Eligibility & Benefits Verification
Real-time eligibility checks against 2,000+ payers before every patient encounter. Catches inactive coverage, incorrect plan details, and benefit limitations before they become denials.
Niyantrix's AI-powered RCM platform automates every stage of the billing lifecycle — from eligibility verification and charge capture to claim submission, remittance posting, and denial resolution. More revenue. Less manual work.
Niyantrix manages the complete revenue cycle — from the moment a patient is scheduled to the day the final payment posts.
Real-time eligibility checks against 2,000+ payers before every patient encounter. Catches inactive coverage, incorrect plan details, and benefit limitations before they become denials.
Certified coders supported by AI review every encounter for accurate CPT, ICD-10, and modifier assignment. Reduces undercoding and ensures maximum legitimate reimbursement.
Every claim passes through 300+ payer-specific edit rules before submission. Our 98% first-pass acceptance rate eliminates costly rework cycles and accelerates cash flow.
Automated ERA/EOB processing with intelligent variance detection. Every underpayment, contractual adjustment, and posting error is flagged for review — capturing revenue others miss.
Root-cause analysis of every denial, automated resubmission workflows, and formal appeals with clinical documentation support. Our denial overturn rate exceeds 72%.
Real-time KPI dashboards covering AR aging, payer performance, denial trends, and collection rates — giving you full visibility and control over your financial health.
Traditional revenue cycle management relies on manual processes that are slow, error-prone, and reactive. Niyantrix's AI identifies problems before they occur — predicting denials, detecting underpayments, and optimizing the entire workflow in real time.
AI flags high-risk claims before submission using payer-specific denial pattern data.
Our models update with every payer policy change, LCD update, and denial trend shift.
AI audits every posted payment for underpayment against contracted rates.
Niyantrix integrates directly with your existing clinical and billing systems — no rip-and-replace required. We connect to your EHR, PM system, and clearinghouse on day one.
Direct HL7 FHIR integration
API-level workflow integration
Full billing module integration
Electronic connectivity to all major payers