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Revenue Cycle Intelligence: From Denial Recovery to Preemptive Optimization

Transform revenue cycle management with AI that learns from every claim, flagging denials before they happen, aligning codes with payor rules, and accelerating reimbursements.
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Analyze: Denial-Driven Intelligence Starts with EOB & ERA Analysis

cliexaAI learns from each denial and rejection to identify trends, payer-specific patterns, and documentation pitfalls, automatically flagging risks before they repeat. 

  • Automated EOB/ERA parsing 
  • Root cause clustering of denials 
  • Real-time feedback loops into coding and documentation 

Resolve: Smart Appeal Management That Learns From Success

cliexaAI learns from your past successes, analyzing historical appeals, payer responses, and claim modifications to predict the best path to resolution. 

  • Suggests precise appeal language based on past outcomes 
  • Highlights documentation that strengthens cases 
  • Automates generation of appeals with minimal manual lift 

Comply: Real-Time Compliance Blueprint for Every Claim

cliexaAI doesn’t just match codes, it engineers a claim compliance blueprint for each payer, diagnosis, and procedure, adapting in real time to policy changes and patient context. 

  • Reverse-engineers payer coverage rules 
  • Cross-references ICD, CPT, lab results, and prior auth requirements 
  • Ensures each submission is defensible and audit-ready 

Harness: Self-Learning Optimization Loop That Gets Smarter With Every Claim

cliexaARCH doesn’t just automate, it evolves. Every claim, denial, appeal, and reimbursement adds intelligence to the system. Over time, the platform adapts to your specific payer mix, subspecialties, and workflows. 

  • Continuous logic refinement from outcomes 
  • Real-time model updates per payer region 
  • Precision tuning for high-volume CPT codes 
Bottom Line

AI-Driven RCM That Doesn’t Just Automate: It Learns

Transform billing from a reactive process into a predictive, intelligent engine. cliexaARCH optimizes claims at every step of the journey: Analyze, Resolve, Comply, and Harness, learning from every submission to improve compliance, prevent denials, and maximize revenue. 

Where Clinical Intelligence Meets Revenue Precision

With deep clinical logic, denial-aware compliance, and adaptive billing prioritization, cliexaARCH transforms RCM into a self-learning, payer-smart engine for predictable revenue. 

Clinical Intelligence, Not Just Automation

  • AI-powered by clinical reasoning, not just generative text.
  • cliexaARCH integrates diagnosis-driven logic and payer alignment into every claim to ensure reimbursement and defensibility.

Clinical Rules Engine with Medical Necessity Justification

  • Beyond compliance, real clinical reasoning is baked into every claim.
  • cliexa’s patented engine mines treatments, labs, and documentation to justify medical necessity and support appeals, automatically aligning every submission with payer policy.

Billing Prioritization powered by AI

  • Submit the right claims at the right time, first.
  • cliexaARCH ranks and recommends high-likelihood claims using learned payer behavior, denial patterns, and payment speed so billers can optimize throughput and accelerate revenue.

The Smartest Link in Your Revenue Chain

Cliexa ARCH bridges the gap between clinical care and billing. Our integrations with athenahealth, Healthie, and Microsoft Azure create an efficient, accurate, and secure path from patient encounter to payment.