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Revenue cycle management

Recover the revenue you're losing to denials and slow collections.

Tribe runs the full healthcare revenue cycle — eligibility to collections — with certified specialists and AI that scrubs claims, predicts denials and prioritizes A/R. This is Tribe's horizontal RCM offer; the healthcare-specific expression is CareHub.

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What is revenue cycle management outsourcing?

Revenue cycle management (RCM) outsourcing hands the financial side of every patient visit to a specialist partner — eligibility and prior authorization before the visit; coding, claims and payment posting after it; then denials, A/R follow-up, patient billing and reporting. Tribe runs the whole cycle with certified specialists and AI, delivered by people, AI agents or a hybrid of both, under a signed Business Associate Agreement.

Revenue cycle management at a glance
CoversThe full cycle — ten stages, eligibility to reporting
Built forClinics and groups, MSOs, ACOs, hospitals and health plans
Delivered byCertified specialists and AI, run on TIOS
Your choicePeople, AI agents, or a hybrid — per stage
ComplianceHIPAA compliant; Business Associate Agreement signed
Healthcare companyCareHub — Tribe's own healthcare operation
Who it's for

For organisations that run on reimbursement.

Clinics & medical groups

Single- and multi-specialty groups that want the whole cycle run — not just claims.

MSOs

Management services organisations running revenue cycle across many practices.

ACOs

Accountable care organisations that need clean claims and reporting across payers.

Hospitals & health plans

Teams that want a partner for the full cycle or for defined stages of it.

People + AI at every stage

Every stage, people and AI.

AI takes the volume and catches problems early. Certified specialists own every judgment call — coding review, appeal strategy, payer conversations and anything sensitive.

StageWhat AI doesWhat people own
Eligibility & benefitsInstant automated payer checksEdge-case coverage questions
Prior authorizationAutomated submission & follow-upSign-off before submission
Medical coding (ICD-10 / CPT / HCPCS)AI-assisted code suggestionCertified coder review & compliance
Charge capture & scrubbingAI claim scrubbing before submissionException handling
Claims submissionAutomated submissionComplex-claim oversight
Payment postingAutomated posting & matchingDiscrepancy resolution
Denial management & appealsPredicts and flags likely denialsAppeal strategy & submission
A/R follow-upPrioritizes A/R by recovery oddsPayer follow-up & negotiation
Patient billingAutomated statements & remindersSensitive collections calls
Reporting & analyticsReal-time dashboardsStrategic review with your team
↑ Clean-claim rate
↓ Denial rate
↓ Days in A/R
↑ Net collections
Choose your mix

Human. AI. Or both.

Human specialists
Trained people on every interaction
AI agents
Digital workers for volume, 24/7
Recommended
Hybrid
AI handles volume; people handle the complex & sensitive
How it starts

Scope. Quote. Pilot. Launch. Govern.

1

Scope

A short conversation about your cycle — volumes, specialties, payers, systems, and where revenue is leaking today.

2

Quote

One written number against the model that fits. No hidden line items.

3

Pilot

A defined pilot with agreed success criteria, so you judge the work on results before scaling it.

4

Launch

Business Associate Agreement signed, access set up under your controls, and quality checks from day one.

5

Govern

Named management, the reports you choose — clean-claim rate, denials, days in A/R, collections — and a people-and-AI mix that shifts as confidence grows.

For healthcare providers specifically, see CareHub — the healthcare-specific expression of Tribe's RCM.
Related

Related services.

Medical billing for practices →Medical office answering →Healthcare operations →Healthcare AI agent →Back office →How pricing works →
FAQ

Questions, answered.

What does Tribe's RCM cover?
The full cycle — eligibility and benefits, prior authorization, coding, charge capture and scrubbing, claims, payment posting, denial management and appeals, A/R follow-up, patient billing and reporting.
Is this healthcare-specific?
This is Tribe's horizontal RCM offer; the healthcare-specific expression is CareHub.
How do you reduce denials?
AI scrubs claims and predicts denials while certified specialists work prioritized A/R and appeals.
Do you handle prior authorization?
Yes. Requests are submitted and followed up automatically, and a person signs off before anything is submitted.
Will you sign a Business Associate Agreement?
Yes. Tribe signs a Business Associate Agreement and handles protected health information to HIPAA requirements.
How is RCM outsourcing priced?
RCM partners usually charge a percentage of collections, a fee per claim, or a rate per dedicated specialist. We quote one written number after reviewing your volume, specialties and payer mix.
What reporting do we get?
Full revenue-cycle visibility — clean-claim rate, denial rate, days in A/R and net collections — in the reports and on the cadence you choose.
We're a small practice. Is this for us?
Small and independent practices usually start with medical billing — the claims-and-collections core of the cycle — and add the rest later.
Are you compliant?
Operations run to recognized standards including PCI DSS and HIPAA; documentation on request.

Recover the revenue you're losing to denials and slow collections.

People first, AI where it helps — and you choose the mix.

Get an RCM assessment →All BPO services →