Resources
The revenue cycle,
explained plainly.
Notes from the team, benchmarks, and a shared vocabulary for the AI layer on top of your RCM.
From the blog
Reading a contract isn't the same as operationalizing it at scale. Why general-purpose chat models can't run a revenue cycle on their own.
Read on LinkedIn →Gen AI Anti-Patterns: Why Most "AI Products" Break in ProductionFive anti-patterns we design against — from mega-prompts standing in for architecture to treating accuracy as binary instead of a confidence score.
Read on LinkedIn →The Rise of the Foundry Engineer: Building Products With, Not Just For, CustomersWhat we learned building our Appeal Management module alongside real customers, and why we staff pods around a new kind of engineering role.
Read on LinkedIn →The Future of Healthcare Operations: How AI Agents Transform Revenue Cycle ManagementWhy rigid RPA breaks when payer rules change, and what a network of role-aware agents looks like across front desk, mid-cycle, and back office.
Read on LinkedIn →10 Months Building With the Best AI Tools: Will AI Replace Software Teams?Ten months of shipping real agents for real healthcare providers — what AI tooling actually changed for our product, engineering, and QA workflows.
Read on LinkedIn →Meet the agents
Nuvae's agent network is organized by where it sits in the revenue cycle — each one role-aware, working alongside the others.
Registration, Scanning, Eligibility
CDI Notes, Charge Capture, PreAuth
Claim Scrubber, Submission
Collection, Denials, Appeals, A/R Recon
Analytics, Voice Call
Glossary
The full financial process from patient scheduling and eligibility through claim submission, payment, and appeal.
Confirming a patient's insurance coverage and authorization requirements before a claim is generated.
A claim paid at less than the rate the payer contract specifies — often invisible without line-by-line rate matching.
A denial is a claim payers refuse to pay at all. An underpayment is a claim they pay, but at the wrong rate.
A HIPAA-required contract between a covered entity and any vendor that handles protected health information on its behalf.
Pursuing payment on claims that are unpaid, underpaid, or stuck in appeal — the 'tail end' of the revenue cycle.
Benchmarks & further reading
Industry-wide administrative burden and automation benchmarks.
Payer denial trends and revenue cycle survey data.
Healthcare Provider cost and margin pressure benchmarks.
Revenue cycle operations research.
Healthcare finance leader sentiment and denial data.
Contract underpayment and leakage analysis.
Peer-reviewed health policy research.
Peer-reviewed clinical and health-systems research.