Software Solution for
Medical Billing Companies
Expand beyond claim submission. Factum RCM equips billing companies with litigation-grade infrastructure to manage complex denials, coordinate administrative appeals, and deliver measurable recovery outcomes that no competitor can match.
70%
Faster appeal preparation
AI pre-populates all templates
0
Manual data entry at intake
automated EHR record pull
5×
More denial volume handled
same headcount, more throughput
100%
Per-client data isolation
no cross-client PHI exposure
The Opportunity
Move Up the Value Chain - From Submission to Full Recovery
Billing companies that only submit claims are commodity vendors. Factum transforms your offering into a full-cycle recovery service - giving clients a reason to stay, a reason to pay more, and a recovery rate your competitors cannot replicate.
Factum RCM Workflow Phases
Your Billing Operation, Scaled by Our 4-Phase Recovery Engine
Factum injects structure and automation into the most labor-intensive steps of the denial management cycle.
Claims Submission
Automated claim scrubbing, NPI and eligibility validation, and payer-specific formatting - eliminating the manual intake bottleneck and ensuring every claim hits its filing window.
Payment Posting
Automated ERA matching and live contract rate benchmarking flags every underpayment against your actual contracted rate before any write-off is processed.
Patient Billing
Accurate patient responsibility calculation and compliant payment portal management - reducing inbound call volume and protecting your clients patient relationships.
Denial Management
For claims requiring escalation, Factum prepares a litigation-ready appeal file - coordinating with your clients outside counsel to hand off a fully documented, court-admissible package.
Platform Capabilities
Technology That Multiplies Your Billing Team's Output
Every feature below is designed around the specific operational constraints of multi-client billing operations.
Multi-Client Denial Dashboard
Manage denial inventories across every provider client from a single operations center. Segment by payer, denial reason code, and recovery stage - so your team always knows where to focus to maximize aggregate recovery.
Automated Appeals Drafting
Factum AI extracts the relevant clinical language from medical records and pre-populates Level 1 and Level 2 appeal templates - cutting preparation time by 70% without sacrificing argument quality.
Client-Isolated Data Architecture
Each provider's PHI and financial recovery data is maintained in a logically isolated environment - ensuring zero co-mingling of sensitive information across your client base. Every client gets their own sovereign data perimeter.
Payer Performance Scorecards
Track denial rates, appeal success rates, and average days-to-payment per payer across your entire client portfolio. Deliver branded recovery reports that demonstrate measurable outcomes and lock in client retention.
Contract Variance Detection
Automated ERA matching and live contract rate benchmarking catches every underpayment before it becomes a write-off - with the variance amount and contract reference pre-populated for your team.
Litigation-Ready File Package
When a claim requires escalation, Factum prepares a court-admissible appeal file - coordinating with your clients' outside counsel to hand off a fully documented, evidence-backed litigation package.
Platform Foundations
The Tools Behind Your Recovery Service
Factum Core™
Factum Core is the sovereign platform foundation that connects workflows, permissions, automation, reporting, and configuration within one operational system. Its unified data model and workflow engine support Factum RCM, Factum Recovery, and all the other custom solutions.
Factum AI™
Factum AI analyzes medical documentation using advanced natural language processing to identify medical necessity indicators and generate a Litigation Merit Score, helping teams prioritize claims with the highest probability of recovery.
Factum Join™
Factum Join integrates with hospital EMR and HIS systems such as Epic and Cerner to automate document retrieval and synchronize claim data across systems.
Factum Security™
HIPAA-hardened infrastructure designed to protect sensitive healthcare claims data. Organizations can deploy Factum within their own environment or through a secure isolated cloud.