For Ambulatory

Get paid for every encounter.

Automated claims preparation, submission, and reconciliation. Inside your EMR. Live in 10 days.

Trusted by leading healthcare organizations

SCA Health
Northwestern Medicine
Texas Health Resources
Dr. Papaliodis
SCA Health
Northwestern Medicine
Texas Health Resources
Dr. Papaliodis
SCA Health
Northwestern Medicine
Texas Health Resources
Dr. Papaliodis
SCA Health
Northwestern Medicine
Texas Health Resources
Dr. Papaliodis
What we do

Built for ambulatory operations.

01

An extra layer of capacity for the team you already run.

Slots into your billers' workflow. We handle the volume. Your team keeps payer relationships, contract strategy, and the cases that need judgment.

02

Catches the contract leakage your team doesn't have time to chase.

Underpayment Watch checks every remittance against your payer contracts. Flags downcoded claims, silent variance, and rate drift your team would miss.

03

Connects the systems you already run, end to end.

Reads from your PMS, codes inside your EMR, submits through your clearinghouse. No rip and replace.

In practice

How a screening colonoscopy runs through Exactrx.

Claim Workflow
Waiting

Op note received

Procedure documented in your EMR

Contract-aware coding

CPT, ICD-10, modifiers assigned and validated

Verification Engine

Scored against payer-specific rules

Claim assembled and batched

Charges and documentation packaged

Submitted to clearinghouse

Batch sent for adjudication

Accepted by insurance, EOB issued

Adjudication complete, payment determined

Auto-posted and reconciled

Payment reconciled, variance flagged

Handoff to billers

Denials, underpayments, and exceptions routed to your team

Specialties we support

OrthopedicsGastroenterologyOphthalmologyPain ManagementCardiologyUrologyGeneral SurgeryENTNeurosurgeryPodiatryOrthopedicsGastroenterologyOphthalmologyPain ManagementCardiologyUrologyGeneral SurgeryENTNeurosurgeryPodiatryOrthopedicsGastroenterologyOphthalmologyPain ManagementCardiologyUrologyGeneral SurgeryENTNeurosurgeryPodiatryOrthopedicsGastroenterologyOphthalmologyPain ManagementCardiologyUrologyGeneral SurgeryENTNeurosurgeryPodiatryOrthopedicsGastroenterologyOphthalmologyPain ManagementCardiologyUrologyGeneral SurgeryENTNeurosurgeryPodiatryOrthopedicsGastroenterologyOphthalmologyPain ManagementCardiologyUrologyGeneral SurgeryENTNeurosurgeryPodiatry
Spine SurgeryPlastic SurgeryGynecologyDermatologyVascular SurgeryBariatric SurgeryOncologyPulmonologyOral SurgeryEndoscopySpine SurgeryPlastic SurgeryGynecologyDermatologyVascular SurgeryBariatric SurgeryOncologyPulmonologyOral SurgeryEndoscopySpine SurgeryPlastic SurgeryGynecologyDermatologyVascular SurgeryBariatric SurgeryOncologyPulmonologyOral SurgeryEndoscopySpine SurgeryPlastic SurgeryGynecologyDermatologyVascular SurgeryBariatric SurgeryOncologyPulmonologyOral SurgeryEndoscopySpine SurgeryPlastic SurgeryGynecologyDermatologyVascular SurgeryBariatric SurgeryOncologyPulmonologyOral SurgeryEndoscopySpine SurgeryPlastic SurgeryGynecologyDermatologyVascular SurgeryBariatric SurgeryOncologyPulmonologyOral SurgeryEndoscopy

Architecture

Your EMR stays the source of truth.

Exactrx pulls from your EMR, runs the work, and pushes results back. No new database. No shadow systems.

// your emr

Op note (out)

Payment posting (in)

source of truth

// exactrx

Reads op note

Codes the case

Validates against payer rules

Posts remittance back

// clearinghouse · payer

Receives claim

Adjudicates

Returns EOB

Routes payment

Production performance

99% first-pass payer approval.

The rate at which our claims are accepted by payers on the first submission, with no rework or appeal. Industry average sits at 85 to 90%.

0%

Exactrx

first-pass approval

85-90%

Industry average

first-pass approval

Implementation

Live in 10 days. Inside your EMR.

We add Exactrx as a user inside the systems you already run. Minimal integration lift. No shadow systems, no IT roadmap. Outcomes pricing means you pay on results, not headcount.

10 days

contract to live

Minimal

integration lift

Outcomes

pricing tied to results

From the field

“RCM comes up every quarter at the board level and the conversation never changes. Denials are up, collections are delayed, and the billing team needs more resources. At some point you have to ask whether more headcount is actually the answer. We do high-volume, high-acuity cases. A denied claim at this center is a real hit to physician distributions. What drew me to Exactrx is the idea of fixing the claim before it leaves the building.”

Board Member

Multi-Specialty Ambulatory Surgery Center

Frequently Asked Questions

Yes. Exactrx slots into the workflow your billers already run, with 99% first-pass approval across surgical and outpatient claims. Your team focuses on payer strategy, contract negotiation, and the cases that need clinical judgment. Exactrx handles the volume work: claim prep, validation, submission, and posting.

Epic, HST, SIS, AthenaHealth, and most major ambulatory EMRs. Exactrx is added as a user inside your existing system. Your EMR remains the source of truth. No new platforms for your team to learn.

Most ambulatory practices are live within 10 days. No integration project, no shadow system, no IT roadmap.

Exactrx maintains payer-specific rule libraries that track place-of-service distinctions, modifier requirements (like PO/PN for HOPDs), bundled payment logic, and prior authorization triggers. Every claim is scored against the rules for its specific site of service before submission.

Exactrx provides financial clearance support for procedures that require prior authorization, validating coverage and flagging documentation gaps before scheduling. The primary focus is the claims process: preparation, validation, submission, and post-submission work.

Yes. Single-site ASCs and multi-site groups run on the same architecture. Each site gets its own payer rule context. You get one analytics view across the portfolio.

Get started

Ready to optimize your revenue cycle?

30-minute conversation with our Nashville team. No pitch deck, just your questions.