Slash the RCM Tax
Leverage the latest AI tools in the new ModMed® RCM AI Platform to better capture the revenue you’ve earned and improve your operational efficiency.
The ModMed RCM AI Platform
Purpose-built for specialty healthcare, the ModMed RCM AI platform will deploy AI agents to work alongside billing teams and help them optimize reimbursement, reduce denials, accelerate claim resolution, and lower the cost of collecting receivables.
It’s time to slash the RCM Tax
The RCM Tax™ is the hidden financial burden that quietly erodes the performance of specialty medical practices every day. Administrative inefficiencies, denied claims, delayed payments, payer complexity, and unnecessary manual work create friction across the revenue cycle, reducing cash flow, increasing operating costs, and preventing practices from collecting the revenue they have earned.
According to a recent MGMA stat poll, 48% of medical group leaders say denials and appeals are their biggest revenue leak. Additionally, hospitals spend an estimated $19.7 billion annually appealing denials. It’s clear that the status quo is no longer sustainable, and healthcare organizations are looking for ways to Slash the RCM tax.
Bringing agentic AI…
As payer requirements become increasingly complex and staffing challenges persist, many revenue cycle teams lack the capacity to pursue every claim with the same level of attention. Lower-dollar claims, time-intensive appeals, and repetitive follow-up activities are often delayed or deprioritized as staff focus on the most urgent work. The AI agents inside the ModMed RCM AI Platform will help eliminate that tradeoff by automating repetitive tasks, prioritizing the highest-impact activities, and guiding staff through complex payer requirements. The result is that billing teams will work claims more efficiently, accelerate reimbursement, and recover revenue that might otherwise remain uncollected.
…to specialty RCM
The ModMed RCM AI Platform is powered by one of the healthcare industry’s richest specialty-specific revenue cycle datasets. Built on over a decade of specialty expertise, the platform draws on hundreds of millions of de-identified historical claims – including millions of denied claims – billions of dollars in annual transactions, payer-specific intelligence, and years of real-world revenue cycle outcomes that will deliver contextual guidance, intelligent automation, and improved visibility across the billing lifecycle. Internal analyses indicate the ModMed RCM AI Platform could help reduce manual accounts receivable (AR) follow-up activities by up to 57%.1
How the ModMed RCM AI Platform works
The ModMed RCM AI platform will bring together five integrated AI capabilities designed to help practices prevent revenue leakage, accelerate reimbursement, improve operational efficiency, and optimize financial performance:
AI RCM Agents
automate time-consuming revenue cycle activities, including generating appeal packages, applying intelligent claim edits, validating claims, executing resubmissions, researching payer requirements, navigating payer portals, and completing repetitive administrative tasks.
AI Workflow Manager
serves as an intelligent command center for human and AI-powered revenue cycle work, providing operational dashboards, intelligent claim prioritization and routing, personalized work queues, workflow automation, and end-to-end performance tracking.
AI Billing Assistant
gives billing professionals conversational, contextual guidance throughout the billing lifecycle by analyzing submission risk, summarizing claim history, surfacing payer requirements, recommending next-best actions, and embedding supporting documentation directly into workflows.
AI RCM Advisor
transforms complex revenue cycle data into actionable financial and operational insights, enabling practice leaders to monitor performance, identify trends and anomalies, understand underlying drivers, generate reports, and uncover opportunities to improve reimbursement, cash flow, and overall financial performance.2
Specialty Intelligence Engine
powers AI interactions across the platform by combining specialty expertise, payer policies, coding guidance, customer-specific workflows, de-identified historical claims, denial patterns, and real-world revenue cycle outcomes into contextual recommendations.
57% less time and touches per claim
Decrease denials:
Help reduce avoidable denials before they occur with predictive AI identifying over 10% of total denials.3
Capture more of what you earn:
Designed to reduce time and touches in your AR management workflows by up to 57%.1
Gain real-time performance visibility:
Focus on accelerating revenue, reducing the average 18 minutes1 it takes to work a single claim, enforcing process consistency, and driving measurable improvements.
What’s your potential return on investment?
How could ModMed help your practice? Let’s do the math.
On average, how long does it take your team to appeal a claim?
10 minutes saved per appeal
Your estimated potential with ModMed4
Our AI is built around 11 specialties, over $5 billion in annual transactions, and one of the healthcare industry’s most extensive de-identified datasets, sampled from:
patient encounters
historical claims⁵
denied claims⁵
years of billing experience⁵
The ModMed RCM AI Platform is a cornerstone of our AI-Powered Practice strategy. The RCM AI Platform represents a fundamental shift in how specialty practices manage financial performance. By combining specialized AI agents with ModMed’s deep medical expertise and human oversight, we'll help practices optimize reimbursement, improve operational efficiency, and give practices greater visibility and control across the revenue cycle.
Joe Harpaz, co-CEO of ModMed
FAQs
When will the ModMed RCM AI Platform become available?
The ModMed RCM AI Platform will support two delivery models designed to meet the needs of specialty practices of every size. Larger practices, enterprise organizations, and Management Services Organizations can deploy the platform to power their own internal revenue cycle operations. Practices that choose ModMed RCM Services can benefit from the same AI platform as part of a fully managed revenue cycle solution.
Portions of the ModMed RCM AI Platform are already deployed within ModMed RCM Services, where its AI capabilities are helping augment revenue cycle operations for managed services customers. A limited early adopter program for self-managed customers is expected to begin in the fourth quarter of 2026, with broader availability beginning in 2027.
The platform will be showcased publicly at MOMENTUM, ModMed’s annual customer conference, in Orlando from October 16–18, 2026. Additional AI capabilities will continue to be introduced as part of ModMed’s broader AI-Powered Practice strategy.
What specialties will the ModMed RCM AI Platform be available to?
The ModMed RCM AI Platform is planned for all EMA® EHR specialties at general availability. Specialties include allergy, dermatology, ENT, OBGYN, ophthalmology, orthopedics, pain management, plastic surgery, podiatry, and urology.
Do I need ModMed Practice Management to use this platform?
Yes. ModMed Practice Management is required to purchase the ModMed RCM AI Platform, as it is natively integrated with real-time claim syncing between solutions.
Can I use the ModMed RCM AI Platform as a ModMed RCM Services customer?
The ModMed RCM AI Platform is currently launched and active inside ModMed RCM Services. ModMed’s billing specialists leverage the RCM AI Platform to process billing, enabling customers to directly benefit from the platform’s capabilities.
Reclaim time for your people and revenue for your practice
Fill out the form to stay up to date on the release of ModMed RCM AI Platform.
Reclaim time for your people and revenue for your practice
Fill out the form to stay up to date on the release of ModMed RCM AI Platform.
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1 Time and Motion Study estimates 18 minutes per claim. ModMed RCM aims to reduce the time it takes to appeal a claim by up to 57% based on internal ModMed analyses of ModMed RCM functionality.
2 Additional fees may apply.
3 ModMed’s Claim Denial Assessment predictive AI model successfully flagged 1,341,930 claims out of 2,204,272 total denials (60.88%), and caught 426,785 targeted denials with a direct Claim Check Decision (19.36%) for all enabled customers, July 2026.
4 THE PROJECTIONS AND POTENTIAL BENEFITS INCLUDED HEREIN ARE BASED SOLELY ON THE ESTIMATES YOU PROVIDED AND ARE FOR ILLUSTRATIVE PURPOSES ONLY. THE EXAMPLES SHARED BY MODMED MAY NOT BE REPRESENTATIVE OF A TYPICAL CUSTOMER EXPERIENCE, AND WE HAVE NOT VERIFIED THEIR ACCURACY. ACTUAL RESULTS AND EXPERIENCE FROM USING MODERNIZING MEDICINE PRODUCTS MAY VARY BASED ON A NUMBER OF FACTORS. MODERNIZING MEDICINE MAKES NO WARRANTY OF ANY KIND, WHETHER EXPRESS, IMPLIED, STATUTORY, OR OTHERWISE WITH RESPECT TO THE INPUTS, PROJECTIONS, OR OTHER INFORMATION SET FORTH HEREIN
5 Based on ModMed Practice Management claims data from 2016 to July 2026.
Disclaimer: This page includes “forward-looking statements,” including information about solutions and features that are not yet available. The decision and timing regarding release and development of solutions and features may be subject to change. Actual solutions and features may differ materially from any of those expressed here or in other forward-looking statements. Any purchasing decisions made by you should be solely based on ModMed’s existing solutions and functionality.