AI Agents Denial Codes Clearinghouse EHR Integration Pricing ROI
Pricing

All three AI agents. Every plan.

Pricing scales with your claim volume — not features. Every plan includes AI agents for revenue cycle management, standard EHR integration, and full clearinghouse connectivity.

S1 — Solo

$3,000/mo

Up to 500 claims/month · 5 seats

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  • All 3 AI agents included
  • Standard EHR integration
  • Clearinghouse connection
  • Email + chat support
  • HIPAA BAA at no charge
  • A/R dashboard access
  • 99.5% uptime SLA

S3 — Practice

$5,800/mo

Up to 2,500 claims/month · Unlimited seats

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  • Everything in S2
  • Dedicated Customer Success Manager
  • 99.9% uptime SLA
  • Denial recovery concierge add-on
  • REST API access for data export
  • Advanced A/R analytics
  • Custom payer portal connectors

Enterprise

Custom

Unlimited claims · MSO / multi-site

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  • Everything in S3
  • Custom agent workflows
  • White-label branding option
  • On-site team training
  • Custom SLA and DPA
  • Dedicated AWS infrastructure
  • Multi-site rollout support

One-time implementation fee: $3,000–$6,500 depending on EHR system — covers integration build, payer ID mapping, UAT parallel testing, and staff training sessions. Invoiced 50% at contract signing, 50% at go-live.

Digital Add-Ons

Extend what your AI agents can handle

Denial Recovery Concierge

+$800/month

Complex denials handled by billing specialists when AI escalation is required.

→ Faster resolution for high-value or edge-case claims

Custom Payer Connector

+$1,200 one-time

Connect to payer portals not in your standard clearinghouse network.

→ Automate submissions, tracking, and responses across any payer

Historical Data Migration

+$1,500 one-time

Import past claims and denial data to train AI models from day one.

→ Accelerate denial prevention and pattern detection

Advanced PA Dashboard

+$300/month

Track prior authorization status, SLAs, and expirations in real time.

→ Reduce delays and prevent avoidable denials

White-Label Branding

+$500/month

Use your own brand across the platform and client-facing workflows.

→ Ideal for MSOs, RCM vendors, and billing partners

Additional Training Sessions

+$250/session

Live onboarding sessions for new staff and workflow optimization.

→ Faster adoption and fewer operational errors

Stop losing revenue. Start recovering it in 30 days.

Your AI agents handle eligibility, prior authorization, and denials — so your team can focus on care, not rework.

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FAQs

Frequently asked questions

Denial management software pricing typically depends on claim volume, automation level, and support features. Modern solutions often follow usage-based or tiered pricing models, allowing healthcare providers to scale costs with their revenue cycle needs while improving collections and reducing manual work.

Healthcare software pricing is influenced by factors such as practice size, claim volume, integration complexity, and feature depth. Advanced capabilities like AI automation, real-time eligibility verification, and denial prevention can also impact overall pricing.

Common healthcare SaaS pricing models include subscription-based, usage-based, and tiered pricing. Many platforms combine these approaches, offering predictable monthly costs with scalability based on claims volume or patient activity.

Most healthcare platform pricing combines subscription and usage-based elements. Providers typically pay a base fee with pricing that scales based on claims volume, making it easier to align costs with actual revenue cycle activity.

Transparent healthcare software pricing should clearly outline all costs, including implementation, integrations, and optional add-ons. Hidden fees often arise from custom workflows, additional training, or third-party integrations, so it’s important to review pricing details carefully.

RCM software pricing scales based on claim volume, number of providers, and operational complexity. Larger practices or multi-location groups typically require higher capacity and advanced features, which are reflected in pricing tiers.

Many healthcare platforms offer demos or limited trials to help providers evaluate features before committing. Availability depends on the vendor, but trials typically focus on showcasing workflow automation and integration capabilities.

Most healthcare platform pricing includes core features such as eligibility verification, prior authorization, denial management, EHR integration, and reporting tools. Higher tiers may include advanced analytics, dedicated support, and custom workflows.

The ROI of medical billing software cost is typically measured through reduced denials, faster reimbursements, and lower administrative overhead. Effective automation can significantly outweigh software costs by improving revenue capture and operational efficiency.

Yes, enterprise healthcare SaaS pricing models are often customized based on scale, integrations, and workflow complexity. Larger organizations may require tailored pricing for multi-site operations, dedicated infrastructure, and advanced automation capabilities.