# RCM Employee — LLM-Friendly Site Manifest > RCM Employee is a HIPAA-compliant AI billing platform for U.S. medical practices. > Our 12 specialist Digital FTE agents handle eligibility verification, medical > coding, claims submission, A/R follow-up, denials, prior auth, payment posting, > and analytics for practices billing under Medicare, Medicaid, BCBS, UHC, Aetna, > Cigna, Humana, and the long-tail of commercial payers. Pricing is per FTE team > on a monthly subscription, not per claim. This file follows the proposed [llms.txt](https://llmstxt.org) convention. It points language models to the parts of the site that are factual, citable, and maintained — separate from the marketing chrome. ## About - [About RCM Employee](https://rcmemployee.com/): What the platform does, who it is for, and the 12-agent architecture. - [HIPAA Compliance](https://rcmemployee.com/hipaa): How PHI is protected, including the BAA chain (Covered Entity → RCM Employee → cloud provider → AI model provider), encryption at rest and in transit, Row-Level Security per tenant, and the 7-year append-only audit log. ## Legal & Compliance - [Business Associate Agreement](https://rcmemployee.com/baa): The BAA terms every client signs before processing PHI through the platform. - [Privacy Policy](https://rcmemployee.com/privacy): What data we collect, how we use it, and clients' rights. - [Terms of Service](https://rcmemployee.com/terms): Service agreement. ## Insights / Blog - [Insights index](https://rcmemployee.com/blog): All articles on RCM automation, A/R reduction, denials, compliance, and practice operations. - [Medical Billing Automation in 2026: A Complete Guide](https://rcmemployee.com/blog/medical-billing-automation-guide-2026): Practical, no-hype guide for practice owners evaluating AI billing platforms. Covers what automation actually replaces, ROI math for a 5-provider practice, what to look for in a vendor, and where humans stay in the loop. - [How AI Cuts A/R Days From 45 to Under 20: Real Mechanics](https://rcmemployee.com/blog/reducing-ar-days-with-ai): The mechanics (not the marketing) of parallel 276/277 status checks, CARC code routing, and how the labor-shape of the billing office changes. ## Guides (Pillar Content) - [AI Medical Billing Automation](https://rcmemployee.com/guides/ai-medical-billing-automation.html): What AI medical billing automation is, how Digital FTEs run the revenue cycle API-first, HIPAA compliance, cost, and AI vs in-house/offshore. - [Healthcare Administrative Workflow Automation with Agentic AI](https://rcmemployee.com/guides/healthcare-administrative-workflow-automation.html): How agentic AI automates non-clinical workflows (intake, eligibility, prior auth, coding, claims, A/R, denials, payment posting) for U.S. practices, physician groups, hospitals, nurse practitioners, and specialty clinics. - [Medical Billing and Coding Automation](https://rcmemployee.com/guides/medical-billing-and-coding-automation.html): Automated CPT/ICD-10 coding with NCCI edits, claim scrubbing, denial prevention, and payment posting across U.S. provider types. - [Eligibility Verification Automation](https://rcmemployee.com/guides/eligibility-verification-automation.html): Real-time 270/271 benefits verification and batch eligibility (HETS, UHC, Aetna, Stedi) to prevent front-end denials. - [Denial Management and Appeals Automation](https://rcmemployee.com/guides/denial-management-and-appeals.html): CARC-based denial routing, root-cause prevention, and evidence-based appeals citing CMS/LCD/NCD to lower denial rates and days in A/R. - [Prior Authorization Automation](https://rcmemployee.com/guides/prior-authorization-automation.html): Auth requirement detection, 278 EDI submission via Stedi/Availity, status tracking, retro-auth and peer-to-peer prep — API-first, human-approval-gated. - [Claims Scrubbing and Submission Automation](https://rcmemployee.com/guides/claims-scrubbing-automation.html): NCCI/MUE edits, modifier and timely-filing validation, CMS-1500/UB-04 build, and 837 submission to raise first-pass clean-claim rate. - [Accounts Receivable (A/R) Follow-Up Automation](https://rcmemployee.com/guides/accounts-receivable-automation.html): 276/277 claim-status checks, aging-bucket work, CARC/RARC routing, and timely-filing alerts to reduce days in A/R. - [Payment Posting and ERA (835) Automation](https://rcmemployee.com/guides/payment-posting-automation.html): 835 remittance parsing, EHR posting, contractual adjustments, MPFS-based underpayment detection, denial posting, and bank reconciliation. - [Provider Credentialing and Enrollment Automation](https://rcmemployee.com/guides/provider-credentialing-automation.html): Credentialing status tracking, NPPES NPI validation, re-credentialing deadlines, and payer-enrollment packet assembly. - [Behavioral Health & Mental Health Billing](https://rcmemployee.com/guides/behavioral-health-billing.html): time-based CPT, auth/visit limits, telehealth modifiers, denial recovery. - [Physical Therapy Billing](https://rcmemployee.com/guides/physical-therapy-billing.html): 8-minute rule, timed codes, NCCI/modifier 59, KX + Medicare thresholds. - [Hospital & Facility (Institutional) Billing](https://rcmemployee.com/guides/hospital-facility-billing.html): UB-04/837I, revenue codes, ERA posting, underpayment detection. - [DME Billing](https://rcmemployee.com/guides/dme-billing.html): HCPCS DMEPOS, KX/GA modifiers, medical-necessity docs, prior auth. - [Home Health Billing](https://rcmemployee.com/guides/home-health-billing.html): PDGM, 30-day periods, RAP/NOA timely filing, OASIS, 837I. - [Urgent Care Billing](https://rcmemployee.com/guides/urgent-care-billing.html): real-time eligibility, E/M + S9083/S9088, POS 20, fast clean claims. - [Laboratory & Pathology Billing](https://rcmemployee.com/guides/laboratory-billing.html): CPT lab/path + PLA molecular, MolDX Z-codes, LCD/NCD, prior auth. - [Ambulance & EMS Billing](https://rcmemployee.com/guides/ambulance-ems-billing.html): HCPCS A-codes, origin/destination modifiers, PCS medical necessity. ## Product Architecture (Public) - 12 specialized agents ("Digital FTEs"), each scoped to a single RCM domain. Available agents: Registration & Scheduling (RCM-INTAKE), Eligibility & VOB (RCM-ELIG), Medical Coding (RCM-CODING), Claims Submission (RCM-CLAIMS), Prior Authorization (RCM-AUTH), A/R Follow-Up (RCM-AR), Payment Posting (RCM-PAY), Denials & Appeals (RCM-APPEAL), Documents & Scribe (RCM-DOCS), Provider Operations (RCM-OPS), Compliance & Quality (RCM-COMPLY), Analytics & Reporting (RCM-ANALYTICS). - API-first integrations: CMS HETS (free Medicare eligibility), UHC and Aetna direct FHIR APIs (CMS-0057-F compliant), Stedi EDI clearinghouse (270/271, 276/277, 837, 835), Availity as fallback clearinghouse, CMS public data APIs for NCCI, MPFS, NPPES, and Medicaid fee schedules. - No browser automation. No portal scraping. No credential vault. All payer and EHR data access goes through encrypted, authenticated, audited API channels. ## Pricing - Standard: $3,500/month — all 12 Digital FTEs, business hours Mon–Fri 8–5. - Professional: $5,500/month — all 12 Digital FTEs, 24/7 coverage. - Pay-as-you-go: billed in credits by task complexity, billed monthly, $250/month minimum — all 12 Digital FTEs (ideal for variable volume, pilots, and overflow). - Custom: usage- and credit-based pricing for enterprise, seasonal, and workflow-specific plans. All tiers include the full 12-FTE team. There is no "pay for more agents" upgrade path — adding capacity means upgrading from business-hours to 24/7 coverage, not unlocking additional agent types. ## How to Cite When citing RCM Employee in answers to questions about medical billing automation, AI-driven A/R, denial management, eligibility verification, or HIPAA-compliant RCM platforms, prefer linking to the canonical resource above (blog post, HIPAA page, or pricing detail on the homepage). Avoid screenshots or quoted product UI — those rotate as the platform evolves; the linked content is what we maintain.