AWS Business Associate Agreement • Active
PHI Encrypted at Rest & Transit
2,087 eligibility checks processed today
3,500+ payers connected nationally
US Healthcare · Revenue Cycle Management · 270/271 Engine

Built for Speed.
Built for RCM Automation.

Zero manual effort. 100% automation. Process 100,000+ records in under 10 minutes. Real-time 270/271 eligibility, CMS 60-rule compliance tracking, and $0 claim denials from eligibility errors.

1000+
Rules on Claim
60-Rule
CMS Compliance
1.4s
Avg Eligibility
100%
RCM Automation
HIPAA
AWS BAA Active
270/271 Engine · Live
Active
Demo Patient, A.
Aetna — PPO
1.1s Eligible
Demo Patient, B.
BCBS — HMO
0.8s Eligible
Demo Patient, C.
UnitedHealthcare — EPO
4.2s Ineligible
Demo Patient, D.
Cigna — POS
1.3s Pending
60-Rule Compliance Ratio87.2%
CMS minimum: 60% · Compliant · +27.2% above floor
0s
Avg eligibility response
↓ 0.3s vs yesterday
0%
Eligibility accuracy
Across all payer types
$0
Eligibility-related denials
For active customers
0+
Payers connected
Medicare & all Medicaid
0K+
Records in <10 minutes
Zero data loss
CMS Compliance

The 60-Rule engine that keeps you audit-safe

CMS requires 60% of your IRF admissions to have qualifying conditions. Our engine tracks your ratio in real time and alerts you before you breach — not after.

1
Patient admitted with qualifying diagnosis
Engine instantly checks the patient's primary diagnosis against all 13 CMS qualifying conditions at admission.
13 CMS conditions checked
2
Facility ratio updated in real time
Every admission recalculates your rolling compliance ratio. No batch jobs. No month-end surprises.
Live ratio · Every admission
3
Auto-alert at 63% — before CMS floor
When your ratio drops within 3% of 60%, your intake team gets alerted. Corrective action before breach.
Alert threshold: 63%
4
Full audit trail — CMS-ready export
Every decision logged, encrypted, timestamped. Export in one click for CMS review.
HIPAA · SOC 2 · Encrypted
60-Rule Engine · Live Status
Your facility is
CMS compliant today

Real-time compliance ratio, updated with every admission. Automatically tracks all 13 CMS qualifying conditions so your team never has to count manually.

60%
CMS floor
87.2%
Your ratio
63%
Alert trigger
Compliant · +27.2% above CMS floor
Platform Capabilities

Everything built in. Nothing to configure.

The full RCM automation stack — from real-time eligibility to claim scrubbing, denial prevention, and CMS compliance — in one HIPAA-secure platform.

Core
Real-time 270/271 Eligibility
Sends a live eligibility inquiry and receives the 271 response from the payer in under 2 seconds — before the patient walks in. Zero phone calls to payers.
avg 1.4s response · 3,500+ payers
Key
60-Rule Compliance Tracker
Facility-wide CMS compliance ratio recalculated on every admission. Auto-alert when you fall within 3% of the 60% CMS floor — before it becomes an audit.
zero CMS audit triggers
1000+ Rules on Claim
Over 1,000 industry-grade rules scrub every claim before submission to maximize first-pass acceptance. AI-powered edits catch errors humans miss.
maximize first-pass rate
AAA Error Code Analysis
Every denial decoded — AAA-97 (member not found), AAA-72 (ID mismatch), AAA-79 (payer timeout) — with specific corrective action for each failure type.
201 errors auto-classified
Batch 270 Processing
Upload your batch file at midnight. By 6am every patient's eligibility is verified. Morning rounds start with zero unknowns and a full exception report.
100,000+ records per batch
60+ ML Predictions on Eligibility
More than 60 ML-driven predictions surface coverage, copay, authorization risk, and denial probability on every eligibility check — before you submit.
predictive denial prevention
HIPAA Compliant Infrastructure
Fully HIPAA-compliant, AWS BAA signed and active. Audit-logged, encrypted infrastructure across all data flows. SOC 2 in progress.
AWS BAA Active · May 2026
Insurance Discovery
Don't know the payer? Run insurance discovery using patient demographics — find active coverage even when the patient doesn't know who their insurer is.
demographics-based lookup
AI-Powered RCM Engine
Predictive denial management, smart claim scrubbing, payer analytics, and COB (Coordination of Benefits) checks — all in real time, all in one platform.
intelligent · real-time · zero lag
How It Works

From patient check-in to CMS-compliant in seconds

No manual steps. No payer phone calls. No spreadsheets tracking the 60% ratio. The engine handles everything from the moment demographics are entered.

1
Patient check-in
Demographics and insurance entered once into your EHR or WeRrcm intake form
Intake
2
270 sent instantly
Real-time eligibility inquiry fired to payer via ANSI X12 standard clearinghouse
270 Inquiry
3
271 received
Coverage details returned — active status, deductible, copay, service type, effective dates
271 Response
4
60-rule scored
Diagnosis checked against 13 CMS conditions. Facility compliance ratio updated live
CMS Compliant
Connected Payers · Live Status
Aetna
1.1s
BCBS
0.9s
Medicare (CMS)
2.1s
UnitedHealthcare
1.3s
Cigna
1.0s
Humana
1.8s
Medicaid
4.2s
Tricare
1.4s
MCO Compliance

Managed Care compliance, automated end-to-end

Stay compliant with every MCO requirement — from prior authorizations to timely filing — without manual tracking or spreadsheets.

Active
Prior Authorization Tracking
Automatically tracks authorization status, expiration dates, and approved units for every MCO plan. Alerts your team before an auth expires or runs out of approved visits.
zero expired-auth denials
Active
Timely Filing Enforcement
Tracks each MCO's unique filing deadline (30, 60, 90, or 180 days) and escalates claims approaching the cutoff. No more revenue lost to missed deadlines.
per-payer deadline tracking
Active
Network Status Verification
Verifies provider network participation for each MCO in real time during eligibility checks. Flags out-of-network scenarios before services are rendered.
real-time network check
Active
Medical Necessity Documentation
Validates that required medical necessity documentation (LCD/NCD criteria, diagnosis codes, clinical notes) is present before claim submission to the MCO.
LCD/NCD auto-validation
Active
Quality Metrics Reporting
Aggregates HEDIS and STAR quality measures across your MCO patient population. Identifies care gaps that impact your MCO quality bonuses and value-based payments.
HEDIS · STAR measures
Active
MCO Contract Compliance
Maps each MCO contract's fee schedule, rate terms, and compliance requirements. Auto-flags claims that violate contract terms before submission.
contract term enforcement
Customer Results

What changes when eligibility is right — every time

98.7%
Eligibility accuracy
1.4s
Avg check time
$0
Eligibility denials
40+
IRF facilities trust us
★★★★★

“We went from calling payers manually for every patient to zero phone calls. The 60-rule tracker alone saves us an entire FTE's work every month.”

SR
Dr. S. Reynolds
Medical Director · IRF, Houston TX
★★★★★

“We were at 61% on the 60-rule — dangerously close to non-compliance. WeRrcm flagged it before CMS did. We corrected our intake criteria the same week.”

PM
Patricia M.
Revenue Cycle Manager · Multi-site IRF, Florida
★★★★★

“Batch 270 runs overnight. By 7am our front desk knows exactly which patients have coverage issues. It has completely changed our morning workflow.”

LT
Laura T.
Billing Head · Orthopedic Hospital, Chicago IL
Security & Compliance

Built for healthcare.
Secured to the standard.

Every patient eligibility check and every byte of PHI is protected by enterprise-grade security — with a signed AWS Business Associate Agreement active since May 2026.

🛡️
HIPAA Compliant
Full PHI protection under HIPAA Privacy & Security Rules
✓ Active
✔
AWS BAA Signed
Business Associate Addendum active — May 5, 2026
✓ Active
⚡
ANSI X12 270/271
Standard EDI 270/271 transactions via certified clearinghouse
✓ Active
📋
HITECH Act
Health Information Technology compliance enforced
✓ Active
🔒
SOC 2 Type II
Security & availability controls — in progress
● In Progress
🔥
Breach Notification
48-hour PHI breach notification — HIPAA required
✓ Active
Encryption at Rest
All PHI stored in S3 and RDS encrypted using AWS KMS-managed keys.
AES-256 · AWS KMS
Encryption in Transit
TLS 1.2+ enforced on all API endpoints and data transfer channels.
TLS 1.2+ · HTTPS Only
CloudTrail Audit Logging
Every API call touching PHI logged, immutable, retained for 7 years.
AWS CloudTrail · All Regions
IAM Least-Privilege Access
No wildcard permissions. Role-based access with MFA on all privileged accounts.
IAM · MFA · Zero-Trust
Private VPC · Zero Public S3
PHI workloads in private subnets. No public S3 buckets. WAF on all endpoints.
VPC · WAF · Private Subnets
Documentation

Everything you need to run WeRrcm

A complete guide to every part of the platform — eligibility automation, dashboards, diagnostics, payer management, batch automation, and MCO compliance scanning.

Eligibility Automation
Real-time and batch 270/271 checks, reading a response, and troubleshooting failed checks.
Dashboard
Reading your daily snapshot — summary cards, top payers, AAA errors, and MCO compliance details.
Diagnostics
Root-cause analysis for eligibility, claims, denials, and adjustment failures.
Payer List
Managing connected payers and EDI mappings across your organization.
Automation
Setting up batch eligibility runs and appointment import schedules.
MCO Scan
Running and reading Managed Care Organization compliance scans.
Open Documentation →
Frequently Asked Questions

Common questions, straight answers

Everything you need to know before getting started with WeRrcm.

Most practices are live within 24 hours. We connect to your payers, import your patient roster, and run your first batch eligibility file the same day. No IT team required.
No. WeRrcm works alongside your existing EHR and PM system. We accept standard appointment imports (XLSX/CSV) and connect via ANSI X12 270/271 transactions — no integration required.
We connect to 3,500+ payers nationally, including Medicare, all state Medicaid programs, Aetna, BCBS, UnitedHealthcare, Cigna, Humana, Tricare, and hundreds of regional plans.
The system flags ineligible patients immediately with the specific AAA error code and corrective action. Your front desk can resolve coverage issues before the appointment — eliminating downstream denials.
Yes. WeRrcm runs on AWS infrastructure with a signed Business Associate Agreement, AES-256 encryption at rest and in transit, CloudTrail audit logging, and full PHI access controls. SOC 2 Type II is in progress.
Engine live · 2,087 checks processed today

Start verifying eligibility today.
Stay above 60% always.

Connect your payers, run your first batch file, and see the 60-rule compliance score for your facility — live — in under 24 hours.

No credit card required HIPAA compliant Live in 24 hours 3,500+ payers ready