Your Revenue Cycle.
One Powerful Hub.
RCM Hub brings your entire medical billing workflow together in one agentic platform. From charge processing and claims submission to payment posting and patient billing, streamline your revenue cycle and keep your practice's financial performance in focus.
Get StartedLess Billing Complexity. More Financial Clarity.
RCM Hub is mdconnection's AI-enabled revenue cycle management and medical billing platform. It takes medical charges, builds and submits insurance claims through our proprietary clearinghouse, processes incoming responses, posts payments to the billing ledger, and manages patient billing, all from one centralized web-based console.
Charge Intake
Patients and charges arrive from your practice system or are keyed in. Each visit becomes an encounter.
Claim Edits
Every encounter is checked before billing. Problems are held for review instead of becoming denials.
Claim Submission
Released encounters are built into claims and sent automatically every 15 minutes, or on demand.
Payer Responses
Acknowledgements, claim status and remittances attach to the claim they answer.
Payment Posting
Payments, contractual adjustments and patient responsibility post to the ledger. Secondary claims build automatically.
Reconciliation
Deposits are matched against your bank's own records, so you know the money actually arrived.
Patient Billing
Patient balances go on statements. Patients pay online, by phone or by mail, or set up a payment plan.
Work & Analytics
Anything that needs a person lands in a work queue, where agents propose the fix. Analytics measures it all.
Charges & Claim Edits
Clean claims start with clean charges. RCM Hub checks every encounter before a claim is built, and tells you exactly what's missing.
- Charges arrive via HL7 or the RCM Hub API, or are entered by hand
- Encounters are held, released, billed or voided, each with a clear reason
- Edits come from payer behavior, CMS rules for Medicare, and your own rules
- Edits that prove wrong more often than right are suspended automatically
- Charge lag tracked from date of service to receipt
- Changes made after billing are caught and queued for resolution
Claims Submission & Tracking
Claims are built and sent through our clearinghouse automatically, and every response comes back to the claim it belongs to.
- Professional and institutional claims (837P / 837I)
- Full claim thread: every send, control number, 999, 277CA and 835
- Line-level payments and adjustments with group and reason codes (e.g. CO-45)
- Search by claim id, CLM01, payer claim number or check number
- Automatic alerts: no 999 within 24 hours, or no 277CA within 3 days
- Real-time claim status inquiries to the payer (276 / 277)
Work Queues
Every denial, rejection, underpayment and unanswered claim becomes a work item, with everything needed to resolve it in one panel.
- 19 queue types, from denials and takebacks to unmatched remittance lines
- Payer reason and remark codes explained in plain language
- Medicare coverage rules from CMS, with an AI plain-English summary
- "What worked before": how similar items were resolved
- Denials grouped by payer, reason and procedure, highest dollars first
- Automatic routing, bulk actions, saved views and keyboard shortcuts
Appeals & Timely Filing
Turn denials and underpayments into recovered revenue, with the documentation payers ask for generated for you.
- Start an appeal at any level directly from a denial or underpayment
- AI-drafted appeal letters, edited and approved by your team
- Organization letter templates filled automatically from the claim
- One-click proof of timely filing with every send and acknowledgement
- Follow-up reminders at 7, 14 or 30 days, or a date you choose
AI Agents You Stay in Control Of
RCM Hub's agents read the work and choose the next step, just as a biller would. You decide how far each one may go, and an agent earns more independence only through its track record.
Shadow
The agent's choice is recorded but not shown, so it can be compared with what your team did.
Propose
The agent suggests an action and a person approves or rejects it.
Act Alone
The agent acts on its own, within limits earned from its record. Limits are never set by hand.
The agents
| Follow-up | Asks the payer about claims that have waited too long |
| Eligibility | Re-checks coverage after an eligibility denial |
| Same fix | Applies a proven resolution to similar items |
| Timely filing | Watches filing and appeal deadlines |
| Duplicate | Spots duplicate claims and denials |
| Balances | Handles small balances and credits |
| Reconciliation | Proposes bank-to-deposit matches |
| Model's choice | Picks the best next step for anything else |
Ledger & AR
ERAs post themselves. Your team only sees what couldn't be posted cleanly, with what was expected beside what came.
- Automatic 835 posting of payments, adjustments and patient responsibility
- Posting issues flagged: underpayments, takebacks, unmatched lines, unknown claims
- AR aging by billing entity and responsibility (primary, secondary, patient)
- Unapplied payments and credit balances tracked for refund
- Period close: closed periods are locked and never reopened
Bank Reconciliation
Posted isn't the same as paid. RCM Hub matches every payer deposit and card batch to what your bank says actually arrived.
- Bank files by upload (BAI2, OFX / QFX, CSV) or SFTP connection
- Reconciliation agent proposes matches to accept or decline
- Match one deposit, several banked together, or refund checks
- Deposit slips for checks and cash banked by hand
- Monthly cash report: bank activity beside posted payments
- No bank logins stored; account numbers kept only as a keyed hash and last four digits
Patient Billing & Collections
Patient balances handled from statement to payment, with online pay links that need no account or password.
- Statement cycles and minimums set per billing entity
- Secure pay links: patients confirm date of birth and pay by card
- Card payments, receipts by print or email, and refunds to card
- Payment plans with printed agreements and default tracking
- Final notices and collection agency placement files
- Write-offs for courtesy, small balance, bad debt and charity
Revenue Analytics
Measure the whole revenue cycle, and click any number to see the claims behind it.
- First-pass acceptance, paid first time, denial rate and touchless claims
- Time to bill, days to pay, days in AR and net collection rate
- Every measure's definition and monthly trend, one click away
- Signals when a measure moves more than chance, or a payer stops paying
- Weekly expected-cash forecast, scored against what arrived
- Standard reports with CSV export and an AI-drafted monthly summary
Two Ways to Run RCM Hub
Each billing entity runs in the mode that fits it, and one organization can manage many billing entities side by side.
| Capability | Billing Mode | Clearinghouse Mode |
|---|---|---|
| Who builds the claim | RCM Hub, from your charges | Your practice system |
| Claim edits before submission | ||
| Claim submission & tracking | ||
| 999 / 277CA / 835 returned | ||
| Payment posting & ledger | ||
| Fee schedules, contracts & pricing rules | ||
| Patient statements & collections |
Looking for a team to run your billing for you? See our RCM Services Pricing.
Standards, Integrations & Security
X12 Transactions
| 837P / 837I | Professional & institutional claims |
| 999 | Batch acknowledgement |
| 277CA | Claim acceptance & status |
| 835 | Electronic remittance advice |
| 270 / 271 | Eligibility inquiry & response |
| 276 / 277 | Claim status inquiry & response |
Integrations
- HL7 charge and patient feeds, with per-partner mappings
- REST API for registered partner systems, authenticated by public key
- Webhooks and caller keys for event notifications
- Clearinghouse, bank (SFTP), statement vendor, payment gateway and collection agency connections
- Shared payer catalog with payer ids, transactions and filing limits
- Every file sent or received stored and searchable
Security & Compliance
- Two-factor sign-in with an authenticator app
- Role-based access per organization or billing entity: biller, poster, payments, analyst and admin
- Complete audit record of every change, view and download
- Support access only through a role, or time-limited, recorded break-glass
- Sandbox environment per organization for testing
- AI use controlled per organization; the monthly summary is drafted from figures alone, with no patient or payer named
Feature rich applications to meet the needs of your dynamic medical practice
Combine the power of all 3 cloud-based applications to manage your medical practice
Billing Dashboard
A powerful global practice analytics platform that combines all of your medical practices under one virtual roof
mdconnection
Enterprise-level cloud-based practice management for scheduling, medical billing, claims and payment handling
RCMHub
An AI-enabled revenue cycle management and medical billing platform