Claims reconciliation
Parse and validate 835 files, then reconcile paid, adjusted, reversal, and patient-responsibility amounts against billed charges.
RCM intelligence · provider groups
RCM issues can be opaque. Arcus makes them clearer.
We turn claims and remittance data into a reconciled, CFO-ready diagnostic: where billed dollars went, which payers and providers drive underperformance, and what to investigate first.
The visibility gap
Every tool sees part of the revenue cycle. No one sees the whole.
Provider groups run on fragmented systems. Leaders know collections are underperforming, but often cannot clearly say where the money is going, which payers or providers drive it, or what to fix first.
Eligibility
Credentialing
Prior authorization
Denial management
Patient collections
Start here
The Arcus RCM Diagnostic
A paid executive engagement, not a free audit or lightweight dashboard. Arcus reconciles remittance data and delivers a clear, prioritized view of where to investigate and what to address next.
Deterministic analysis first. Interpretation second. Every figure traces back
to the source claims data.
835 ERA analysis
Parser validation and reconciliation
Financial waterfall analysis
Revenue attribution
Concentration analysis
Diagnostic brief and hypotheses
What Arcus analyzes
Five analytical layers, built from reconciled remittance data.
Financial waterfall
Trace billed dollars through contractual adjustments, payer denials, patient responsibility, reversals, and net collected cash.
Revenue attribution
Attribute payment outcomes without treating contractual writeoffs or patient responsibility as payer recovery opportunities.
Concentration analysis
Surface where exposure concentrates by payer, provider, procedure, location, adjustment category, and reversal behavior.
Diagnostic brief
A CFO-ready narrative: what the data shows, hypotheses grounded in it, discovery questions, and prioritized next steps.
UnitedHealthcare41%
Aetna27%
BCBS plan18%
Other payers14%
What leaders get
A prioritized, CFO-ready view of where to act.
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Revenue leakage view
Where billed dollars are being lost across adjudication and collection.
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Payer and provider drivers
The concentrations behind most of the financial exposure.
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Prioritized findings
Ranked by financial materiality and actionability, not raw code volume.
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Discovery questions
What to answer before acting on each pattern.
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Implementation roadmap
Practical workflow fixes, vendor decisions, controls, and monitoring steps.
Built for each provider group, not general RCM.
Carve-outs, authorization rules, COB, and medical-necessity patterns vary by payer.
Provider mix and location variation create attribution questions generic reports miss.
Provider group stacks are assembled from vendors that each see only part of the cycle.
Arcus is independent of any single RCM vendor, so recommendations follow the evidence.
Engagement model
From diagnostic to durable revenue-cycle improvement.
Diagnostic
Reconcile claims data into a CFO-ready view of payment outcomes.
Review
Walk findings, highlight high-value areas, and frame open questions.
Workflow and vendor
Review eligibility, auth, coding, denial, patient, and vendor workflows.
Roadmap
Prioritized fixes, vendor changes, operating controls, and monitoring steps.
Retainer support
Implementation support, ongoing 835 refreshes, and quarterly readouts.
Method
Deterministic first. Auditable throughout. Careful about what data can prove.
Arcus quantifies exposure, highlights concentrations, and surfaces hypotheses grounded in reconciled claims data. We identify patterns that warrant review, not upstream root cause from 835 data alone.
Every figure reconciles back to the source remittance.
Reversal claims are surfaced separately from ordinary recovery work.
Contractual writeoffs are validated before being labeled as leakage.
AI is secondary to clean data, governed rules, and consultant judgment.
Next step
See where revenue is leaking and what to fix first.
Bring a sample of your 835 files. Arcus can show how a paid diagnostic turns payment outcomes into a prioritized operating conversation.
Schedule an RCM diagnostic review
Opening the booking calendar.