, checking, and computing — on all of it, not the easy 80%.

Fraction

Of legacy billing rates

Priced like software, not staffing — with year-one savings guaranteed in writing.

INCISE AI is a newly built platform. Figures describing legacy billing costs and industry denial rates reflect published market data; performance claims for this platform will be published from our own client book as it accumulates.

Your Data, Your Practice

Control means the system works for you — and leaves when you say so

Your practicePHI stays here → Local AI nodeon your network → de-identified aggregates only → Quality reviewimproves the rules

⌂

Designed so patient data never leaves the building

An AI node on your network does the work on protected health information. Only de-identified aggregates ever leave your walls. BAA executed with every client.

US-based operations

Every person who touches your claims or a federal dispute portal is US-based and identity-verified.

↻

A system that learns permanently

Every output is reviewed against a quality rubric. Every miss becomes a permanent rule and a regression test, so the platform gets sharper on your payers over time.

⇩

Your data, your exit

Complete portability guaranteed by contract — claims, remittances, dispute files, and benchmarks export in usable formats. Staying should be a choice, not a trap.

Included Capability

When a payer underpays, the platform doesn't just flag it

Federal law created a dispute process for underpaid out-of-network claims. Most practices never use it, because the deadlines are short and the filings are technical. The platform finds those claims automatically — and our US-based analysts pursue them.

	The Volume Model	The INCISE AI Model
Filing philosophy	File everything; let the arbitrator sort it out	Every claim screened; only qualified disputes are filed
Eligibility	Fight challenges after filing	Screened pre-filing against current federal rules
Attestations	Bulk filings under your provider identity	A US-based analyst reviews and signs every attestation
Timelines	Promised, then missed	Managed against every federal deadline — tracked, never promised
Built for	The old rules, adapting under scrutiny	The current regime — batching, fee structure, portal-native

Out-of-network dispute resolution is one capability inside the platform — not the reason to buy it. A practice that never files a dispute still runs its entire revenue cycle here.

Pricing

Simple, aligned, and in writing before you commit

No percentage-of-everything contracts. Pricing follows the work: automation is priced like software; human judgment is priced to the labor; recovery work is contingency-only.

◆

Platform billing — priced like software

Your office runs billing and coding on the platform: AI coding, claims, denials, AR. A fraction of legacy billing rates, for all payers.

◆

Dispute resolution — all-inclusive

Out-of-network negotiation and federal arbitration with every filing fee and arbitration cost included. One rate, nothing hidden.

◆

Backlog recovery — contingency only

Old denied and unbilled claims from before we arrived. No recovery, no fee — ever.

✓

Implementation — savings guaranteed

A one-time implementation with a year-one savings guarantee: if your first-year INCISE AI billing fees exceed your documented prior billing costs for equivalent volume, we credit the difference.

Your exact pricing arrives with your free revenue analysis — modeled on your actual volume and payer mix, itemized in writing, before you sign anything.

Getting Started

Proof before commitment

You switch when the numbers say so — not when a salesperson does.

Free Revenue Analysis

Send 12 months of remittance data under BAA. An itemized dollar map of your full revenue flow — what the platform can recover, automate, and improve, by payer and by procedure.

2 weeks · no cost, no obligation

Program Design

Per-payer strategy, documentation templates, integration plan with your existing EHR. Sometimes the answer is "change nothing" — and we'll tell you so.

2 weeks

Parallel Run

INCISE AI runs alongside your current biller. Same claims, measured head-to-head: clean-claim rate, denial rate, days-to-cash. Your cash flow is never at risk.

90 days

Take Over on Proof

Your documented baseline becomes the permanent performance benchmark. One-time implementation, year-one savings guaranteed.

Day 90+

If the numbers aren't compelling, we'll both know in two weeks — at zero cost.

Start with the free revenue analysis. Your data, under BAA, analyzed by the platform and reviewed with you line by line.

You didn't outsource your billing.You outsourced knowing what's going on.