Case study
OrbixMed
An AI-powered revenue cycle platform for healthcare providers, coordinating specialised agents across eligibility, coding, claims, denials, and payments.
At a glance
Overview
Project overview
OrbixMed is a revenue cycle management platform for healthcare providers and clinics in the US. Its core, OrbixMed OS, coordinates AI agents that each handle one stage of the revenue cycle.
We built the platform and its public website, including the agent orchestration layer and the product areas for eligibility, coding, claims, denials, payments, and analytics.
The challenge
Business challenge
In many practices, eligibility checks, coding, claim submission, and denial handling happen in different portals and spreadsheets. Context gets lost between steps, and denials are often worked without the information that caused them.
The platform also had to be designed for protected health information from the start, with access controls and audit trails rather than security added later.
The solution
What we built
We designed an orchestration layer in which every agent works from the same patient, payer, and claim record. The result of an eligibility check is already attached when a claim is built, and coding context stays with a denial when it is worked.
Security controls are part of the platform itself: data encryption in transit and at rest, multi-factor authentication, role-based permissions, and audit logs of access and claim activity.
Features delivered
What shipped
The main capabilities in the live product.
- Real-time 270/271 eligibility and coverage checks
- Coding support for ICD-10, CPT, modifiers, and payer rules
- Claim scrubbing, X12 generation, and submission
- A single denials worklist for routing, appeals, and tracking
- ERA posting, patient billing, and AR ageing
- Prior authorisation submission and tracking
- Analytics for KPIs, denial trends, and revenue forecasting
- Encryption, MFA, role-based access, and audit logs
Screens
Inside the product
Client testimonial
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