RCM
Capture more, deny less, collect faster.
Shift Agents code every visit, work every denial, and follow every balance on your EHR, and flag the few claims that need your team.
Shift Agents · RCM
Helen R. · Visit billed clean, same day
1 of 4
- IV
Insurance Verification Agent
Coverage confirmed for 9/26.
- CC
Charge Capture Agent
Coding
- CC
Charge Capture Agent
Modifiers
- CC
Charge Capture Agent
Claim
Seen 10:40am · billed by 6pm
The revenue cycle today
The revenue is earned. Then it leaks.
Charges left off the claim, denials no one has time to work, balances that age past 90 days. Every figure below is a cited industry benchmark, not a Shift claim.
~3–5%
of revenue lost to under-coding and missed charges
HFMA
11.8%
of claims denied on first submission
Kodiak, 2024
Up to 65%
of denied claims are never reworked
HFMA
~13.5%
of AR sits past 90 days at the median practice
MGMA
From patient seen to claim paid
Revenue doesn’t disappear. It gets left behind.
Between the visit and the payment, money stays behind in the gaps: a charge the template skipped, a rejection nobody saw, a balance that belonged to another payer. Shift Agents work every claim at the same time, so more of what you earn gets paid.
- The coverage nobody re-checked Insurance Verification
Eligibility confirmed on the date of service, before the claim is coded.
- The auth that never reached the claim Prior Auth
Auth numbers matched to the service and attached before the claim goes out.
- The charge the template left out Charge Capture
Every visit coded from the note, not the template: procedures, drugs, modifiers, all of it.
- The claim nobody followed up Denial Management
Denials, rejections, and unpaid claims worked to a decision before the filing limit.
- The balance that turned 90 Patient Balances
Checked against the EOB first, then collected by text, with payment plans, before it becomes bad debt.
- Claim paid. Balance settled. Nothing left behind.
This week’s claims
Fri 4:00pm
+ 204 more claims this week
Dana W. · Denial Management Agent · working
Showed “submitted” for 45 days, but the payer had no record: rejected at the clearinghouse on an old member ID. Refiled with 11 days of timely filing left. Her $840 statement is on hold.
MemoryThis payer reissues member IDs every January.
Each claim shows only the stages it needs: coverage · coded · submitted · paid · patient balance.
Illustrative week. Patients and amounts are representative, not results.
How it works together
Shift Agents share the same coverage record, the same fee schedule, the same payer rules, and the same audit trail. A denial is worked with the coverage record that verified the visit, not a re-lookup. And they remember what they learn: this payer wants the NDC on drug lines, this one reissues member IDs every January.
Explore the platform →Control & trust
Choose the autonomy tier per agent: start with coder and biller review on everything, move to exception-based as accuracy proves out. A physician’s E&M level is never raised without their sign-off, and a claim the note doesn’t support is held, not sent. Every action logged.
Security & compliance →See it work on your claims.
Bring 90 days of notes. We’ll show you what they should have billed.