- Bots execute tasks without understanding risk
- Rules are static and identical for all practices
- Systems fail when data is incomplete
- Accuracy drops sharply across specialties
Innovation Hub
Innovation Hub
Intelligence Engineered for Real-World Revenue Cycle Performance
Across the RCM industry, innovation often stops at basic automation. SCIO's Innovation Hub goes further—engineering practice-aware, specialty-compatible Intelligence Agents that guide decisions, manage risk, and execute with accuracy across the revenue lifecycle.
- This is not automation for activity.
- This is intelligence for outcomes.
Platform Overview
Why Generic Automation Fails in Healthcare RCM
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Across The Industry
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SCIO's Belief
Accuracy must come before automation. Intelligence must guide execution. SCIO innovates by first understanding context, variability, and risk, then applying automation only when confidence is high.
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A Practice-Aware Revenue Operating Layer
SCIO operates a layered intelligence architecture that adapts to how revenue actually behaves across practices.
Architecture pillars:
- Practice-level configuration
- Specialty-aware logic models
- Payer behavior learning
- Risk-based decision scoring
- Outcome-driven tuning
This architecture ensures consistent accuracy across oncology, surgery, diagnostics, and multi-specialty groups.
Automation Suite
Agent-Driven Revenue Execution (Not Bots. Not Apps.)
The SCIO Intelligence Suite is a coordinated ecosystem of AI-powered Intelligent Agents. Each agent reasons, recommends, and executes with context.
What makes SCIO agents different:
- Adapt to each practice's risk profile
- Behave differently by specialty
- Learn from real claim and EOB outcomes
- Operate confidently even with incomplete data
Eligibility & Coverage Intelligence Agent
Built for Real-World Data Complexity
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Industry Standard Tools
- Depend on valid member ID
- Binary "eligible / not eligible" logic
- Uniform checks across all specialties
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SCIO Advantage
- Eligibility rules customized per practice
- Compatible across all specialties
- Insurance discovery even without member ID
- Uses demographics, payer patterns & history
- Flags coverage probability, not just yes/no
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Outcome
Higher front-end accuracy, fewer preventable denials.
Authorization Risk Intelligence Agent
Detecting Revenue Risk Others Miss
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Industry Approach
- Checklist-based auth logic
- No learning from historical denials
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SCIO Intelligence
- Risk-scored authorization logic
- Trained on past denial patterns
- Specialty-specific authorization behavior
- Proactively flags high-risk encounters
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Outcome
Reduced auth-related denials, stronger front-door control.
AR Intelligence & Cash Orchestration — TrackAR™
From Aging Buckets to Cash Strategy
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Industry Approach
- Sort AR by days or balance
- Same follow-up everywhere
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SCIO Intelligence
- Monitors 200,000+ AR lines monthly
- Prioritizes by :
- Cash impact
- Resolution probability
- Payer responsiveness
- Specialty cash patterns
- Dynamic reprioritization in real time
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Outcome
Faster cash recovery, higher yield per AR touch.
Denial & Next-Action Intelligence — Decision Nest™
Revenue Decision Intelligence (Not Just Denials)
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Industry Tools
- Look only at denied claims
- Depend on CARC/RARC codes
- Reactive after revenue delay
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Decision Nest™ intelligence
- Analyzes EOB + claim billed data + payer guidelines + medical records
- Evaluates paid, partial, denied, zero-paid claims
- Correlates:
- CPTs, modifiers, units
- Clinical documentation
- Authorization context
- Payer adjudication logic
- Recommends next-best revenue action, such as:
- Appeal with clinical support
- Coding or modifier correction
- Unit adjustment per policy
- Rebill / no-action / payment variance review
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Outcome
Right action at first touch, reduced rework.
Payment Integrity Intelligence Agent
Accuracy with Financial Context
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Industry Tools
- Post what payer sends
- Catch underpayments late
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SCIO Intelligence
- Validates payments against:
- Expected reimbursement
- Historical payer behavior
- Specialty norms (drugs, procedures, bundles)
- Flags variances early
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Outcome
Higher posting accuracy and faster recovery of missed revenue.
Intelligent Automation Orchestration
Coordinated Execution, Not Isolated Bots
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Industry Automation
- Siloed bots
- Spreadsheet-driven logic
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SCIO Orchestration
- Agents work as a digital revenue workforce
- Automation triggered only after intelligence validation
- Human-in-the-loop governance
- Fully auditable workflows
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Outcome
Scalable automation with enterprise safety.
Analytics & AI Engine
From Reporting to Revenue Foresight
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SCIO Intelligence Operates Across
- $3.2B+ billed revenue annually
- $2.1B+ net collections
- 9.4M+ claims processed
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Capabilities
- Predictive AR and denial trends
- Revenue risk alerts
- Specialty and payer insights
- Executive-ready dashboards
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Outcome
Leaders act before revenue is lost.
Innovation Lab
Where Intelligence Is Continuously Refined
- Prototype → Pilot → Measure → Scale
- Client-driven innovation cycles
- Continuous learning loops
Outcome:
Innovation that works in production.
Emerging Technologies
- GPT agents
- RPA orchestration
- Intelligent workflows
Future Roadmap
The journey toward autonomous RCM
- Adaptive, self-learning intelligence
- Reduced manual dependency
- Predictable, scalable revenue outcomes
Tech Partnerships
Across the industry, automation moves work.
At SCIO, intelligence moves revenue outcomes.