Replaced our billing agency with AI-native RCM 5 months ago - Pros and Cons
This is going to be long. So, apologies in advance.
Our setup: Group practice, 22 clinicians, mostly commercial + some Medicaid, multi-state (3 states). 60% of our revenue comes from our first practice. Others are much newer. We were using a specialized billing agency at 6% of collections for about 7 years but as I started expanding I wanted to optimise billing across locations and switched to an RCM agent by Supahealth in January 2026.
What I like:
Initial denial rate has gone from 14.2% to 7.7%. Almost half. Which is amazing as cash cycle has improved.
Days in AR have gone from 52 days to 27 days. This gives us about $220K extra now.
Lower fees (closer to 3% of collections vs. 5.5%).
So, its a great tool for cost optimisation and better revenue management.
Cons:
Switch was difficult. I had to deal with agency and tool company both for almost two months. The move could have been quicker.
AI systems do not work for all payers. The tool output from what I am seeing varies with payer system, which is something I did not expect. The The denial rate for small payers would be still double digits. As per customer support, this could take almost a year to fix.
There is no human escalation mechanism anymore. Work is fast but in case anything goes wrong like in case of small payer systems - there are no humans. Support team does help but you know its not completely their fault. This is not really a con of the tool per se but the direction in which things are moving after the advent of AI.