HIPAA Compliant · AI-Powered · Multi-Clinic

AI Revenue Intelligence
Platform for Healthcare

Prevent denials, detect underpayments, and maximize collections with AI-powered billing intelligence built for clinics, labs, and high-complexity healthcare environments.

No credit card required · 30-day free trial · Cancel anytime

35%
Average reduction in claim denials
$180K
Average annual underpayments recovered
4 hrs
Saved per biller per week
98%
Claim accuracy with AI validation
Platform Intelligence

Revenue intelligence at every step

From the moment a patient is registered to the moment payment clears — every touchpoint is automated, validated, and optimized for maximum collections.

AI-Powered

AI CPT & ICD-10 Intelligence

Type a test name and receive instant CPT code suggestions. AI analyzes diagnosis codes, payer rules, and billing history to recommend optimal codes with confidence scores.

Pre-Submission

Denial Risk Scoring Engine

Every claim is scored 0–100% for denial probability before submission. CPT/ICD-10 rules, modifier checks, authorization flags, and frequency limits — all automated.

ERA 835

Underpayment Detection

ERA 835 files are parsed automatically. Every payment is compared to your contracted rate. Underpayments are flagged instantly with recoverable dollar amounts.

Real-Time

Revenue Intelligence Dashboard

Real-time KPIs: total charges, net collections, expected vs actual, cash vs insurance, denial rates — all in one view, auto-refreshed every 30 seconds.

Lab Analytics

Lab Volume & Test Profitability

Identify which tests generate revenue and which erode margins. Track daily sample volume, revenue per CPT, lab cost vs reimbursement, and top referring physicians.

Forecasting

Revenue Forecasting AI

Predict next 30-day collections based on pending claims, payer behavior, and historical approval rates. Low, mid, and high scenarios with actionable recommendations.

HIPAA

HIPAA Compliance Built-In

Every PHI access is logged with user, IP, and timestamp. AI features operate exclusively on de-identified data. Full compliance score dashboard included.

Multi-Site

Multi-Clinic Architecture

Manage multiple clinics and labs from one platform. Each clinic maintains full data isolation. Administrators see consolidated intelligence across the entire network.

Why Hope RCM

Why Healthcare Organizations
Choose Hope RCM

Not all RCM platforms are built the same. Here is what makes Hope RCM the intelligence layer that healthcare revenue teams trust.

Built for Complex Billing Environments

Hope RCM was engineered from the ground up for the billing complexity of independent labs and multi-specialty clinics — not adapted from generic software.

AI Trained on Real Billing Workflows

Our denial risk engine and CPT intelligence are trained on actual healthcare billing patterns — not generic NLP models. Every recommendation is grounded in revenue cycle reality.

Multi-Clinic and Lab Support

Manage an entire network of clinics and labs from a single platform with full data isolation per entity and consolidated intelligence across the organization.

Audit-Ready Compliance System

Every PHI access, configuration change, and billing action is logged with user, IP, and timestamp. HIPAA technical safeguards are built into the core — not bolted on.

Revenue-Focused Intelligence, Not Just Automation

Hope RCM does not just automate tasks — it surfaces insights that directly increase collections, identify underpayments, and prevent revenue leakage before it happens.

Workflow

From intake to payment in 5 steps

A complete, automated revenue cycle — every step designed to increase accuracy, reduce denials, and accelerate collections.

01

Patient Intake

Secure, automated intake with encrypted PHI and structured data capture — protected from the first keystroke.

02

AI Claim Validation

Every claim validated before submission with denial risk scoring and rule-based checks across CPT/ICD-10, modifiers, and authorization flags.

03

837P Submission

Seamless submission with clearinghouse integration and real-time status tracking — no manual EDI handling.

04

ERA Reconciliation

Automatic payment posting with underpayment detection and adjustment tracking — every ERA 835 reconciled against contracted rates.

05

Revenue Analytics

Real-time insights showing revenue performance, denial trends, and financial opportunities — updated every 30 seconds.

Flexible Add-Ons

Expand as your practice grows

Every plan includes the full core platform. Add specialized capabilities when you need them — no forced bundles.

AI

Advanced AI Models

Connect your own OpenAI, Anthropic, or Gemini keys for custom AI workflows and higher throughput.

Integration

Clearinghouse Integration

Direct EDI connections to Availity, Change Healthcare, Waystar, and more — automated claim routing.

Scale

Multi-Clinic Network

Add additional clinic or lab entities with full data isolation and consolidated network-level reporting.

Analytics

Custom Reporting & BI

Build custom dashboards, scheduled exports, and executive-level financial intelligence reports.

Compliance

HIPAA Compliance Package

Full BAA, annual risk assessment, breach incident response, staff training logs, and compliance scoring.

Enterprise

White-Label Branding

Replace Hope RCM branding with your own logo, colors, and domain for client-facing deployments.

Competitive Advantage

Why Labs Choose Hope RCM

Labs that switch to Hope RCM recover an average of $180K/year in underpayments and reduce denial rates by 35% within 90 days.

Manual Billing

Spreadsheets & Paper

Generic RCM

Off-the-shelf Software

★ HOPE RCM

Hope RCM

Lab-Built AI Platform

Lab-Specific Capabilities
Lab Volume & Test Profitability
CPT/ICD-10 AI Suggestions
Limited
Referring Physician Analytics
Sample Chain of Custody
ERA 835 Auto-Posting
Manual
AI & Intelligence
Denial Risk Scoring (pre-submission)
Revenue Forecasting AI
Underpayment Detection
Manual
Payer Behavior Intelligence
AI Denial Category Suggestion
Compliance & Security
HIPAA Audit Logs (immutable)
Partial
SOC 2 Readiness Tracker
BAA Management
Manual
PHI De-identification for AI

Ready to see the difference? Schedule a personalized walkthrough with our team.

Pricing

Transparent, outcome-based pricing

Every plan includes the full AI engine. Choose the tier that matches your claim volume and complexity.

Small Clinic

Purpose-built for independent clinics and small practices focused on reducing denials and increasing collections.

$499/month
AI claim validation & risk scoring
Patient & sample intake
CPT / ICD-10 AI suggestions
ERA 835 auto-posting
Revenue intelligence dashboard
Denial management workflow
HIPAA audit logs
PDF & Excel reports
Email support
Most Popular

Lab

Engineered for high-volume labs with complex billing, multi-payer contracts, and advanced analytics requirements.

$1,500/month
Everything in Small Clinic
Unlimited claims
Lab volume intelligence
Test profitability analysis
Referring physician analytics
Payer behavior intelligence
Revenue forecasting AI
Multi-clearinghouse support
Biller productivity dashboard
Priority support

Enterprise

For health systems, multi-lab networks, and organizations requiring custom integrations and dedicated support.

$3,000/month
Everything in Lab
Unlimited clinics & providers
Custom clearinghouse integration
Dedicated account manager
Custom AI model tuning
SLA guarantee
BAA included
White-label options
Full API access & webhooks
HIPAA Compliant

Designed for audit-ready
healthcare environments

Designed to meet HIPAA technical safeguards and built for audit-ready healthcare environments. Every PHI access, configuration change, and billing action is logged with user, IP, and timestamp — immutable and exportable for regulators.

Hope RCM enforces role-based access control, AES-256 encryption at rest, TLS 1.3 in transit, and full data isolation per clinic — so your organization is protected at every layer, from intake to payment.

End-to-end encryption

AES-256 at rest, TLS 1.3 in transit — every byte protected

Complete audit trail

Every PHI access logged with user, IP, action, and timestamp

Role-based access control

Owner, Biller, Admin — each role sees only what they need

AI data isolation

AI models never receive patient identifiers — de-identification enforced at the API layer

A+
HIPAA Technical Safeguards Score
§164.312(a) — Access Control
§164.312(b) — Audit Controls
§164.312(c) — Integrity
§164.312(d) — Authentication
§164.312(e) — Transmission Security

Built for audit-ready environments. Every configuration change, login event, and data access is immutably logged.

Customer Stories

Trusted by billing teams nationwide

Labs and clinics are recovering revenue they didn't know they were losing.

“We recovered $47,000 in underpayments in the first 90 days. The ERA auto-posting alone saved my team 12 hours a week.”

Maria T.
Billing Director · Regional Reference Lab
$47K recovered
in 90 days

“Our denial rate dropped from 18% to 4.2% within two months. The AI scrubber catches things my billers would miss.”

James K.
Revenue Cycle Manager · Multi-Specialty Clinic
18% → 4.2%
denial rate

“The HIPAA compliance dashboard gave me peace of mind I never had before. Our last compliance review was the smoothest we've ever had.”

Sandra L.
Lab Owner · Independent Clinical Lab
100%
audit ready

“Setup took less than a day. The AI CPT suggestions are remarkably accurate — our coders say it's like having a senior coder reviewing every claim.”

Dr. Patel
Medical Director · Urgent Care Group
< 1 day
to go live

“The patient portal links and automated payment reminders cut our days in AR from 52 to 31. Patients actually pay their balances now.”

Rachel M.
Practice Administrator · Women's Health Center
52 → 31
days in AR

“The executive revenue report gives me a real-time view across all our locations. I can see which payers are slow and where we're leaving money on the table.”

Carlos V.
CFO · Hospital Outreach Lab
6 locations
unified view
ROI Calculator

How much are you leaving on the table?

Adjust the sliders to see your estimated annual revenue recovery with Hope RCM.

500
claims/month
18%
industry avg: 18%
$320
per claim
Monthly Revenue Lost
$28,800
at 18% denial rate
Monthly Recovery
$21,600
projected at 4.5% denial rate
Annual ROI
$259,200
estimated annual recovery

Based on industry benchmarks. Actual results vary by payer mix, specialty, and billing practices.

Trusted by clinics and labs

Stop Losing Revenue to
Denials and Underpayments

Join clinics and labs using Hope RCM to increase collections, reduce billing errors, and take control of their revenue cycle with AI.

No credit card required · 30-day trial · Full access from day one