For Ambulatory
Get paid for every encounter.
Automated claims preparation, submission, and reconciliation. Inside your EMR. Live in 10 days.
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.
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
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
10 days
contract to live
Minimal
integration lift
Outcomes
pricing tied to results
“In my experience, Exactrx is a high-value partner for ASCs seeking a RCM solution that is operationally disciplined, clinically aligned, and built to support growth. Their expertise elevates the reliability and performance of the surgical environment, and I fully endorse their integration into ASC operations.”
Janet L. Carlson, MSN, BSN, RN, NE-BC, FACHE
Founder & Chief Executive Officer, Vertex Surgical Solutions
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.
Ready to optimize your revenue cycle?
30-minute conversation with our Nashville team. No pitch deck, just your questions.