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Stop Revenue Leakage Before It Starts.
Organization-specific RCM intelligence that learns your unique denial patterns
RCM BPOs struggle to deliver personalized denial prevention across diverse client practices. Generic rules engines can't account for the unique patterns of a pediatric clinic vs. orthopedic practice vs. behavioral health group - forcing BPOs to use one-size-fits-all approaches that miss 8-15% of potential revenue for their clients.
Each client practice has unique denial patterns based on their payer mix, specialty focus, and documentation habits. Generic RCM rules miss these organization-specific vulnerabilities, making it impossible for BPOs to deliver truly personalized service.
Context RCM analyzes your historical claims and remittance data to identify your organization's specific denial triggers and underpayment patterns. Instead of generic rules, you get intelligence tailored to your client's actual performance data.
Prevent Denials — Receive alerts during claim entry when a claim matches your historical denial patterns. For example: If your client frequently gets denials for modifier -25 with evaluation codes, Context flags similar combinations before submission.
Recover Underpayments — Systematic analysis of ERAs against your contracted fee schedules identifies payment discrepancies. Automatically flag when Insurance pays $150 for a code you're contracted for $175.
Build Smarter Teams — Provider and staff-level coaching insights show common patterns without punitive monitoring. Help your front desk understand why certain eligibility checks matter for your specific payer mix.
Context RCM enables BPOs to deliver practice-specific intelligence at scale. Analyze each client's historical data to identify unique denial patterns, underpayment trends, and staff coaching opportunities - without manually building custom rules for every practice.
Founded by Rumpa Giri, a healthcare technology executive with 20+ years of experience in revenue cycle optimization, AI, and infrastructure modernization. Context RCM is pioneering a rules-and-intelligence-first approach that complements existing RCM systems without disruptive integration.
We're currently working with behavioral health, pain management, and oncology practices to validate our denial prevention intelligence approach. Recent findings include discontinued CPT codes affecting hundreds of claims, $100+ reimbursement discrepancies, and collections efficiency opportunities.
Ready to See What We Can Find in Your Revenue Cycle?
Get a FREE Week 0 Revenue Cycle Health Check - we'll analyze your top 20 CPT codes against CMS policies and identify hidden opportunities.
Takes less than 2 minutes. No credit card required. Limited to 5 free audits per quarter.
Questions? Email contact@contextrcm.com
Context RCM LLC, 2025
Context RCM LLC, 2025
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