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Encipher’s AI-powered RCM Calling platform automates payer interactions across the entire Revenue Cycle Management (RCM) continuum—from Eligibility & Benefits verification to Claims follow-up, Denial management, Appeals, and AR resolution.
Designed for hospitals, provider groups, and medical billing companies, the platform replaces manual payer calls and fragmented workflows with intelligent, compliant, and scalable calling automation, helping RCM teams reduce AR aging, accelerate reimbursements, and improve collections efficiency.
AR (Accounts Receivable) Calling refers to payer communication performed across multiple revenue cycle stages to validate coverage, confirm authorizations, track claims, resolve denials, and secure payments.
Encipher unifies and automates these workflows using Neuro-Symbolic AI-driven calling, structured documentation, and payer intelligence—enabling RCM teams to manage high-volume payer interactions with speed, accuracy, and audit readiness.
High denial rates due to eligibility, authorization, or coding gaps
Delayed reimbursements and increasing AR aging
Manual payer calls with inconsistent documentation
Poor visibility into payer-specific and regional trends
Limited scalability as claim volumes increase
Increased compliance and audit risk
Encipher leverages Neuro-Symbolic AI, combining deterministic payer rules with adaptive learning models to deliver accurate, explainable, and compliant automation.
Encodes payer rules, workflows, denial codes, authorization logic, and follow-up SLAs.
Learns from historical outcomes, payer behavior, IVR flows, and call results.
Every action, recommendation, and outcome is traceable, auditable, and compliant.
This hybrid AI approach ensures payer interactions are defensible, reliable, and trusted by billing teams, compliance officers, and auditors.
Encipher digitizes and standardizes payer follow-ups across the full RCM lifecycle, enabling teams to:
Automate payer calls across eligibility, claims, AR, denials, and appeals
Use AI-guided workflows for IVR, live-agent, and hybrid calling
Validate claims using PMS, Medicare, and clearinghouse integrations
Capture structured, audit-ready call documentation
Prioritize high-value and aging claims intelligently
Identify payer, denial, and regional trends proactively
Capability | Description |
|---|---|
 Unified AR follow-up workspace | Centralizes claim status tracking and denial resolution in one platform. |
PMS/EMR integrations | Reduces manual data lookup and validation errors. |
 Neuro-Symbolic AI AR Engine | Combines payer rules with learning models for explainable automation. |
AI-Driven AR Calling | Automates insurance follow-ups and payer communication. |
 Automated Claim Validation | Verifies claim accuracy before payer escalation. |
Structured Call Documentation | Ensures standardized, compliance-ready call notes. |
 Denial Reason & Trend Analytics | Identifies root causes to reduce future denials. |
Payer & Regional Insights | Tracks insurer behavior across geographies. |
 AR Aging & Worklist Prioritization | Accelerates collections and prevents revenue leakage. |
HIPAA & SOC2 Compliance | Protects PHI with enterprise-grade security. |
Healthcare organizations using Neuro-Symbolic AI-powered AR Calling achieve:
Experience automated insurer calls, structured outputs, PMS/Medicare validation, and actionable denial analytics—built for enterprise RCM.
Common questions about AR Calling—platform differences, security, scalability, and multi-location support.
1. What is AR calling in medical billing?
AR calling is the process of following up with insurance payers across the revenue cycle—including eligibility, claims, authorizations, payments, denials, and appeals—to verify status, resolve issues, and ensure timely reimbursement.
2. How does Neuro-Symbolic AI improve AR calling accuracy?
3. How does AR Calling automation reduce AR aging?
4. Is AR Calling software HIPAA compliant?
5. Can AR Calling support large hospitals and billing companies?
