Six Stages. End-to-end. SLA-bound.
The reason most RCM outsourcing fails isn't the people, it's the process. We engineer the operating model first, codify it into SOPs, instrument it with analytics, and only then layer AI. What follows is the actual model we run for every client.
Every Workflow. Measured.
Every stage of the revenue cycle operates against defined SLAs, analytics thresholds, and payer-specific execution standards.
Before OlympusAI is deployed, we map your current-state workflows against MGMA/HFMA benchmarks to identify leakage, operational delays, denial patterns, and reimbursement gaps. From eligibility verification to denial recovery, every workflow is instrumented with real-time analytics, SLA tracking, and specialty-specific execution controls.
The result is a revenue cycle built around visibility, accountability, and measurable financial outcomes.
"We didn't outsource our revenue cycle. We bought a better one."
Pre-Encounter
Most practices verify eligibility the morning of the appointment, but by then, the denial is already baked in. We run real-time 270/271 verification, prior-auth confirmation, and patient cost estimation before the encounter opens. Every coverage gap is flagged and resolved before the patient walks in.
Charge Capture
We cross-reference every charge against the EHR, surgical schedule, and physician notes in real time. Every discrepancy is flagged before the claim is built.
Coding & Scrub
We apply 800+ payer-specific edits before anything leaves the queue, using AAPC and AHIMA-certified coders augmented by AI trained on 47M historical claims. First-pass acceptance rate: 98.4%.
Submission & Follow-Up
Most practices follow up on unpaid claims on a fixed schedule - weekly batches, manual worklists, and staff-dependent. We score every claim for denial probability 72 hours before submission, route high-risk claims to a specialist before they go out, and follow up at the exact moment each payer's SLA expires.
Denials, Appeals & Recovery
We appeal every denial within the payer SLA, with payer-specific clinical language drafted by AI and reviewed by specialists. For out-of-network disputes, our IDR win rate is 87%.
Reporting & Continuous Improvement
We deliver a live CFO dashboard every Monday - denial rate, A/R days, net collection ratio, and clean claim rate, all benchmarked against MGMA / HFMA medians, with monthly cohort drill-downs and quarterly board-ready output.
How We Deliver.
AI & Analytics,
Working Underneath.
You don't operate the AI. You don't manage the analytics. They run quietly in the background, alongside our 1,700 specialists & Agentic AI workflow, working every claim, every payer, every shift.
Predictive Denial Intelligence.
Our AI scores every claim 72 hours before submission against 47M historical claim outcomes. High-risk claims auto-route to specialist review.
- Denial rate cut to 5% from the 12-14% industry baseline.
- Calibrated confidence scoring per claim
- Auto-routes to AAPC-certified human reviewer
- Continuously retrained on payer behavior
Agentic AI Workflow
Trained specialized agents work the parts your team hates: payer portal logins, status calls, appeal drafts, underpayment scans. They run 24/7, never miss an SLA, and feed every action into your live dashboard.
- Portal agents — 800+ payer interfaces
- Voice agents — lifelike status calls
- Appeals agents — payer-specific clinical drafts
- Recovery agents — underpayment variance scans
CFO-grade Analytics
Live dashboard, weekly variance against MGMA / HFMA medians, monthly cohort drill-down, quarterly leakage map. The dashboard your CFO didn't know they needed, and won't run revenue cycle without ever again.
- Live KPIs — denial, A/R, NCR, clean-claim
- Cohort drill-down by payer / specialty / location
- Weekly variance vs. MGMA / HFMA medians
- Quarterly board-ready output
From Kickoff to
Cash Impact.
Most RCM transitions take six months to show measurable cash flow improvement. Ours don't. Here's the standard 90-day arc, by week.
Diagnostic & baseline.
- Current-state mapping against MGMA / HFMA medians.
- Leakage quantification.
- Payer-specific denial analysis.
- To-be operating model design.
- Findings memo delivered to CFO.
- EHR/PM integration.
- Specialist team build.
- Workflow runbook handoff.
- Parallel processing on prior 60-day claim cohort to validate.
- Full cutover to Plutus Health-managed RCM.
- First weekly CFO dashboard.
- Initial SLA compliance audit.
- Quarterly business review schedule locked.
12 Services. 25 Agents. One Operating Model.
Each service is delivered through specific OlympusAI agents with measurable KPIs and human-in-the-loop SMEs. Click into any service to see the agent, the autonomy threshold, and the CFO-grade outcomes.
The complete OlympusAI 3.0 platform, 25 agents in production across 9000+ providers, trained on $1.7B in annual claim data.
End-to-end medical billing run by 25 AI agents, supervised by AAPC-certified humans. Outcome-based commercial model.
99.2% coding accuracy. 5x throughput per coder. Specialty-tuned across 17 verticals.
99.2% verification accuracy. 1,847 verifications/day per CSM. Eliminates 15-25% of denials
18-hour median TAT (vs 4-6 days industry). 84.6% approval rate. 234 auths in flight per CSM
+$284K average monthly recovery. 142 secondary policies found per month. 8-14% of self-pay AR recovered.
1,247 denials prevented monthly. 67% appeal win rate. $1.2M monthly recovery.
28-day median AR vs 39-day industry baseline. 892 payer calls/day per CSM. 3-5x throughput.
45-60 day median time-to-credential vs 90-120 day industry. 100% CAQH attestation compliance.
3-5x finding rate vs random sampling. 12 minutes per audit (vs 2 hours). 1.5-3% revenue recovery.
83% IDR win rate (vs 55% industry). Case prep cut from 40 hours to 4 hours per dispute.
Director-level RCM leader plus the entire Olympus platform. Plug in within 2 weeks.
Reasoning agents that adapt to portal changes. We replaced our own 70+ RPA bots; we can replace yours.
2-4% revenue lift from previously missed charges. 24-hour flagging SLA against your EHR.
+18% patient self-pay collection. +34% payment plan adoption. Statement cycle tuned to patient preference.
65% of denials originate at registration. Verify eligibility in real-time at scheduling, eliminate the source.
97% first-pass clean claim rate vs 75-85% industry. 1,200+ payer-specific edits per cycle.
10% of claims drive 40% of revenue. Multi-payer COB, OON/IDR, high-dollar surgical — routed through specialists.
UB-04 institutional billing for ASC, FSER, and specialty institutional providers. Without hospital assumptions
AR is a phone problem. We solved phones. 892 calls/day per CSM at $0.40/call vs $8 fully-loaded human.
DRG accuracy without the Big Box CDI overhead. Right-sized for mid-market hospitals and specialty inpatient.
Dual-lens DRG validation: revenue optimization + audit defensibility. Maximize and survive the audit.
+0.15-0.40 RAF lift typical first year. 92%+ HCC capture. Continuity tracking across years for MA & ACO.
RADV defense as ongoing posture, not crisis response. 2-3 hours per file vs 10-15 hours manual.
Recommend AND execute. PE diligence, RCM transformation, payer strategy, EHR migration, CFO coverage.
13-week rolling cash forecast (±5% accuracy). Weekly variance vs MGMA/HFMA. CFO-grade financial packs.
Ready to See Where Your Revenue Is Leaking?
Our 30-day diagnostic baselines your current state against MGMA / HFMA medians, quantifies the leakage, and shows you the to-be model, before you sign anything.