01
Eligibility
Checks coverage and plan status up front, so claims never stall on a lapse.
COVERED
PPO - IN NETWORK
AI revenue cycle automation
Get paid for the care you've already delivered.
QHB's AI agents take over claim follow-up end to end: payer portals, calls, denials, appeals. Your team works the exceptions, not the queue.
HIPAA compliant. BAA executed for every customer.
Simulated claim 1 of 5: #8814 from UnitedHealthcare, 38 days in AR.
CLAIM #8814 · UNITEDHEALTHCARE
Choice Plus
$2,140.00
$2,680.00 billed
Stuck 38 days
Day 38Aged past 30 days with no payer response
Portal checked
Checked UnitedHealthcare portal via Availity
Payer called
UnitedHealthcare rep confirmed payment scheduled
Paid
Payment posted back to your EHR
ar.scan · claim aging 38d · flagged for follow-up
Day 38 in ARFollow-up active
Auto follow-up runs every 3 days until resolved
~12%
of claims are denied on first submission
$25+
average cost to rework a single denied claim
85%+
of denials are preventable with consistent follow-up
<35 days
in AR is the benchmark for top performers - many organizations run 40-50+
The problem
The AR treadmill.
Every unpaid claim needs the same three things: a status, a call, and a next step. Today your staff provides all three by hand.
On hold, again
Hours a day on hold with payer IVRs, just to learn a claim is still pending.
Portal sprawl
A dozen payer portals, each with its own login, layout, and idea of a claim's status.
Denial pile-up
Denials land without a next step, so they age into the 60+ day bucket.
Rework eats margin
Every reworked denial costs $25 or more - and takes your biller's whole morning.
How it works
From submitted to paid, in fewer days.
Every open claim gets worked daily, with a full audit trail. Your team sees results, not task lists.
02
Portal checks
Pulls claim status, denial codes, and payment details across every payer portal.
status check - payer portal
CLM 8814PENDING - CO-197
03
Payer calls
Places the call, works the phone tree, waits on hold, and comes back with an answer, not a callback.
DIALMENU 3HOLD 14:02AGENT
04
Denials and appeals
Reads each denial, drafts the appeal with records attached, and files it.
CO-197 - DENIEDDOS 03/14
Appeal filed - records attached0.9s
Reversed+$2,140.00
05
Resubmissions
Corrects payer IDs and COB issues, then sends the claim back out clean.
PAYER ID 87726->03432
Resubmitted - clearinghouse accepted0.9s
06
Posting
Writes payments, reference numbers, and notes straight back to your EHR.
ERA 835$2,140.00
EFT 004118$3,760.00
NOTE -> PM SYSTEMPOSTED
Edge cases
Where claims get stuck.
The obvious follow-ups are easy. QHB is built for the exceptions that quietly drain your AR - the cases most workflows were never designed to handle.
Eligibility lapses
Coverage that ended mid-treatment gets caught before the claim ever goes out.
COB conflicts
When two payers each point at the other, the agents establish the primary and resubmit.
Denial codes
CO-197, CO-29, PR-204 - every denial is read and routed to the right next step.
Payer ID mismatches
Wrong clearinghouse IDs are corrected and the claim is sent back out.
Missing authorizations
Auth gaps are flagged and chased with the payer before they can age.
Underpayments
Expected versus actual reimbursement is compared on every remittance.
Who it's for
Built for the teams that live in AR.
For hospitals and health systems
Clear the backlog without adding headcount.
Your billers step off hold and into exception review. The agents work the portals, the calls, the denials, and the resubmissions directly in your current EHR.
See the profile ->
For physician groups and clinics
Follow-up that never slips.
Clean claims in, faster payments out. No more follow-up lists gathering dust between billing cycles.
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For RCM and billing firms
Take on more clients without hiring.
Onboard new client portfolios in days. Every claim carries a client-ready audit trail, while your team stays focused on the work that needs a human.
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Integrations
Works with the stack you already have.
Connect your EHR and clearinghouse, and pilot on your own claims in days - not quarters.
Epic
EHR
Cerner
EHR
athenahealth
EHR
eClinicalWorks
EHR
Waystar
Clearinghouse
Availity
Clearinghouse
Pricing
Pricing tailored to your organization.
No generic tiers. Your claim volumes, payer mix, specialties, and EHR all shape the right model, so we scope pricing to your AR after a short conversation.
Security
Built for PHI from day one.
PHI encrypted with AES-256 in transit and at rest, covered by a signed BAA before the first claim, and independently certified.
HIPAA compliant
A BAA is executed with every customer before any PHI is handled.
Encryption
AES-256 encryption in transit and at rest.
Full audit trail
Every agent action is logged, timestamped, and reviewable.
FAQ
Common questions about AI in the revenue cycle.
What is QHB?
Quality Health Billing is an AI revenue cycle platform that works accounts receivable for healthcare providers. A coordinated team of AI agents follows up on every claim - checking payer portals, calling payers, working denials, filing appeals, and resubmitting claims - so your staff stays off hold and works only what needs a human.
Does QHB actually call payers?
Yes. The agents place real calls, navigate the IVR, wait on hold, and come back with an answer from an actual human at the payer - around the clock, on your behalf.
Which EHRs and clearinghouses does QHB work with?
QHB works with the stack you have today, including Epic, Cerner, athenahealth, eClinicalWorks, Waystar, and Availity.
How much does QHB cost?
Pricing is tailored to your organization: your claim volumes, payer mix, specialties, and EHR. Book a demo and we'll scope it to your AR.
Is QHB HIPAA compliant?
Yes. QHB is HIPAA compliant and executes a BAA with every customer. Data is encrypted in transit and at rest, and every agent action is logged to a full audit trail.
Who is QHB built for?
Hospital and health system revenue cycle teams working a growing backlog, physician groups that want faster follow-up, and RCM and billing firms growing client volume without growing the team.
What happens during the demo?
Thirty minutes. We walk through how the agents take a claim from submitted to paid, mapped to your payer mix, and scope a pilot on a slice of your open claims.
Get started
Watch it work your own AR.
We'll walk through the agent queue on claims like yours, then scope a pilot together.
- A 30-minute walkthrough, no deck
- Mapped to your payer mix and EHR
- Pilot scoped on a slice of your open claims