R1 offers Phare, an AI‑driven Healthcare Revenue Operating System that automates patient intake, real‑time claim coding, and end‑to‑end denial management for large health systems. By integrating with EMRs, payer and financial systems, the platform reduces cost‑to‑collect, speeds payment collection, and improves net revenue yield while keeping compliance through human‑oversight of exceptions.
Funding
Funding not disclosed
Founders
Product
Problem
Healthcare providers face fragmented, manual revenue cycle processes that require extensive coordination across claim adjudication, patient intake, and denial management, leading to high administrative costs, delayed payments, and revenue leakage.
Solution
R1 delivers Phare, a Healthcare Revenue Operating System that orchestrates the entire revenue cycle through AI‑driven specialist and orchestration agents. The platform automates patient intake (Phare Access), real‑time claim coding and safety‑net rules (Phare Claim), and end‑to‑end denial follow‑up (Phare Flow), while embedding two decades of revenue cycle expertise into each action. By integrating with EMRs, payers, and financial systems via a unified data exchange, Phare provides contextual, system‑level insight that aligns payer and provider incentives and enables instant adjudication. Human experts intervene only for exceptions, ensuring compliance and risk management while maintaining high throughput. The result is accelerated payment collection, reduced cost‑to‑collect, and increased net revenue yield for health systems.
Target Audience
Primary customers are large U.S. health systems and hospital networks seeking enterprise‑level revenue cycle transformation, as well as physician groups and community hospitals that require AI‑enabled RCM automation.
Features
- Agentic architecture with specialist AI agents for intake, coding, and denial management, coordinated by orchestration agents across the cycle
- Real‑time claim adjudication using AI‑trained coding models and pre‑bill safety‑net rules
- Automated patient intake that verifies insurance, secures authorizations, and captures accurate demographic data
- End‑to‑end denial automation that follows up on claims, manages appeals, and escalates exceptions to human experts
- Unified Data Exchange that ingests, cleans, and normalizes data from EMRs, payer systems, and banks for seamless workflow integration
- Compliance‑first framework with built‑in risk monitoring, audit trails, and human oversight
- Analytics dashboard that tracks throughput, yield improvement, cost‑to‑collect reduction, and patient satisfaction metrics