Revenue operations without the fragmented tooling.

ArkCloud RCM builds the X12 837 professional claim from the claim and its service lines and validates it before anything is sent. A claim with an error-level finding is stopped with the reasons listed, rather than discovered days later as a clearinghouse rejection. Claims can be sent one at a time or in batches, and each submission records its file name and interchange control number, so the clearinghouse's acknowledgements can be matched back to it.

Eligibility verification and prior authorisation tracking sit beside the claim, so coverage and authorisation can be confirmed before the claim goes out. Real-time eligibility runs through Availity and needs your Availity credentials.

Claims are uploaded as 837P files to your clearinghouse's SFTP mailbox, using the mailbox credentials your clearinghouse issues. The 999 and 277CA acknowledgements and 835 remittances it leaves there are collected every 15 minutes and applied to the claims they name, so a rejected claim does not sit at submitted waiting for someone to download a file. Until the mailbox is configured the submission is refused with a clear error and the claim stays pending, so nothing sits in a queue that was never going to send.

Electronic remittance advice (X12 835) is read and posted against the claims and charges it pays. Anything the posting cannot match with confidence - no matching claim, more than one, an amount that does not agree, a claim not in a postable state, or a remittance already posted - goes to an exceptions queue for a person to resolve instead of being forced onto the nearest account. The same remittance cannot be posted twice.

Denials land in a work queue with their category, payer, root cause and claim adjustment reason code, so the team can decide what to work first. Appeals are created, submitted and closed out with their outcome against the denial they answer, and denial analytics break the pattern down by payer, category, root cause and reason code - the starting point for fixing the cause rather than reworking the same denial every month.

Patient balances are worked from queues, with escalation rules you set by days aged, balance, time since last contact or number of statements sent - changing the account's status, flagging it for review, or placing it with and recalling it from a collection agency. Payment plans and patient statements are tracked on the account alongside them.

Card payments run through Stripe once it is connected. Card data goes to Stripe and is never stored by ArkCloud.

Collections work is regulated, and the software should make the rules visible at the moment they matter. Before an automated call, text or email goes out, the patient's recorded communication preferences are checked: an opt-out, a cease-and-desist, attorney representation, a bankruptcy notice, or no recorded consent for that channel stops the action and says why. A patient with no preference record on file is treated as not having consented to calls or texts; email follows the opt-out rule.

Calls are checked against the 8am-9pm window in the patient's own time zone, and one outside it is logged as a call-time violation and raises a compliance alert. Call frequency is counted per account over the last day and the last seven days, with the weekly default set at Regulation F's seven-calls-in-seven-days presumption for telephone calls. Violations roll up into FDCPA compliance reports.

These controls support your compliance programme; they do not replace it. Whether a given contact is lawful remains your organisation's responsibility - see how we approach compliance.

AR ageing shows where the money is and how old it is, with snapshots so this month can be compared with last, and a CSV export for finance. Cash-flow forecasting projects collections from your own historical performance only; where that history is missing, the forecast says so rather than filling the gap with assumed rates.