Claim Reconciliation
RCM teams processing thousands of claims per month are stuck in a loop of repetitive, manual work.
Problem
The Challenge
RCM teams processing thousands of claims per month are stuck in a loop of repetitive, manual work:
Pull an Explanation of Benefits (EOB)
Compare it to a draft claim generated by brittle tooling
Fix discrepancies across multiple portals and systems
Submit and repeat
Even when a system "creates a draft claim," it often misses key details — forcing human teams to spend minutes per claim just to get it submission-ready.
Solution
The Solution
An automated Claim Creation + Reconciliation workflow that drafts higher-quality claims directly from EOBs
- 1
Retrieve EOBs + draft claims via Browser Agent
XY's Browser Agent navigates the same web portals your team already uses, pulling both the EOB source-of-truth and the existing draft claim that needs correction.
- 2
Reconcile data automatically across systems
Instead of forcing billers to bounce between screens and tabs, XY assembles the full claim context and identifies mismatches between what payers returned (EOB) and what's currently in the claim.
- 3
Draft a cleaner, submission-ready claim
XY generates an updated, higher-quality claim draft — reducing downstream corrections and rework.
- 4
Human-in-the-loop review
Your team sees everything in one place inside the XY app, and only needs to review, approve, and submit. The heavy lifting happens in the background.
Outcome
Why It Matters
This workflow replaces minutes of repetitive claim reconciliation work with near-ready drafts — saving clicks, reducing processing time, and improving throughput without adding headcount.
~1,000s
of clean claims drafted daily
Volume worked across parallel queues
~3 days
of time saved weekly
Modeled on a 5-day work week
~$1M
of claims optimized for acceptance
Dollar value moving through the workflow
Ready to automate this workflow?
See how XY.AI can transform your medical billing & rcm operations with a personalized demo.