01
Intake + scrub
837 files and API claims are normalized and checked before submission.
Edits caught pre-submit
For billing teams and RCM leaders
RCM automation
that gets you paid.
From approved 837/835 data to prioritized recovery work, Romadix gives billing teams one operating layer for cleaner follow-up and clearer revenue decisions.
837/835
native claim and remittance intelligence
No creds
customer credential handoff not required for intelligence
1 queue
for billing teams and RCM leadership
Cleaner first-pass claims
Fewer avoidable coding and authorization misses reach adjudication.
Less provider admin drag
Teams spend less time on payer callbacks and manual rework.
Faster payment confidence
Expected-vs-paid visibility helps reduce surprises after posting.
Better patient experience
Fewer billing reversals and clearer follow-up ownership.
Connectivity across commercial and government payer workflows
Epic
Cerner
Athena
eClinicalWorks
NextGen
AdvancedMD
Kareo
DrChrono
Practice Fusion
Greenway
Epic
Cerner
Athena
eClinicalWorks
NextGen
Epic
Cerner
Athena
eClinicalWorks
NextGen
AdvancedMD
Kareo
DrChrono
Practice Fusion
Greenway
Epic
Cerner
Athena
eClinicalWorks
NextGen
Operational workflow
One claim path from intake to reconciled payment.
Your team sees exactly where each claim stands, what changed, and what to do next.
01
Ingest
Ingest approved 837/835 data, normalize records, and preserve source evidence for every finding.
02
Validate + route
Apply payer edits, prepare clean claims for approved paths, and route acknowledgments and denials to the right queue.
03
Post + recover
Reconcile 835s, compare expected allowables, and prioritize secondary/appeal opportunities for review.
Live claim journey
From claim ingest to recovered cash.
Avg actionable queue latency
< 4 hours
02
Payer adjudication
999/277CA responses are parsed and routed by denial reason and urgency.
Real-time status updates
03
ERA posting
835 remits are matched, posted, and reconciled against expected allowables.
Auto-post + variance checks
04
Recovery queue
Underpayments, denials, and secondary opportunities are prioritized for action.
Next-best action ready
Engineered for measurable RCM outcomes.
One platform for denial prevention, posting accuracy, and recovery prioritization.
Reduce preventable denials and recover high-value short-pays.
Recover 3-5% in net collectible revenue.
Romadix detects recoverable variances, denial categories, and secondary opportunities directly from adjudication and remit events.
- Denial root-cause triage
- Underpayment variance detection
- Secondary opportunity routing
$4.1M
Average annual recovery opportunity
Who this is for
Built for teams accountable for cash acceleration.
If you own denial performance, payer follow-up, or posting accuracy, this is designed around your day-to-day workflow.
Medical billing companies managing multiple client entities and payer mixes.
Provider RCM teams that need one view across locations and specialties.
Revenue cycle leaders measured on days in A/R, denial rate, and net collections.
Billing services+
Standardize QA, payer edits, and follow-up queues across every client book.
Provider groups+
Reduce preventable denials and monitor claim velocity by specialty and location.
Enterprise RCM+
Coordinate posting, variance detection, and recovery from a single operating layer.
Command center
A single revenue cycle command view.
Claim velocity, denial mix, variance exposure, and queue priorities in one operating dashboard.
96.8%
Clean Claim Rate
2.1d
Denial Queue Age
$184K
Net Recovery
Provider benefits
How provider teams benefit in day-to-day operations.
Romadix is built to improve billing outcomes while reducing the administrative burden on the people supporting care.
Clinicians and care teams
Protect clinical time by reducing claim-related interruptions.
- Cleaner claim data lowers follow-up requests for documentation clarification.
- Fewer avoidable denials reduce rebilling cycles tied to completed encounters.
- Less back-and-forth with billing preserves focus on patient care delivery.
Front desk and authorization staff
Catch issues earlier so work is done once, not repeatedly.
- Eligibility, authorization, and payer-edit issues surface before submission.
- Queues are prioritized by impact, reducing inbox sprawl and manual triage.
- Clear ownership and next action improves day-to-day throughput consistency.
Practice and service-line leadership
Get clearer operational and financial control across provider teams.
- Visibility into denial mix, queue age, and recovery value by lane.
- More predictable net collections from tighter pre-submit and recovery workflows.
- Performance data to guide staffing, payer strategy, and process accountability.
Outcome profile
Cleaner operations, faster cash, stronger control.
Teams move from reactive rework to managed throughput with clear accountability at each stage.
Before Romadix
- Manual triage to identify what to work next.
- Denied and short-paid claims discovered too late.
- Queue ownership spread across disconnected tools.
With Romadix
- Priority queues based on claim value, age, and recoverability.
- Denials and variances categorized with recommended next action.
- Leadership view across claim velocity, rework load, and cash impact.
Revenue intelligence
Prioritize the work that actually moves cash.
Denials, underpayments, and secondary opportunities are triaged with context and next action.
Built for real billing queues.
The system highlights root causes, reimbursement variance, and secondary opportunities so your team can work from impact instead of guesswork.
Root cause trends update automatically as adjudication responses arrive.
Expected-vs-paid variance is calculated at remit posting time.
Secondary opportunities appear immediately after primary payment events.
Denial intelligence
See top denial drivers and route rework by reason code and urgency.
Denials by root cause
148 open this week
Top 5reason codes
- 31%Authorization missing
- 24%Timely filing
- 18%Coding mismatch
- + 2 more categories
Underpayment monitor
$18,450 identified
AetnaPaid 88% of expected
UHCPaid 93% of expected
BCBSPaid 85% of expected
CignaPaid 91% of expected
Largest variance
BCBS: 15% short-paid
Underpayment detection
Compare expected vs paid allowables and push variance recovery quickly.
Secondary recovery
Auto-trigger secondary flows and keep queue age visible by claim.
Secondary recovery queue
12 claims auto-triggered
R. Foster
SC-2215
$415.50
J. Kim
SC-2203
$289.00
A. Morales
SC-2198
$512.90
Oldest item age1d 4h
Pricing approach
Bundle-first packages for SMB RCM teams.
Start with Core, then expand into Intelligence and Autopilot when your team is ready. Limited add-ons keep packaging flexible without creating buying friction.
Most transparent
Core
$0.20–$0.25 per claim
For SMB billing teams that want predictable claim processing costs.
- Usage-based pricing with a practical monthly minimum.
- Claim intake, validation workflows, and core queue operations.
- Ideal for practices and RCM teams standardizing first-pass quality.
Most outcome-focused
Intelligence
Custom / Starting range
For teams prioritizing denial and underpayment insight.
- Adds prioritization and next-best-action context for recovery work.
- Designed for multi-provider SMB operations with growing queue complexity.
- Quoted based on claim mix, payer profile, and workflow depth.
Most automation-heavy
Autopilot
Custom / Performance-aligned
For teams ready to add approved execution lanes after workflow calibration.
- Includes approved automation lanes for recovery and follow-up orchestration.
- Can be priced as per-claim uplift and/or percentage of recovered dollars.
- Quoted after workflow calibration to avoid overpaying for unused capacity.
Optional add-ons (kept intentionally limited)
We avoid a la carte sprawl. Most teams use 2–4 add-ons, then move up to bundled tiers as volume grows.
Denial Prevention Copilot
Timely Filing Guardian
Secondary/COB Optimizer
Patient Balance Orchestrator
Market reference note (as of March 5, 2026):
Claim.MD publicly labels its Unlimited plan as “Unlimited Claims” and “Unlimited ERA.” We did not find a published monthly claim cap on that plan page. Their documentation does state a technical limit of 10,000 claims per uploaded file.
Source: Claim.MD Pricing and Supported File Formats.
Customer Stories
Trusted by Modern RCM Teams.
From digital health startups to regional health systems.
-67% Denials
"We went from 12% denial rate to under 4% in the first quarter. The ROI was immediate."
D
Director of Revenue Cycle
Regional Health System
99.9% Uptime
"Finally, a platform that treats claims like code. Our engineering team actually enjoys the API docs."
V
VP of Technology
Digital Health Startup
$380K Recovered
"The underpayment detection alone recovered $380K we didn't even know was missing."
C
CFO
Multi-Specialty Group
Model your recovery opportunity.
Estimate potential impact from claim volume, denial rates, and reviewable recovery work.
ROI Calculator
Savings Estimator
Estimate your potential savings from reduced denials and faster recovery.
5,000
50050,000
(Professional or Facility)
$350$100$10,000
10%
2%25%
Current Monthly Loss
$175,000
500 denied claims
Projected Monthly Loss
$24,063
275 denied claims
Revenue Recovered
$59,063
from prevented denials
Rework Cost Savings
$5,625
@ $25/denial avoided
Projected Annual Savings
$776,250
$64,688 / month
Results are estimates only. Schedule a consultation for a personalized analysis.