OmbraqelynAI
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Healthcare revenue cycle team reviewing claims and adjudication data

Healthcare Revenue Cycle, Automated End to End.

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Ombraqelyn AI is the complete AI platform for healthcare revenue cycle management. From patient intake to account closeout, it unifies every operational stage: verifying insurance eligibility, securing prior authorizations, generating compliant medical codes from doctor notes, scrubbing claims for first-pass acceptance, overturning denials, and reconciling payments. By automating manual billing workflows, your team eliminates backlog, accelerates cash collections, and captures full reimbursement with total compliance.

see how it works
dashboard module

The Dashboard, your central revenue command center.

The Dashboard is the executive command center for your entire revenue cycle. It unifies real-time intelligence across coverage verification, coding, claims submission, denials, and cash collections into one centralized view — empowering leadership to monitor financial health, eliminate billing bottlenecks, and protect organizational cash flow.

Ombraqelyn AI — Dashboard

initial denial rate

Real-time monitoring of first-pass adjudication rejections across all active payers, tracking denial velocity reductions toward industry-benchmark levels under 5%.

1 / 3

< 2.4s

real-time eligibility & edi turnaround

Sub-Second Benefit Adjudication

Ombraqelyn AI executes automated 270/271 eligibility verifications and pre-submission edits in under 3 seconds, clearing patient coverage in real time before clinical check-in.

99.1%

pre-submission scrub accuracy

Universal Claim Integrity

Ombraqelyn AI enforces automated multi-payer rule scrubbing across millions of outpatient and hospital records, intercepting coding errors prior to transmission to eliminate clearinghouse denials.

$520M+

active claims volume routed

Continuous Revenue Defense

Ombraqelyn AI actively safeguards over half a billion dollars in clinical billing across our network, auditing 835 remittance feeds in real time and automating evidence packets for overturned denials.

The Nestack Healthcare Suite

Built for every corner of modern healthcare operations.

Healthcare operations move differently across each clinical and administrative vertical, with unique regulatory workflows, evidence requirements, and documentation standards. Explore our purpose-built AI platforms designed for each healthcare sector.

Healthcare financial operations command center managing revenue cycle claims
Revenue Cycle ManagementCurrent
Ombraqelyn AI
Healthcare billing & RCM teams
Clinical research team reviewing medical trial protocols
Clinical Research & Trials Management
Qavreniq AI
CROs & clinical research teams
Care coordinator planning patient transition with family
Care Coordination & Patient Transitions
Carenexum AI
Health systems & ACO care navigators
Acute care hospital operations command center
Hospitals & Acute Care Health Systems
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Acute care hospital systems
Wellness practitioner conducting an integrative client consultation
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Serevance.AI
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Healthcare staffing team coordinating clinician shift rosters
Healthcare Recruitment & Staffing
Klyqorent AI
Staffing agencies & health systems
Psychiatrist consulting in a clinical practice setting
Behavioral Health & Psychology
Veqthorin AI
Psychiatry & behavioral clinics
Home healthcare clinician providing skilled care to patient at home
Skilled Home Health & HHA
Pryqelva AI
Home health agencies & HHAs
Healthcare strategy advisory meeting with executive stakeholders
Healthcare Transformation Intelligence
Averqentra AI
Health systems & advisors
Dental clinician reviewing modern diagnostic imaging records
Dental Care Delivery
Occluvaryn AI
Dental groups & DSO practices
Calm therapist office setting for behavioral health session
Behavioral Health & Mental Health
Serenqora AI
Behavioral health operators
Caring moment with a senior resident in an assisted living community
Senior Living & Memory Care
Elyqentra AI
Assisted living & CCRCs
A patient at home going through a care plan together with a family member
Digital Health & Virtual Care
Qevarynth AI
Digital health operators
Two clinicians reviewing outpatient operations and diagnostic records together
Outpatient & Ambulatory Care
Tamvoriq AI
Outpatient specialty clinics
Healthcare consulting practice leaders conducting engagement review
Healthcare Consulting Services
Zyqrelvoth AI
Healthcare consulting practices
Skilled nursing team planning resident daily care routines
Post-Acute Care & SNF Management
Esvyqolthra AI
Skilled nursing facilities & SNFs
Medical billing auditing team resolving payer variances
Medical Billing & Adjudication Reconciliation
Reconcivia AI
Hospital billing & MSO teams
Ophthalmology practitioner evaluating diagnostic eye scans
Ophthalmology & Optometric Practices
Ophtheriq AI
Eye surgery centers & ophthalmologists
Biomedical engineering team calibrating surgical equipment
Medical Device & Surgical Equipment Fleet
Medarqis AI
Surgical hospitals & biomedical teams

The complete revenue cycle, module by module.

Ombraqelyn AI structures your entire revenue cycle into distinct, specialized operational modules. From initial insurance coverage verification and medical coding to claims submission, denial appeals, payment reconciliation, and AR closeout, every module eliminates operational friction and protects your bottom line.

Ombraqelyn AI — Coverage & Authorization
Coverage & Authorization

Verify patient insurance benefits and secure required prior authorizations before care begins.

Your intake team scans patient insurance cards or imports the daily schedule directly from your EHR. The module instantly runs electronic 270 inquiries to verify active coverage, deductibles, and copays within seconds. When prior authorization is required, operators upload clinical notes with one click, letting the system dispatch 278 requests to payers and track statutory 72-hour decision deadlines so treatment is approved before the visit.

Ombraqelyn AI — Charge & Coding
Charge & Coding

Convert clinical encounter documentation into compliant, billable codes.

Medical coders open provider encounter records and operative notes directly inside the coding workbench. The module automatically scans documentation, recommending compliant ICD-10, CPT, and HCPCS codes linked directly to clinical text excerpts with modifier validation. Coders review the highlighted evidence, accept or adjust suggested codes with a single keystroke, and release audited charges directly to billing without manual chart searching.

Ombraqelyn AI — Claims & Edits
Claims & Edits

Scrub billing errors, validate payer rules, and transmit clean electronic claims.

Billing specialists monitor outgoing electronic claim batches before clearinghouse submission. The module automatically scrubs 837P and 837I files against comprehensive payer rules, instantly flagging missing subscriber IDs, unlinked authorizations, or NPI discrepancies. Operators click highlighted error alerts to make one-click corrections on the spot, verify timely-filing countdown timers, and release 100% clean claims directly to clearinghouses.

Ombraqelyn AI — Denials & Appeals
Denials & Appeals

Investigate claim rejection causes and generate evidence-backed appeal packets.

Denial management specialists access automated work queues grouped by CARC and RARC reason codes rather than sorting spreadsheets. When a denial arrives, operators view the exact policy rationale alongside the patient's original claim history. The system automatically compiles necessary medical records, clinical guidelines, and payer appeal forms into a complete packet that operators review and dispatch with a single click to overturn denials.

Ombraqelyn AI — Payment Posting
Payment Posting

Reconcile electronic remittances, balance ledgers, and catch underpayments.

Payment posting staff ingest electronic 835 ERA files and bank EFT trace files into an automated matching queue. The module auto-posts approved payments and contractual adjustments to patient ledgers while matching disbursements to bank deposits. When actual reimbursement falls below negotiated fee schedules, operators are alerted instantly with underpayment flags to initiate recovery workflows before closing out batches.

Ombraqelyn AI — Patient Billing
Patient Billing

Deliver transparent statements, resolve patient inquiries, and collect balances.

Patient financial counselors manage post-adjudication balances through a centralized communication hub. The module generates clear statements breaking down total charges, insurance payments, and patient deductibles in plain language. Staff use the workspace to answer patient inquiries, accept secure online credit card payments, or establish custom recurring payment plans that auto-sync with the practice management ledger.

Ombraqelyn AI — AR & Closeout
AR & Closeout

Prioritize aging receivables, automate status inquiries, and resolve accounts.

Revenue cycle teams work dynamically ranked AR queues ordered by dollar value, deadline risk, and recovery probability rather than static aging buckets. Operators trigger automated 276 electronic claim status checks that retrieve 277 payer updates without waiting on phone holds. Staff resolve lingering claims, write off approved adjustments, and finalize month-end financial closeouts with verified ledger integrity.

between the screens

More Time for the Care That Matters

AI handles the routine work around each patient visit, so your team can spend less time on admin and more time with people.

Patient holding hands with family member before clinical visit

The Visit

Coverage and authorizations are verified and cleared before patient arrival.

Physician with stethoscope focusing on patient care

The Clinician

Clinical encounter notes translate to compliant billing codes without distracting from care.

Healthcare practice front desk and billing administration team

The Front Desk

Scheduling, intake checks, and clean claims stay organized automatically.

traditional saas vs ombraqelyn ai

Don’t settle for the AI your software chose.

Most platforms ship one generic model and your billing team works inside its limits. Ombraqelyn AI puts an orchestration layer between the revenue cycle workflow and specialized models, so each operational stage runs on the intelligence that suits it.

traditional saas
Built-in
AI

One model, one pass, and no step you can point somewhere else.

You work within its limits.

ombraqelyn ai — routed workflow
01

Verify coverage & prior authorization

Layout-aware OCR extracts insurance card IDs, while real-time 270/271 benefit parsing and 2026 CMS-0057-F SLA timers safeguard pre-service approvals.

Mistraldocument ocr & extraction
02

Link clinical notes to billable codes

Structured reasoning over operative notes and physician charts matches diagnoses and procedures to ICD-10-CM/PCS and CPT codes with evidence provenance.

Claudestructured reasoning
03

Scrub claims & track filing deadlines

Deterministic claim validation engines enforce thousands of clearinghouse edits and monitor the 12-month Medicare timely-filing countdown.

Hugging Faceinference providers
04

Cluster CARC denials & draft appeals

Long-context models analyze 835 remittance codes, payer policies, and medical records to synthesize compelling, evidence-backed appeal packages.

Geminilong context
05

Reconcile ERA remittances & bank EFTs

Automated payment matching compares 835 remittances against cash bank traces, detecting underpayment contract variances inside your secure VPC.

Llamaprivate deployment
06

Automate 276/277 claim status & AR recovery

Embeddings prioritize high-recovery aging accounts, while automated 276/277 queries retrieve live adjudication status without phone hold times.

Cohereembed & rerank
one structured client recordevery module · one thread · practice-wide view

Note: Model names and marks are the property of their owners and appear here to say which APIs a workflow step can be routed to. No endorsement or partnership is implied.

how it works

Getting started is simple and seamless. 

  1. 01

    Connect your clinical & billing systems

    Connect your Electronic Health Record (EHR), practice management software, and clearinghouse. The platform automatically imports patient registrations, clinical encounter notes, fee schedules, and historical claims into one unified revenue cycle environment.

  2. 02

    Automate coverage, coding & claims

    Insurance coverage and prior authorization requirements are verified before care takes place. Doctor documentation is analyzed to recommend accurate billing codes with clinical evidence, and claims are scrubbed against payer rules to ensure first-pass acceptance.

  3. 03

    Recover denials, reconcile cash & close accounts

    Remittances and payments reconcile automatically against bank deposits while underpayments are flagged. Denied claims are analyzed for rapid appeal, and aging receivables are prioritized so every earned dollar is collected and closed.

built for scale

Your Healthcare Revenue Cycle Management AI agents, run like production systems.

Pinned to its one relevant industry playbook, and connected through the documented APIs of the EHR, clearinghouse, and banking tools your organization already runs on.

discover nestack agents
  • Google Calendar
  • Outlook Calendar
  • Zoom
  • Twilio
  • SendGrid
  • Slack
  • Mailchimp
  • Microsoft 365
  • Stripe
  • Square
  • HubSpot
  • Google Drive
  • Dropbox
  • DocuSign
  • QuickBooks
  • Xero

Note: Tool names and marks belong to their respective owners. No endorsement or partnership implied. Integration availability depends on your existing systems, licences, API access and implementation scope.

what we are held to

Revenue carries duties.
We hold every one.

A healthcare revenue cycle organization is answerable for the claims it submits, the transaction standards it upholds, and the protected health data it safeguards. Ombraqelyn AI is built to the federal standards below, so the statutory requirements governing billing provenance, prior authorization timelines, and HIPAA EDI compliance are enforced seamlessly.

  • HIPAA Administrative Simplification

    Healthcare Transaction Tracking

    Tracks eligibility, authorization, claim, and remittance records while identifying missing transaction information.

  • CMS-0057-F

    Prior Authorization Monitoring

    Monitors authorization requests, document status, payer responses, and applicable decision deadlines.

  • HIPAA Privacy & Security Rules

    Patient Access Controls

    Supports role-based permissions and activity logging to help manage access to sensitive billing information.

  • ICD-10-CM, CPT & HCPCS

    Coding Documentation Checks

    Flags incomplete coding fields, missing documentation, and records requiring human review.

  • Medicare Timely Filing Requirements

    Medicare Filing Alerts

    Calculates standard Medicare claim deadlines and alerts teams about approaching submission dates.

Note: Ombraqelyn AI is not a certification and does not make your practice compliant. These are standards the platform supports operationally: it captures the consent, logs the access and retains the records your own privacy, security and accessibility obligations depend on. Conformance assessment, audit and certification remain yours.

ADD-ONS

Add the hardware your workflow needs.

Compatible hardware components that connect directly with Ombraqelyn AI through documented device drivers, network protocols, and secure cloud APIs. Each certified device feeds an existing operational module, transforming physical documentation and in-person patient payments into clean, real-time digital records.

Duplex Insurance Card & ID Scanner
Coverage & AuthorizationTWAIN / Local Gateway WebSocket

Duplex Insurance Card & ID Scanner

Dual-sided desktop scanner feeding Coverage & Authorization via TWAIN device gateways. Captures high-res insurance card imagery and auto-extracts member IDs, group numbers, and copay tiers directly into electronic 270 eligibility verification inquiries.

High-Speed Batch Document & EOB Scanner
Charge & Coding & Payment PostingNetwork Share SMB / Ingestion API

High-Speed Batch Document & EOB Scanner

High-volume sheet-fed scanner feeding Charge & Coding and Payment Posting via secure SMB shares and cloud ingestion APIs. Digitizes paper EOBs, clinical operative notes, and paper CMS-1500 claims into structured OCR queues for instant coder review and payment reconciliation.

Point-of-Service EMV Payment Terminal
Patient BillingPCI-PTS IP Protocol / Gateway Webhook

Point-of-Service EMV Payment Terminal

PCI-PTS certified smart card terminal connected to Patient Billing via encrypted network protocols and gateway webhooks. Processes in-person patient copayments, deductibles, and payment plan tokenization with real-time balance posting to patient accounts.

Note: Hardware, installation, and integration are not included in the standard subscription. Additional charges apply based on the hardware selected, integration modules required, and implementation scope.

our prices

Predictable pricing for your revenue cycle.

A first conversation maps your billing volume, clearinghouse connectors, and EHR setup. From there it is one plan at one price, whichever operational modules of your revenue cycle you run on Ombraqelyn AI. No per-seat limits, no surprise platform licensing.

the complete rcm platform
$200/mo

Starting at $200/mo — every module, unlimited operators, billed monthly.

  • dashboard
  • coverage & authorization
  • charge & coding
  • claims & edits
  • denials & appeals
  • payment posting
  • patient billing
  • ar & closeout
Know more
Note: AI API usage is charged separately. Clients must recharge their AI credit balance based on their usage.

Nothing is locked in. Move at the pace your practice moves — change or pause whenever it suits you.

onboarding

What your onboarding fee covers

A one-time setup that gets your practice fully live before your first monthly cycle — we import your client records and appointment history, connect the calendar, intake and messaging you already run on, and tune every Ombraqelyn AI module to the way your practitioners actually work.

how it runs

Two ways to run Ombraqelyn AI — same platform, same monthly subscription. Only the onboarding may differ by your requirements.

Cloud (SaaS)

Runs in Nestack's managed cloud — the fastest way to go live. We handle HIPAA BAA execution, security patching, clearinghouse connectivity, and scaling so your billing team logs in and starts working.

Private / self-hosted

The same Ombraqelyn AI platform deployed inside your own infrastructure — your cloud, AWS/GCP/Azure VPC, or on-prem — for healthcare organizations handling sensitive electronic PHI, claims, remittances, and proprietary payer contracts. Your data never leaves your environment, and the monthly subscription stays the same.

Essential

$1,000+one-time
  • Kickoff call with your RCM operations lead to map billing specialties, NPIs, and payer mix
  • Ombraqelyn AI workspace provisioned with your branding, clearinghouse connectors, and operator accounts
  • Setup of standard ASC X12N transaction mappings (270/271, 837P/837I, 835, 276/277)
  • Coverage verification and prior authorization pipeline configured with payer rules and SLA timers
  • Core charge capture and medical coding validation rules aligned to your specialty code sets
  • Roles and permissions set for access specialists, coders, billers, and denial analysts
  • Live-readiness walkthrough and an operational runbook before your first billing cycle

Plus

most chosen
$2,500+one-time

Everything in Essential, plus:

  • Guided migration of historical claims, remits, and denial records with root-cause clustering baseline
  • Two integrations wired up — your EHR/PMS, clearinghouse SFTP, or banking lockbox feed
  • Document processing trained on your referral orders, operative notes, and payer EOB layouts
  • Payer contract fee schedules ingested for automated underpayment variance detection
  • Live training session for billing specialists, coders, and appeals managers with full recordings
  • A dedicated RCM onboarding specialist through your first live adjudication cycle

Enterprise

$5,000+one-time

Everything in Plus, plus:

  • Multi-facility, hospital system, or MSO rollout across multiple billing groups and tax IDs
  • Bespoke integrations with EHR/PMS, SAML/SSO, enterprise BAA, and custom audit log export
  • High-volume ERA/EFT automated reconciliation and custom banking lockbox ingestion
  • Custom appeals argument library and payer-specific clinical precedent templates
  • Role-based training tracks and administrator enablement for revenue integrity leadership
  • Named RCM implementation director with a committed go-live date and quarterly performance reviews
common questions

Your questions answered plainly.

How does pricing work, and are there any hidden per-claim or per-seat fees?

Pricing is simple, transparent, and predictable. Starting at just $200/month, you get full access to all 8 operational modules across your entire revenue cycle organization. There are zero per-claim fees, no percentage-of-collections cut, and no punitive per-seat licensing. Every billing specialist, certified coder, and executive can collaborate in the platform without extra charges.

What if Ombraqelyn AI isn't the right fit? Are we locked into a long-term contract?

No. We believe in earning your trust every month. You are never locked into a rigid multi-year commitment or restrictive vendor trap. Subscriptions run on straightforward month-to-month terms that you can pause, adjust, or cancel at any time directly from your account. Your billing data and audit logs remain 100% yours to export whenever you need.

How fast will our practice see measurable ROI in cash flow and AR days?

Most practices experience tangible cash-flow improvements within their first 30 days. By automating upfront 270/271 eligibility verification and catching billing edit errors before clearinghouse transmission, clean claim rates typically rise above 94%. Customers consistently compress their average days in AR from over 50 days down to under 38 days, dramatically reducing costly timely filing write-offs and accelerating cash collections.

How does Ombraqelyn AI compare to hiring more billing staff or outsourcing to an agency?

Traditional RCM outsourcing agencies often charge 4% to 9% of your total practice collections while offering minimal visibility into root-cause denials. Hiring additional billing personnel incurs heavy recruiting, training, and salary costs. Ombraqelyn AI augments your existing team with tireless intelligence — automating repetitive portal checks, 835 payment reconciliations, and appeal packet assembly so your staff can resolve complex claims faster without increasing overhead.

How do you protect patient data, and is a signed HIPAA BAA included?

Patient privacy and statutory compliance are foundational. All protected health information (ePHI) — including 837 claim files, 835 remittances, and clinical documentation — is encrypted in transit and at rest with strict role-based access controls and immutable audit trails. Prior to processing any live data, we execute a comprehensive, legally binding HIPAA Business Associate Agreement (BAA) with your practice.

How does onboarding work, and will your team help connect our EHR and clearinghouse?

We provide white-glove technical onboarding at every step. Our implementation engineers assist in configuring secure SFTP or API connections to your existing EHR, practice management system, and clearinghouses (such as Availity, Change Healthcare/Optum, or Waystar). We ingest your negotiated payer fee schedules and historical CARC/RARC denial codes so the system is calibrated to your exact billing rules from Day 1.

Didn’t find your answer? Send us a message — we’ll respond with care and clarity.