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END-TO-END, WORK-FREE RCM

The RCM & Prior Auth solution for telemedicine & specialty clinics

Stop managing fragmented black boxes. Foresight orchestrates everything from eligibility and prior auths to claims and denials.

We use predictable rules custom-built for you, surgical AI automation, and optional managed services tailored to your specific clinical area, medication mix, processes, and relationship with payers.

3 min to submission

92% 1-st pass rate

85% autohandled

3 min to submission 92% 1-st pass rate 85% autohandled

How it works

  • A futuristic digital device with holographic screens illustrating an AI-powered prior auth and revenue cycle management (RCM) tool, and a cube projecting a geometric wireframe, on a flat surface.

    Custom, transparent Logic

    We don't just pull and submit data; we build apply custom rules derived from your specific set up and relationship with payers for maximum accuracy, handling all parts of the PA and RCM cycle

  • A futuristic digital device with holographic screens illustrating an AI-powered prior auth and revenue cycle management (RCM) tool, and a cube projecting a geometric wireframe, on a flat surface

    Proactive, not reactive

    We run dual-layer eligibility checks and determine PA requirements, co-pays, etc instantly. If a PA is needed, Foresight auto-compiles clinical evidence, submits it, and chases the status, gating the prescription or claim until approval is secured

  • A digital illustration showing a cube with a neural network inside, connected to a stack of servers. Green arrows indicate data flow from the cube to the servers, with a green checkmark signifying successful processing. illustrating an AI-powered RCM

    Smart Submissions

    Claims and PAs are scrubbed against payer-specific rules (not just generic formatting). We fix errors programmatically and route to the correct payer automatically. 90%+ of volume runs on autopilot. When an edge case occurs, it is surfaced in a prioritized queue with AI-suggested fixes for your team or our optional managed services team to address

We handle claims and PAs end-to-end

Full managed services, or automation + your team. When it’s your team dealing with non-automatable tasks, we show them what, why, and how to fix it.

  • Value-first queues: Highest-dollar items on top

  • Pipeline visibility: See stuck items across PAs and claims instantly

  • One-click fixes: Problems come with solutions attached

Operate with confidence

Every flagged claim or PA shows exactly what's wrong and suggests how to fix it. We extract necessary data from your EHR with confidence scores and guardrails.

from the start to high-volume

Designed for digital health and specialty clinics managing complex workflows like GLP-1, TMS, infectious diseases, or addiction. Single clinic or nation-wide telemedicine group. We handle the nuance of recurring visits, authorization limits, and specific documentation requirements that generic RCM tools miss

custom for your practice

The era when only the largest health systems could afford to build custom RCM solutions is over. We adapt our product for each customer to deliver client-specific results accommodating your data and relationship with payers, the analytics you need, etc

    • Every denied claim costs you $48 on average to rework

    • 8% of your revenue disappears into billing complexity

    • Your best clinicians waste 2 hours daily on admin work

  • We use predictable, custom-built rules + AI only where needed to lift the workload of creating PAs or claims and submitting them off you. We integrate with all EHRs and submit claims and prior authorizations using clearinghouses, electronic prior auth APIs and prior authorization portals as needed for maximum coverage.

  • Other vendors promise AI magic. We deliver predictable revenue

    • Rules for what's certain (patient demographics, POS codes, time based E/M, etc.)

    • AI only where needed and when needed (e.g., ICD-10 and CPT codes)

    • Every decision traced and auditable

    • Submission and re-try playbooks per payer and clinical area

  • Turn denials from dead ends into dollars

    • We scan denial reasons to transform them into targeted fixes

    • E.g., CARC 197 → Missing auth → Auto-attach from ePA system → Resubmit → PAID

    • See denial patterns by payer, provider, while Foresight continuously learns and improves from past performance

Tap your revenue recovery potential

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