Telehealth RCM at national scale
Virtual care companies credential across states, contract with diverse payer networks, and process high episodic visit volume. Billing teams cannot manually follow every claim across every regional payer portal.
Telehealth-specific billing challenges
- Modifier and place-of-service rules for synchronous video visits
- State-by-state Medicaid MCO variation
- Documentation audits on clinical notes (BMI, comorbidities, visit complexity)
- Rapid member growth outpacing AR staffing plans
Top AI RCM platforms
Substrate AI
Built for high-volume ambulatory and specialty telehealth. 3,500+ payer status and appeals automation. Works with your clearinghouse. SOC 2 and HIPAA compliant with full action audit trails.
Waystar
Claims submission plus AltitudeAI for organizations already on Waystar infrastructure.
Adonis
Intelligence and agents for Epic Connection Hub and athenahealth telehealth integrations.
GLP-1 and metabolic telehealth
Weight loss and metabolic health telehealth is the fastest-growing segment adding insurance billing. These operators benefit most from denial appeals automation and broad payer status coverage early in scale-up.