Revenue cycle agents for EHR vendors

What are revenue cycle agents for EHR vendors?

A revenue cycle agent does the repetitive follow-up between a claim leaving the practice and the money posting. It asks the payer where the claim stands, reads the remit, checks enrollment and compares what was paid with what was owed.

"For EHR vendors" means the buyer is the software company, not the practice. The agents run inside your product for every practice on it, and the results appear in your interface as your own.

This page is for product and engineering leads at an EHR or practice management company. For the overview, see the EHR page. If you run a billing company, see claim status automation for billing companies.

RCM automation for EHR vendors: what the agents do

Your customers ask for the same things again and again. Daybook answers each one inside your product.

ERA and EFT enrollment, tracked

Enrollment is checked payer by payer for every provider on the platform. A visible tracker shows where each enrollment stands. Activation dates are set so ERAs are not cut off early, and every submission is reconciled.

• Enrollments are added by hand, or start on their own when a new payer appears. They land in a queue for a biller to accept.
• The agent does the portal steps, including bulk clearinghouse submissions, and checks each portal on a schedule.
• People handle wet signatures, missing forms and steps the customer has to take. Then the agent picks the enrollment back up.
• Failed uploads are retried. Anything else shows a clear error saying what went wrong.

For the workflow, read how to track ERA enrollment across many clients.

835s posted, not keyed

Every 835 is proven to the cent and matched to its claims line by line. Each payment carries its source (ERA, import or manual). Payments post through the path your system already has, and anything that does not balance is held for the customer's posting lead to decide.

Claim status for stale claims

Every unpaid claim gets an X12 276 overnight, without a portal login. The 277 answer lands on the claim in plain words, with the denial reason and the next step. No more awaiting-payment black hole: in-app nudges flag anything that sits too long. The method is in how to check claim status with every payer without portal logins.

Underpayment detection

Each paid line is re-adjudicated against the practice's contract with that payer. A line paid short is flagged on the claim with the contract line it missed, and an appeal is drafted. Expected payment comes from contracted rates, published fee schedules, state rules and the patient's plan. The rules are written as fixed code, not left to an AI model. See underpayment detection software.

Embedded RCM for practice management software: how it connects

Daybook works alongside your system, not instead of it. Nobody switches software.

• Code in your repositories. Daybook ships pull requests against your repositories. The screens follow your workflow, and your engineers own the code afterwards.
• One API call per portal action. Daybook maps each payer portal and builds a browser automation for it. A whole action (sign-in, two-factor authentication, then the task) is one API call.
• EDI where it exists. Claim status runs on 276/277 without a portal login, and remits come from the 835.
• Your account or ours. The automations run on Cloudflare Browser Run, in your own account or hosted by Daybook. They can run in a separate account, apart from your core systems, with a live view of each run.
• Your playbook as fixed rules. Every payer quirk, workaround and denial reason your team has learned goes into one knowledge base. Daybook runs it as deterministic rules, so the same claim gets the same answer every time.

Build, buy a platform, or embed agents

An EHR vendor adding revenue cycle AI has several routes, and each is right for someone. The table keeps to what each option publishes.

Best for each:

• Build in-house: best for a vendor with spare engineering capacity and payer experience on staff. What to weigh before building claims automation in-house covers the trade-offs.
• Stedi: best if you want raw clearinghouse connectivity and will build the follow-up workflow yourself. Stedi offers "fully managed, API-based transaction enrollment" and notes that "ERA enrollment is exclusive to one clearinghouse".
• Candid Health: best if you would rather replace your billing engine than extend it. Candid invites billing services to "white-label our RCM automation platform" (Candid).
• SuperDial: best if your main gap is payer phone calls. It returns results by "CSV, API, webhook, dashboard, or system write-back" (SuperDial). Its site names the EHRs it works with, such as Epic, athenahealth and ModMed (SuperDial). Daybook's site names no medical EHR. See SuperDial alternatives.
• Daybook: best if you want enrollment, remits, claim status and underpayments inside your existing product, built by an engineer who hands you the code.

White-label claim status and the rest, under your name

Daybook runs inside your own tools so it looks native, and your customers never need to know which infrastructure is behind it. The tracker, posted remits, claim status answers and underpayment flags all carry your brand. Daybook does not run a billing company and will not compete with the RCM companies it works with.

What your team and your customers still decide

Agents do the volume work. Your team keeps every billing decision, and nothing is offshored.

Inside your product, your customers' billers stay in charge. They:

• accept each enrollment from the queue;
• decide on anything that does not balance on a remit;
• approve every appeal before it is sent, including those drafted from an underpayment flag;
• make every call on write-offs and posting.

Your product team decides how the screens look and where the nudges appear. Your engineers own the code once it ships.

How pricing works

Daybook uses usage-based pricing: no subscriptions, no seats, and customers pay only for what Daybook processes. A forward-deployed engineer can handle the onboarding.

After the BAA, Daybook starts on one practice, or one payer and one system, with milestones agreed up front. It expands to the rest of your platform once they are met. The site publishes no unit rate; how usage-based pricing works for claims automation explains the model.

Security

Daybook is HIPAA compliant and signs a BAA with each customer before any PHI is processed. Its SOC 2 audit is in progress. Each customer gets a separate database, served by its own Worker. Data is hosted in the United States. Accounts are named, with no shared logins, and an audit log records sign-ins and changes. The security page has the details.

What it looked like at Ease Health

"Daybook came in, mapped how our claims move across our systems, and built what was missing inside of what we already have. Status checks, remit balancing and payer enrollment now run on their own, and the team works the exceptions instead of the queue." Raymond Wang, CTO, Ease Health

• 4 weeks from kickoff to code in Ease's repo.
• 20 hours down to 13 hours per batch of 50 enrollments, with review on.
• 13 hours a week of fetching and converting remits becomes an upload.

Is this right for you?

Daybook fits if most of these are true:

• Your EHR or practice management product bundles RCM, or your customers keep asking it to.
• Your customers lose time to portal logins, stale claims and remits keyed by hand.
• You want the feature in your own codebase and under your brand, not a separate app.
• You would rather pay for what is processed than per seat.

It is a weaker fit in three cases:

• You want to replace your billing engine outright: look at a white-label platform.
• Payer phone calls are your only gap: look at a voice agent vendor.
• You sell to a single practice, not a platform of them. Daybook works through billing companies and software vendors, not individual practices.

If you serve dental offices, how claim data gets written back to a dental practice management system shows the write-back side.