AI RCM Automation

AI revenue cycle automation for home care

From eligibility to audit, we automate the revenue operations running on top of your AlayaCare environment — so denials disappear before the visit, cash arrives faster, and every action is traceable.

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The shift

Your revenue cycle stopped being a back-office problem.

Most agencies don't lose revenue to one big mistake — they lose it in the seams. Eligibility checked after the visit instead of before. Authorizations entered three days late. Denials worked one at a time. The work is real, but it's manual, reactive, and invisible until the cash doesn't land. We put an automation layer on top of AlayaCare that runs that work continuously, surfaces problems before they become denials, and logs every step.

The manual way

  • closeEligibility checked after the visit, if at all
  • closeAuthorizations keyed in by hand, days late
  • closeDenials chased one claim at a time
  • closeNo record of who did what, or when

The Daya Labs way

  • check_circleEligibility verified at intake, recert, and before each visit
  • check_circleAuthorizations ingested and entered the same day
  • check_circleDenials prevented upstream, not worked downstream
  • check_circleEvery automated action logged and auditable
What we automate

One automation layer. Every revenue workflow.

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Automated Eligibility Management

Catch coverage lapses before the visit, not after the denial

We run eligibility checks automatically at the moments that matter — at intake, at recertification, and on a defined cadence before scheduled visits. Results land back on the AlayaCare client record, with lapses surfaced before a caregiver shows up at the door.

  • check_circleChecks at intake, recertification, and before each visit
  • check_circleResults written straight to the AlayaCare client record
  • check_circleLapses flagged early so visits aren't delivered against dead coverage
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AlayaCare Automation

The unglamorous middle of the platform, run for you

Auth ingestion, billing, data sync, and monitoring agents — the operational layer AlayaCare doesn't close on its own. We engineer the workflows directly in your environment so handoffs stop breaking and the manual middle disappears.

  • check_circleAuthorization ingestion and same-day entry
  • check_circleBilling and claim (re)generation workflows
  • check_circleMonitoring agents that watch for breaks and exceptions
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Audit Tracking

A complete, defensible record of every automated action

Every check, entry, and exception is logged with who, what, and when. Built on SOC 2 controls, the audit trail gives your team — and your payers — a defensible record without anyone keeping a spreadsheet.

  • check_circleFull audit trail of every automated action
  • check_circleSOC 2 aligned controls and one-year log retention
  • check_circleTraceable history for payer audits and internal review
The payoff

Get paid faster, lose fewer claims

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Fewer denials

Eligibility and authorization problems are caught upstream, where they're cheapest to fix — before they become a rejected claim.

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Shorter days to cash

Auths enter the same day and reconciliation runs continuously, so the lag the manual work was injecting is gone.

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Defensible by default

Every action is logged and traceable, so audits and internal reviews stop being a fire drill.

The proof

What we delivered for Care Advantage

>$1M
Annual cost savings
>50%
Reduction in manual work
Zero
Data entry errors
100%
Audit ready

Medicaid eligibility automation for Care Advantage, a Virginia-based home care provider — built and run by our forward-deployed engineers, with measurable gains within weeks.

By keeping AlayaCare perfectly in sync with Medicaid eligibility data, we've drastically reduced claim rejections and ensured faster reimbursements.

Erin BaggettVP REVENUE CYCLE, CARE ADVANTAGE

Stop chasing paperwork. Start closing claims.

See how the automation layer runs eligibility, AlayaCare workflows, and audit tracking on top of your environment — with the math for your agency.