Our AI agents sit on hold with insurance companies.So your billing team never has to.
ClearCycle automates the one workflow that eats your AR team's day: calling payers for claim status and settlement details. Voice AI agents dial, navigate IVRs, wait on hold, verify every claim — and write the answers into your system. Humans step in only for exceptions.
- HIPAA + BAA on day one
- Every call recorded & transcribed
- Humans take over the exceptions
RCM is a broad field. We don't do billing, coding or credentialing — we own ONE workflow end-to-end: automated voice calls to insurance companies for claim status and settlement data.
The call problem eating your AR team's day
Claim follow-up is the most valuable and most avoided work in any billing office. Here's what we hear in almost every call audit we run.
Staff burn 2–4 hours a day on hold
One status call takes 10–45 minutes including hold time. Multiply that by hundreds of open claims and your AR day is gone before denials even start.
AR ages because nobody can call every claim
Teams queue up only the big-dollar claims. Everything else waits — and quietly ages from 60 to 90 to write-off.
Low-dollar claims never get checked
A $180 claim isn't worth 30 minutes of a biller's time — but ten thousand of them a year absolutely is. Death by a thousand skipped dials.
Portals don't answer the real questions
Check dates, EFT trace numbers, offsets, underpayments, remark context — payers still make you call for the details that close a claim.
Payer knowledge quits when billers quit
Every payer has its own IVR maze, verification quirks and magic words. That knowledge lives in one person's head — until they leave.
No record of what the payer actually said
'The rep told us it was processed' wins zero disputes. Without recordings and structured notes, payer conversations are hearsay.
What our voice agents do so your staff doesn't
One workflow, engineered deeply: dial, hold, verify, capture, document, escalate. Running in parallel across every payer, all day.
Dials Every Payer & IVR
Agents navigate phone trees, menu prompts and provider verification across all major commercial and government payers.
Waits On Hold
A 40-minute hold costs your team zero minutes. Agents queue in parallel — dozens of payers at once.
Verifies Claim Status
Received, pending, denied, paid, in review — with expected decision dates on every open claim.
Captures Settlement Data
Allowed amounts, paid amounts, adjustments, check dates, EFT trace numbers and remit availability.
Extracts Denial Details
CARC/RARC codes plus the rep's spoken explanation — the context codes alone never give you.
Checks Prior-Auth Status
Pending authorizations followed up on schedule so procedures never stall waiting on a fax-back.
Flags Underpayments
Variance against your fee schedule routed to an escalation queue — the silent 3–7% most practices lose.
Documents Everything
Recording, transcript, summary and structured fields written back into your PM/EHR automatically.
Warm-Transfers Exceptions
When a rep says something that matters — dispute, appeal deadline, missing docs — a human takes over with full context.
Re-Calls On Schedule
Payer said 'check back Friday'? The agent calls back Friday. Pending claims re-dialed automatically until resolved.
From free audit to full coverage in four weeks
Start with one payer and two weeks of real transcripts. If the numbers don't convince you, the recordings will.
Free Call Audit
We analyze your AR aging and estimate the payer calls your book implies — hours your team loses weekly and dollars sitting uncalled.
Pilot Scoping Call
Pick one payer or one aging bucket. We define what the agent captures, where it writes back, and the success metrics.
Go-Live Pilot
Agents start calling with your scripts and verification data. You review transcripts daily; we tune until the numbers hold.
Scale & Coverage
Extend to every payer and bucket. Weekly coverage reports show 100% of open claims followed up — with exceptions on your desk same day.
We call the payers.We write into your system.
No new dashboard to babysit, no EHR migration. Agents work every major commercial and government payer — and the answers land as structured notes, statuses and amounts where your team already lives.
- Payer-specific playbooks encoded: IVR paths, verification quirks, magic words
- Dozens of calls in parallel — queue depth no human team can match
- Your data stays yours: every recording and transcript exportable anytime
Six workflows. One obsession: the payer phone call.
Start with the workflow that hurts most — each one runs on the same agent engine with payer-specific playbooks behind it.
Claim Status Calls
The core workflow: every open claim, called and documented, on a weekly rhythm.
- Current status: received, pending, denied, paid — plus expected decision date
- Reason codes and the rep's spoken explanation for any pending state
- Next action + call-back date logged and re-dialed automatically
Pilot this workflow in two weeks, on one payer.
Get a free audit for claim status calls →Settlement & Remit Verification
Check dates, EFT trace numbers and allowed amounts — pulled straight from the payer's mouth.
- Paid / allowed / adjustment amounts per claim and per line
- Check cut dates, EFT trace numbers and remit availability
- Offsets and recoupments explained and flagged for review
Pilot this workflow in two weeks, on one payer.
Get a free audit for settlement & remit verification →Denial Reason Capture
Codes tell you what. The rep tells you why. We get both — recorded.
- CARC/RARC codes plus verbatim reason from the payer rep
- Appeal windows, dispute addresses and required documentation
- Reprocess instructions captured and routed to your denial queue
Pilot this workflow in two weeks, on one payer.
Get a free audit for denial reason capture →Prior-Auth Follow-Ups
Pending auths called on schedule — no procedure stalls in a fax queue.
- Current auth status: pending, approved, additional info needed
- Missing documentation requirements stated by the payer
- Reference numbers and expected decision dates, logged
Pilot this workflow in two weeks, on one payer.
Get a free audit for prior-auth follow-ups →Old AR Recovery Dials
The 90+ bucket nobody has time to call is exactly where agents are cheapest.
- Why each aged claim stopped moving — told by the payer directly
- Re-open / reconsideration paths and deadlines for every claim
- Payment promises documented with rep reference numbers
Pilot this workflow in two weeks, on one payer.
Get a free audit for old ar recovery dials →Lost / No-Pay Claim Tracing
'We never received it' ends here — traced, reference-numbered, and resubmission-ready.
- Payer receipt confirmation or rejection routing for every missing claim
- Correct submission channel and address from the rep
- Proof-of-timely-filing details to defend every resubmission
Pilot this workflow in two weeks, on one payer.
Get a free audit for lost / no-pay claim tracing →Agents handle the volume. Humans handle the exceptions.
Every call runs autonomously until it matters — then a human with full recordings and context takes over. That boundary is engineered, not improvised.
The agent does, autonomously
- Dials payers and navigates IVR phone trees and provider verification
- Holds in parallel — dozens of payers at once, unlimited patience
- Converses with live reps: answers questions, confirms IDs and spellings
- Captures codes, amounts, dates, reference numbers verbatim
- Records, transcribes, summarizes and writes back to your system
- Re-calls on payer-promised dates until the claim resolves
Your team steps in, with context
- Rep disputes or contradicts — warm-transfer to a human mid-call
- Appeal deadlines and dispute windows surface an escalation ticket
- Underpayment variance beyond your threshold flagged same day
- Anything outside the approved data scope declined and escalated
- Every escalation arrives with recording, transcript and claim history
- A named account manager reviews exceptions and coverage weekly
Your patients' data, guarded like it's ours
Revenue work means PHI work. Our security posture is audited, documented, and available for your compliance team to review.
HIPAA-compliant workflows
Compliance built into every step of the cycle, with quarterly internal audits.
BAA signed on day one
A Business Associate Agreement before any PHI is ever touched.
End-to-end encryption
AES-256 at rest, TLS 1.3 in transit, encrypted backups in US data centers.
Role-based access
Least-privilege access, SSO + MFA enforced, every action in an audit trail.
ISO 27001 · SOC 2 Type II
Independently audited security posture, reports available under NDA.
Continuous training
Every team member passes HIPAA and security training with annual re-certification.
220 providers, 18,400 claims a month, nine billers stuck on hold
How parallel call batching took one billing group from 34% claim coverage to 100% — without adding a single person, and with compliance locked down before day one.
Client name withheld under BAA — full reference available on request
The problem: nine people, one phone queue, never enough hours
Their AR team could only reach about a third of open claims each week. Status calls averaged 24 minutes — most of it hold time — so billers triaged by dollar value and let everything under $500 age quietly. Payer knowledge lived in two senior billers' heads, and when one left, three payers' workflows stalled for a month.
- Only 34% of open claims touched in any given week
- ~24 min average per status call, 71% of it pure hold time
- Claims under $500 effectively never called — aging to write-off
- No recordings: payer disputes came down to 'he said, she said'
- 2 senior billers held all payer-specific IVR knowledge
What we deployed: parallel call batches, one workflow, zero new software
We started with a two-week pilot on a single payer, then scaled to all 40. Instead of one biller making one call at a time, our agents run call batches in parallel — dozens of payer lines open simultaneously, each agent holding, verifying and documenting independently. Overnight batches mean the AR team logs in to completed data, not a call list.
- 1Nightly batch build — Open claims pulled from their PM system and grouped into payer-specific batches with verification data attached.
- 2Parallel dialing — Dozens of agents dial simultaneously — hold time runs concurrently instead of stacking up serially.
- 3Live rep conversation — Each agent completes provider verification, asks the scripted questions, captures status, amounts, dates and reference numbers.
- 4Write-back before 7 AM — Structured results, recordings and transcripts posted to the claim record so the team starts the day with answers.
- 5Exceptions queued — Disputes, appeal windows and underpayment variances escalated with the recording attached — humans act, never re-dial.
Why parallel batching is the whole savings engine
A human makes calls one after another — hold time adds up in a straight line. Agents run concurrently, so 200 calls take about as long as the single longest call, not the sum of all of them.
What the team got back
| Metric | Before ClearCycle | After ClearCycle |
|---|---|---|
| Status calls per week | 620 attempted | 3,700 completed |
| Biller hours on hold weekly | 248 hrs | 0 hrs |
| Billers assigned to dialing | 9 FTE | 3 FTE (exceptions only) |
| Time from call to data in PM | Manual, same-day if lucky | Automatic, before 7 AM |
| Sub-$500 claims followed up | Rarely | Every cycle |
Handled with compliance as the constraint, not an afterthought
Nothing ships until the data path is locked down. For this client, the BAA was signed before a single record moved, and agents were scoped to the minimum data needed to verify a claim.
- BAA executed before any PHI access — day one, no exceptions
- Minimum-necessary data scope: agents see only what a status call requires
- AES-256 encryption at rest, TLS 1.3 in transit, US-based data centers
- Agents decline and escalate any request outside the approved scope
- Every call recorded, transcribed and retained under client-controlled policy
- Role-based access with MFA; every action written to an immutable audit trail
- SOC 2 Type II and ISO 27001 controls reviewed by their compliance officer pre-launch
"We didn't add headcount and we didn't change systems. The calls just started getting made — all of them, every week, including the small claims we'd written off as not worth the time. My team now works exceptions instead of hold music, and every payer conversation is on the record."
What would parallel call batching save you?
Same math we ran for the client above — applied to your call volume.
Your numbers — move the sliders
Estimate only. Agent cost modeled at $1.90 per completed call; your exact tier is confirmed in the pilot proposal.
The same pattern, across other clients
Recent engagements. Identifying details abbreviated under BAA — full references available on your scoping call.
Ohio · 220 provider clients
"Our billers were paying full salaries to sit on hold. Now agents clear the call queue overnight and the team spends mornings on denials, not dial tones."
Texas · 14 providers
"Settlement verification calls caught a payer systematically underpaying our cath-lab codes. $96K a quarter we had no idea about."
Florida · 9 locations
"When a payer disputed a denial reason, we played them the recording of their own rep. Appeal approved in a week."
The people who trusted us with their revenue
"My AR team used to spend half of every day waiting for payers to pick up. That job doesn't exist anymore. ClearCycle's agents do it, record it, and drop structured answers into athena every night."
"The pilot was the easiest yes of my career — one payer, two weeks, and we watched transcripts roll in. By week three they were calling every open claim we had, including the $22 ones we all used to ignore."
"Every payer conversation is recorded and transcribed. Our dispute win rate changed overnight — payers argue a lot less when you can quote their rep's words back with a timestamp."
Pay for completed calls. Never for hold music.
No seats, no licenses, no surprise line items. One per-call price with volume tiers — and a call only counts when a documented outcome lands in your system.
Roughly 70% below the loaded cost of a staff member making the same call. Your exact tier arrives with the pilot proposal — after the free audit, before you sign anything.
Per completed call
You pay per completed payer call with a documented outcome — not per hour, not per seat, not per 'integration'. Idle time is our problem, never yours.
Hold minutes on us
A 40-minute hold costs the same as a 4-minute call. You'll never pay a premium because a payer was slow that day.
Pilot-friendly start
Start with one payer or one AR bucket for two weeks. Real transcripts, real write-backs, real numbers — then decide.
Cancel monthly
Month-to-month billing with your data, recordings and transcripts exportable anytime. If we don't perform, leaving is an email.
The questions every billing leader asks us
The agent dials the payer, navigates the IVR, completes provider verification, waits on hold, then speaks with the representative to verify claim status or settlement details. It captures codes, amounts, dates and reference numbers, records and transcribes the full call, and writes structured results into your system.
Yes — this is not tone-dialing or a chatbot. The agents hold natural conversations: they answer rep questions, clarify claim details from your verified data set, confirm spellings and IDs, and know when a conversation needs a human. Thousands of these calls complete every day.
Agents operate on a scoped, rights-cleared patient data set with strict HIPAA guardrails. If a request falls outside the approved scope, the agent politely declines and escalates to your team with full call context — it never improvises with PHI.
On exceptions: a rep disputes something, an appeal deadline surfaces, documentation is missing, or settlement variance exceeds your threshold. The agent warm-transfers or opens a prioritized ticket with the recording and transcript attached — your team acts with full context, no re-dialing.
Every call is recorded, transcribed and summarized, with audio and structured fields stored under your account and written back to your PM/EHR. 'The payer said X on Tuesday at 2:14 PM' becomes a fact, not an argument.
Native write-backs for athenahealth, eClinicalWorks, AdvancedMD, Epic, NextGen, Kareo/Tebra and DrChrono — plus API and scheduled CSV for anything custom. Claim notes, statuses, amounts and dates land where your team already works.
Yes on both. ClearCycle is HIPAA compliant with SOC 2 Type II and ISO 27001 attestations, and a Business Associate Agreement is signed before any data is accessed.
Per completed call with volume tiers — typically $1.90–$2.60 for a full status call including hold time, roughly 70% below the loaded cost of a staff member making the same call. Your exact tier arrives with the pilot proposal.
Portals answer 'received/pending/paid' — they don't tell you the check date, EFT trace, offset reason or the rep's explanation for a denial. We check portals first (cheapest path) and call when payers force a conversation, which for settlement-level detail is most of the time.
Your team is on hold right now.Find out what it's costing you — free.
We'll quantify the payer calls your AR book implies, the staff hours they consume, and the dollars aging uncalled — then show you the pilot plan. Keep the report either way.
- 1We reply within one business day to schedule a 30-minute scoping call
- 2You share a sample AR aging report (we send a secure upload link + BAA)
- 3In 48 hours you receive your Call Audit: payer calls per week, staff hours absorbed, dollars sitting uncalled, and a one-payer pilot plan
Request received.
A senior specialist (not a salesperson) will reach out within one business day to schedule your 30-minute scoping call.