How companies integrate RCI
Five integration patterns for the knowledge layer. Each with code examples, architecture flows, and the endpoints you need.
Pre-Submission Enrichment
Before a claim is submitted, call RCI to validate the code, check modifiers, verify the billing form, and estimate payment. Catch errors that cause 86% of preventable denials.
For: RCM platforms, billing companies, clearinghouses
Post-Denial Resolution
After a denial comes back, call RCI to interpret the CARC/RARC codes, get an appeal strategy with required documentation, and understand the root cause — all via API.
For: Denial management, AI RCM, billing companies
AI Agent Grounding
Connect your AI billing agents to RCI via MCP server or REST API. Ground every decision in authoritative knowledge instead of training data that goes stale.
For: AI RCM platforms, voice AI, coding assistants
EHR-Embedded Knowledge
Embed coding guidance, payment estimates, and prior auth checks directly into your EHR workflow. Replace internal rule engines with a single API that stays current.
For: EHR vendors, practice management systems
Clearinghouse Enrichment
Add billing knowledge validation to your claim processing pipeline. Catch form, POS, modifier, and filing errors before claims reach payers. Batch API for high-volume processing.
For: Clearinghouses, health information exchanges