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CIVIE RCM

Billing that starts
at the order.

Revenue cycle management built for radiology: charges captured from the exam, coding from the signed report, claims checked before they leave and denials worked by agents, on the same record as CIVIE RIS, PACS and reporting.

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  • Charges from the exam
  • Coded from the report
  • Scrubbed before it leaves
  • Denials worked by agents

Exam to paid

One claim,start to paid.

  1. Checked before the visitAn agent verifies benefits by phone and the authorization is on file before the slot.
  2. Charged from the examThe CT and the 100 mL of contrast the technologist logged become charge lines.
  3. Coded from the signed reportDiagnoses come from the report, with a coder reviewing every suggestion.
  4. Clean before it leavesPayer, CCI and authorization edits pass, then the claim goes out.
  5. Paid, and status without a callAn agent reads the status from the payer portal: paid on first submission.
  6. Posted to the depositThe remittance posts itself and is matched to the bank deposit.
  7. The patient’s part, by textThe $200 copay goes to the patient as a plain bill in EasyPay.

Illustrative screen · claim LSH-26-0924-55172: payer, dates and amounts from CIVIE’s recorded runs on synthetic data · fictional patient

Master patient index

Three records.
One patient.

Send us any data from anywhere and we'll match the patient. Records with different MRNs and name spellings link to one MPI number, then open as one full record, so patient accounts aren't duplicated.

What it links

Different MRNs
Each hospital, imaging center and clinic keeps its own MRN, linked to the same patient.
Different spellings
DIAZ^MARIA^L, Diaz, Maria and M DIAZ resolve to one person.
One MPI number
Studies, insurance and history open as one full record.

How matching works: each record is compared on the patient's identifying details, so name spellings and MRNs don't need to match.

  1. Three records, three MRNs
  2. Linked to one MPI number
  3. Opened as one full record
Illustrative loop · sample data

Agents

The calls and portals,handled.

CIVIE agents make the payer calls and portal checks a claim needs, say they’re automated, and write every answer back to the record. These are real recorded runs on synthetic data.

Benefits verification
Benefits verification call to a payerRecorded run · synthetic patient data · Oct 10, 2026

SSamanthaCIVIE voice agentPPayersimulated caller

Samantha

Hi, this is Samantha, an automated assistant calling on behalf of Northside Imaging. I'd like to verify benefits for a patient who has an outpatient CT scan scheduled with us. Is this the provider services line?

Turn 1 of 7 · CT abdomen and pelvis with contrast (CPT 74177)

Real output from CIVIE's benefits-verification voice agent, in a simulated payer call. Paced for reading; the times shown are the real ones. Not for clinical use.

Charge capture

Every charge,from the exam.

Billing that starts at the charge only sees what it’s sent. CIVIE RCM takes charges from every place they happen and checks each against the order and the signed report, so nothing billable is missed or billed twice.

Charge queue2 lines · $3,550.00
  1. 74177CT abdomen and pelvis w/ contrastJ. Alvarez, CT tech · CIVIE RISOrtiz, DNorthside Imaging$3,250.00
  2. Q9967Iohexol 350, 100 mLJ. Alvarez, CT tech · CIVIE RISOrtiz, DNorthside Imaging$300.00

Matched to the order and the signed report · 2 of 2 · no duplicates

Illustrative queue · the CT’s two lines are the recorded claim’s · other patients and amounts are fictional

Coding

Coded fromthe signed report.

CIVIE AI reads the final report and suggests ICD-10 and CPT codes with the passage that supports each one. Coders accept, change or reject every suggestion, and the edits payers apply run before the claim goes out.

CT ABDOMEN AND PELVIS WITH CONTRASTSigned by Dr. Rachel Stein · 09/24/2026 14:40

IndicationRight lower quadrant pain.

ExamCT abdomen and pelvis with contrast.

TechniqueAxial images of the abdomen and pelvis after 100 mL of iohexol 350 IV, with coronal and sagittal reformats.

Findings

4 mm nonobstructing calculus in the lower pole of the left kidney. No hydronephrosis.

The appendix is normal in caliber without surrounding inflammation.

No bowel obstruction or free fluid. The liver, spleen and pancreas are unremarkable.

Impression4 mm nonobstructing left renal calculus. No acute finding to explain right lower quadrant pain.

Suggested from the report · reviewed by a coder

  • CCI edits
  • LCD and NCD coverage
  • Diagnosis supports the CPT
  • Payer-specific edits

Illustrative report and coding · fictional patient · real CPT, HCPCS and ICD-10 code values

Denials

Every denial pointsat its cause.

Because the claim links back to the order, each denial reason points at the step that caused it. Agents find, explain and appeal; people decide what’s written off, and nothing is written off without a rule you set.

Denials4 open · worked by agents and your team

  1. Order
  2. Eligibility
  3. Authorization
  4. Exam
  5. Report
  6. Coding
  7. Claim

Traced to authorization

The authorization on file covers 74176, without contrast. The exam was done with and without.

Updated authorization requested from the payer; the appeal is packaged with the order and the signed report.

Appeals agentReady for your approval

Illustrative queue · real CARC codes, fictional claims and payers · no automatic write-offs

Posting and reconciliation

Posted to the deposit,not just the claim.

Remittances post themselves and are matched to the bank deposit, so the money in the account and the money on the claims agree. Missing ERAs and lockbox files are flagged, and underpayments go to a person.

EFT 7302245519$4,912.30Deposited 10/08/2026
Lone Star Health · ERA 8355 claimsMatching to the deposit
  1. Ortiz, DCT abdomen and pelvis · LSH-26-0924-55172$1,084.60Waiting
  2. Lund, RCT coronary angiography · LSH-26-0923-44108$1,612.40Waiting
  3. Nguyen, TUS abdomen, complete · LSH-26-0925-38821$214.80Waiting
  4. Patel, AMRI brain w/o · LSH-26-0926-51290$1,563.40Waiting
  5. Lee, SMRI knee w/o · LSH-26-0926-51377$437.10Waiting

Illustrative deposit · the first claim is the recorded one; the others are fictional

The patient’s part

Bills patientscan actually read.

The copay goes out by text the day after posting, as a plain-language bill with no login or app. Patients see where the money went, pay, or choose a plan.

  • $3,550.00billed for the CT and contrast
  • $1,084.60paid by Lone Star Health on EFT 7302245519
  • $200.00left for the patient, the copay the benefits call confirmed
See CIVIE EasyPay

Illustrative screens · the recorded claim’s amounts · fictional patient

Software, hybrid or fully managed

Pick the model.Keep the ecosystem.

Run CIVIE RCM yourself, share the work with CIVIE’s billing team, or let CIVIE run the whole revenue cycle. All three run on the same platform, so moving work is a change in ownership, not a migration.

Managed RCM services
Charge capture and coding
Claims and status checks
Denials and appeals
Payment posting and refunds
Patient collections and calls
Reconciliation
Your data and reportsFull access, in every model

CIVIE’s automation agents run inside your team’s software.

Every part

Every part of the cycle,its own page.

From coding and denials to patient payments, open any part to see how it works.

Q9967 × 100From the technologist’s logCharge captureContrast and supplies from the technologist’s log, matched to the order and the report.N20.0From the impressionRadiology codingICD-10 and CPT from the signed report, with the passage that supports each code.CO-197Traced to authorizationDenial managementEach denial traced to the step that caused it, and appealed with the records attached.PaidRead from the payer portalClaim statusStatus read from EDI, clearinghouses and payer portals, with the next action written back.$200.00The copay, by textPatient collectionsEstimates before the visit, and plain bills by text after it.Renews 12/14Tracked by our teamCredentialingLicensing, privileges and payer enrollment, filed and tracked by CIVIE’s team.PendingChased by a voice agentAuthorization follow-upPending authorizations chased by voice agents and written back to the order.HybridYou choose who owns each areaManaged RCMSoftware, hybrid or fully managed, on the same platform.

Results

Revenue youcan measure.

98.7%
of claims paid on first submission
Up to 28%
higher collections for practices moving to CIVIE RCM
85%
of remittance lines posted without a person touching them

Results across CIVIE RCM clients.

In their words

What customers say.

  • CIVIE removed the stress from MIPS reporting and gave us confidence in every submission.
  • CIVIE gave us confidence that AR recovery wouldn’t introduce risk into our environment.
  • We finally negotiated from facts, not assumptions.

FAQ

RCM questions,
answered.

  • Either, or both. Your team can run it as software, CIVIE's billing team can work alongside yours in a hybrid model, or CIVIE can run the full revenue cycle for you, all on the same platform.

Next steps

Bring a month
of your denials.

We’ll show how CIVIE RCM would work them, with your payers and codes, as software, hybrid or fully managed.

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