RCM Toolkit
Precision tools for every step of the claim
Scrubbing, documentation validation, follow-up automation and file conversion — the practical tools that keep claims clean and cash moving.
Tool 01
Claim Shield — Medical Scrubber AI
Validates coding accuracy and checks CPT / ICD pairing, MUE limits, Excludes1 rules, audit rules and payer-specific compliance before a claim leaves your building.
- CPT / ICD validation
- MUE and Excludes1 checks
- Audit-rule and payer-logic checks
- Clear, correctable findings
Medical validator
- Medical necessity confirmed
- ICD–CPT linkage valid
- Bundling issue — corrected
- No conflicting diagnoses
Technical validator
- Payer-specific rules met
- No duplicate submission
- Follow-up rules applied
- Schema validation passed
Tool 02
Documentation Validator AI
Ensures SOAP and clinical notes meet medical, insurance and compliance requirements — so the documentation supports the codes billed.
- Completeness of SOAP notes
- Insurance and compliance requirements
- Audit-ready documentation
- Supports CDI programmes
Notes that stand up to audit
Missing elements are flagged before submission, not after rejection.
Tool 03
RiteMailer
An automated follow-up and communication engine with Outlook integration. It automates claim follow-up emails, reminders and communication workflows.
- Outlook integration
- Automated claim follow-up
- Reminders and escalation workflows
- Consistent, trackable communication
Follow-up that never slips
Every outstanding claim gets a timely, consistent nudge.
Tool 04
Rite Universal Converter
Automatically extracts, merges and converts submission, resubmission and remittance files — XML or JSON — into structured Excel for analysis and reconciliation.
- XML / JSON to Excel
- Submission, resubmission & remittance files
- Merged, analysis-ready output
- Removes manual file wrangling
Files in, intelligence out
Turn raw claim files into spreadsheets your finance team can use.
How they fit
Upstream controls, downstream results
Denial and rejection findings from RiteRCM feed back into Claim Shield rules and training, so each cycle gets cleaner than the last.
Clean claims start here.
Book a demo or speak to our team today. We will map your workflow and show you where automation pays back first.