AI-enabled RCM services · for athenahealth practices

Fix revenue leakage, without rebuilding your back office.

A new RCM operating model for athenahealth physician groups. 
Certified onshore specialists from CaduceusHealth, amplified by Flow AI.
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The 10th largest athenahealth client. Supporting 3,500+ providers since 1997.
The athenahealth specialists

Specialists who already know your system, not a team learning on your claims.

Certified onshore RCM specialists who live inside athenahealth every day. 
Not a tool you run, not offshore labor — amplified by AI.
3,500+
athenahealth providers supported
350+
hospital, PE-backed, and private practices
290+
onshore experts across 44 states
since 
1997
serving athenahealth practices since
For private and multi-specialty practices

A cardiology denial and an oncology denial are not the same fight.

Revenue leaks differently in every specialty. Pick yours.
Cardiology
Orthopedics
Oncology
Primary care & IPAs
Multi-specialty & MSOs
Cardiology
High-dollar imaging and procedural claims, exposed to medical-necessity denials.
Imaging, diagnostics, and interventional claims carry payer-specific medical-necessity rules that quietly drive denials. Prior authorization on advanced imaging and procedures is constant, and a single missed or wrong auth turns a high-dollar claim into a write-off.
Start with
Prior Authorization
Denials Resolution
Orthopedics
Protect surgical revenue 
from modifier, bundling, and prior-auth leakage.
High-dollar surgical and procedural revenue is exposed to modifier errors, bundling and global-period rules, and NCCI edits. Prior auth is relentless across imaging, surgery, PT, and DME, and workers’ comp, auto, and personal-injury claims carry their own rules, liens, and follow-up a general billing team is not built for.
Start with
Coding & Audits
Prior Authorization
Oncology
Buy-and-bill drug and infusion claims where one denial is a cash event.
Buy-and-bill drug and infusion claims are enormous, so a single denied or underpaid regimen is a cash event, not a rounding error. Reimbursement on ASP-based drugs is thin, authorization and step-therapy requirements are constant, and J-code and NDC billing is unforgiving on units and wastage.
Start with
Denials Resolution
Financial Services
Primary care & IPAs
Thin per-visit margins where front-end leakage compounds fast.
Thin per-visit margins mean front-end leakage and eligibility errors compound quickly across a large patient panel. Volume outpaces a lean billing team, and the same denials repeat because no one has time for root-cause work.
Start with
Call Center
Denials Resolution
Multi-specialty & MSOs
Every specialty leaks differently, and no one owns the whole picture.
Coding rules, payer mix, and front-desk capture vary by location, so performance drifts as you add providers and practices. With no single owner watching across sites, the highest-value recovery work falls behind everywhere at once.
Start with
A diagnostic across all three services

Lean teams lose revenue to bandwidth.
Multi-site groups lose it to visibility.
The diagnostic tells you which leak is yours.

Lean teams lose revenue to bandwidth.
Multi-site groups lose it to visibility. The diagnostic tells you which leak is yours.

Services

Pick the service that fits, from solo practice to full network.

You do not have to hand over everything. We come in alongside your team, starting with the one service leaking the most.
Provider Coding Audits
CPMA/CDOE review against CMS guidelines, with provider education.
CODING
Claim Resolution & Denials
Bi-weekly root-cause review, so the same denial stops coming back.
DENIALS RESOLUTION
Scheduling
Fill the schedule and capture clean data at the first touch.
CALL CENTER
Prior Authorization
Carry the auth burden so a missed one never becomes a denial.
CALL CENTER
Provider Coding Audits
CPMA/CDOE review against CMS guidelines, with provider education.
CODING
Claim Resolution & Denials
Bi-weekly root-cause review, so the same denial stops coming back.
DENIALS RESOLUTION
Scheduling
Fill the schedule and capture clean data at the first touch.
CALL CENTER
Prior Authorization
Carry the auth burden so a missed one never becomes a denial.
CALL CENTER
Provider Coding Audits
CPMA/CDOE review against CMS guidelines, with provider education.
CODING
Claim Resolution & Denials
Bi-weekly root-cause review, so the same denial stops coming back.
DENIALS RESOLUTION
Scheduling
Fill the schedule and capture clean data at the first touch.
CALL CENTER
Prior Authorization
Carry the auth burden so a missed one never becomes a denial.
CALL CENTER
Patient Contact Center
A dedicated team for updates, payments, and balances — measured on dollars collected.
CALL CENTER
Financial Services
Lockbox reconciliation, unpostables, refunds, and takebacks.
DENIALS RESOLUTION
Medical Coding
AAPC-certified coding across every specialty, clean the first time.
CODING
Patient Contact Center
A dedicated team for updates, payments, and balances — measured on dollars collected.
CALL CENTER
Financial Services
Lockbox reconciliation, unpostables, refunds, and takebacks.
DENIALS RESOLUTION
Medical Coding
AAPC-certified coding across every specialty, clean the first time.
CODING
Patient Contact Center
A dedicated team for updates, payments, and balances — measured on dollars collected.
CALL CENTER
Financial Services
Lockbox reconciliation, unpostables, refunds, and takebacks.
DENIALS RESOLUTION
Medical Coding
AAPC-certified coding across every specialty, clean the first time.
CODING
services SUPERCHARGED BY ai

Decades of expertise, now amplified with AI

Certified across the board
AAPC and AHIMA certified coders across every specialty, not generalists learning on your claims.
Quality is engineered in
Rigorous certification, monthly QA, and retraining whenever accuracy dips below threshold.
Deep athenahealth expertise
Dedicated athenahealth financial workflows, posting, and Tier 1 platform support. We work inside your system, with no rip and replace.
Root cause, not just cleanup
We open with an audit of your top payers, holds, and denials, then run bi-weekly root-cause reviews so the same denial does not come back.
Amplified by AI
Certified experts and AI work together, so more claims get worked with less manual effort and throughput rises as the engagement matures, without you hiring.
A dedicated SPOC, on a cadence
A dedicated account manager, with weekly, biweekly, and monthly AR reviews. You always know where your revenue stands.
REVENUE DIAGNOSTIC ASSESSMENT

Measure where the money is

LEAP measures the velocity of cash in the first 60 days, the window where most collectible revenue is decided.
LEAP · Leading Edge Acceleration Process
90%
of collectible revenue is decided in the first 60 days. LEAP benchmarks each engagement against a 90%+ 60-day cash target, with denial holds under 4%.
Cash collected
within 60 days
90%+
vs. 80–85% industry avg
Claims resolved
within 60 days
96%+
vs. 72–78% industry avg
Denial rate
‍
<5%
vs. 12–18% industry avg
Predictable reimbursement across payers
95%+
vs. 75–85% industry avg
Outcomes based on industry benchmarks and Flow customer deployments. Results vary depending on your current starting point.
How it works

One diagnosis, then we build
the report and walk you through it.

Get a written report with a dollar figure on every gap. No commitment.
Metric
Current
Benchmark
Status
Annual $ impact
First-pass resolution
74.8%
85.0%
Critical
$393K
Days in AR
66 days
35 days
Critical
$292K
Denial rate
13.9%
9.0%
Critical
$149K
Clean claim rate
85.3%
90.0%
At risk
$70K
Net collection rate
94.7%
96.0%
At risk
$74K
Appeal success rate
87.5%
85.0%
On target
-
Start alongside, prove value, expand

Englewood Health left an underperforming vendor, brought Caduceus in alongside, and grew eightfold.

From roughly $30M to $240M and from 50 to 500+ providers, with 55 multispecialty practices unified into one network. The proof that you can start narrow, show results, and expand on your own timeline.
8x
Over the

partnership
The no-commitment next step
Your data. Your report. No cost.
Send your claims data, get a dollar figure on every gap.
A read from the 10th largest athenahealth client, not a generic audit.
Request your diagnostic
Request your diagnostic
Download a sample report
Download a sample report
01
Leakage report
Share claims data. We find the highest-impact gaps.
02
Diagnostic
A KPI scorecard with the annual dollar impact of each gap.
03
Review & decide
Start with one service. No rip and
replace.
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