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features
design
support

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Description

OptiPayRCM's platform offers streamlined automation for revenue cycle management, focusing on the critical "last-mile" by seamlessly connecting with EHRs, clearinghouses, payer portals, and various other systems through adaptable interfaces, ensuring that your billing workflows are efficiently managed from start to finish. The centralized engine is designed to perform functions such as eligibility verification, claim submissions, payment postings, denial management, and comprehensive accounts receivable processes, leveraging artificial intelligence and robotic process automation to minimize manual tasks and enhance cash flow. With real-time dashboards and analytical reports, users gain insights into essential performance metrics while benefiting from customizable automation that accommodates exceptions and specific workflows. Its capabilities lead to a significant reduction in first-pass denials by as much as 63%, expedite claim status inquiries up to 50 times faster than traditional methods, and shorten payment cycles by up to 35%. Additionally, the platform is compatible with over 200 healthcare systems and facilitates direct integrations through EHRs, FHIR, EDI, and HL7, making it a versatile solution for modern healthcare billing challenges. This comprehensive ecosystem ensures that healthcare providers can optimize their revenue cycles efficiently and effectively.

Description

Paradigm Senior Services provides a comprehensive, AI-driven revenue cycle management solution designed specifically for home-care agencies that handle billing for various third-party payers, including the U.S. Department of Veterans Affairs (VA), Medicaid, and several managed-care organizations. The platform automates and enhances each phase of the billing and claims workflow, encompassing tasks such as verifying eligibility and authorizations, managing state- or payer-specific enrollment and credentialing, submitting accurate claims, addressing denials, and reconciling payments. It seamlessly integrates with widely used agency management software and electronic visit verification systems, enabling the scrubbing of shifts, weekly authorization verifications, and efficient payment reconciliations, all of which contribute to a reduction in denials and a lighter administrative load. Additionally, Paradigm offers "back-office as a service" for healthcare providers; this means that even if agencies have their own billing personnel or scheduling applications, Paradigm is equipped to manage claims processing, functioning as a dedicated, expert billing department. This flexibility allows agencies to focus more on patient care while leaving the complexities of billing in the hands of specialists.

API Access

Has API No 

API Access

Has API No 

Screenshots View All

Screenshots View All

Integrations

No details available.

Integrations

No details available.

Pricing Details

No price information available.
Free Trial No 
Free Version No 

Pricing Details

No price information available.
Free Trial No 
Free Version No 

Deployment

Web-Based Yes 
On-Premises No 
iPhone App No 
iPad App No 
Android App No 
Windows No 
Mac No 
Linux No 
Chromebook No 

Deployment

Web-Based Yes 
On-Premises No 
iPhone App No 
iPad App No 
Android App No 
Windows No 
Mac No 
Linux No 
Chromebook No 

Customer Support

Business Hours No 
Live Rep (24/7) No 
Online Support Yes 

Customer Support

Business Hours No 
Live Rep (24/7) No 
Online Support Yes 

Types of Training

Training Docs Yes 
Webinars No 
Live Training (Online) Yes 
In Person No 

Types of Training

Training Docs Yes 
Webinars Yes 
Live Training (Online) Yes 
In Person No 

Vendor Details

Company Name

OptiPayRCM

Founded

2025

Country

United States

Website

optipayrcm.com

Vendor Details

Company Name

Paradigm

Founded

2015

Country

United States

Website

www.paradigmseniors.com

Product Features

Revenue Cycle Management

Accounts Receivable No 
Claims Management No 
Collections Management No 
EHR/EMR Integration No 
For Healthcare No 
ICD-10 Compliance No 
Insurance Verification No 
Medical Billing No 
Patient Portal No 
Patient Registration No 
Patient Scheduling No 
Payment Processing No 

Product Features

Home Care

Billing & Invoicing No 
Care Plan Management No 
Caregiver Management No 
Client Management No 
Field Communication No 
Insurance Management No 
Payroll Management No 
Scheduling No 
Visit Verification No 

Medical Billing

Claims Processing No 
Claims Scrubbing No 
Code & Charge Entry No 
Compliance Tracking No 
Customizable Dashboard No 
Dunning Management No 
Invoice History No 
Patient Eligibility Checks No 
Practice Management No 
Quotes/Estimates No 
Remittance Advice No 

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