🏥 RCM AI Agentic Architecture

Comprehensive Revenue Cycle Management with 12 Specialized AI Agents

12
AI Agents
$4,348
Monthly Cost
70%
Processing Reduction

🤖 Specialized AI Agents

1
Supervisor Agent
Orchestrates all RCM workflows and agent interactions with intelligent routing and coordination
2
Patient Intake Agent
Automates patient registration, demographic verification, and insurance validation
3
Eligibility Verification Agent
Real-time insurance eligibility checking and benefits verification
4
Clinical Coding Agent
Converts clinical documentation to accurate ICD-10, CPT, and HCPCS billing codes
5
Claims Scrubber Agent
Pre-submission claim validation and error detection to maximize clean claim rates
6
Claims Submission Agent
Automated claim submission to payers with real-time status tracking
7
Payment Posting Agent
Automated payment reconciliation and ERA processing
8
Denial Management Agent
Intelligent claim denial analysis, root cause identification, and resolution workflows
9
Provider Credentialing Agent
Automated provider enrollment, credentialing, and contract management
10
Charge Capture Agent
Ensures complete charge capture and identifies missed revenue opportunities
11
RCM Insights Agent
Advanced analytics, reporting, and business intelligence for RCM optimization
12
Audit & Compliance Agent
HIPAA compliance monitoring, audit trail management, and regulatory adherence

💰 Cost Analysis Summary

Estimated Monthly Cost: $4,347.80

Bedrock Foundation Models $2,160 (50%)
Amazon Textract $750 (17%)
Bedrock Data Automation $500 (11%)
OpenSearch Serverless $346 (8%)
Other Services $592 (14%)

Key Assumptions: 10,000 patient encounters/month, 50,000 pages/month, 120,000 agent interactions/month