CX Horizon Services delivers end-to-end revenue cycle management for hospitals, physician groups, and specialty practices. Our capabilities span coding, claims submission, denials management, and accounts receivable, led by former senior leaders from major U.S. hospital systems and delivered from the Philippines with integrated AI-assisted workflows.
What we run
Engagements can be structured across the full revenue cycle or scoped to a specific functional area. Capacity expands over time in line with client priorities.
AI-assisted eligibility checks. Human-validated approvals. Everything that happens before a clinical procedure generates revenue. Get this right and the rest of the cycle behaves.
Proficient on tools such as: athenahealth · Epic · Cerner · NextGen · eClinicalWorks · Allscripts · Availity · Waystar · Change Healthcare, etc.
AI-suggested codes. AAPC / AHIMA-credentialed sign-off. Where coding, documentation, and compliance turn the procedure into a clean, defensible claim.
Proficient on tools such as: 3M Encoder · TruCode · Optum CAC · AAPC Codify · Epic Resolute · athenaCollector · Iodine · Nuance, etc.
AI-flagged denial patterns. Human-driven recovery. Where money actually lands in the bank: billing, claims, denials, payments, recovery.
Proficient on tools such as: Waystar · Change Healthcare · Trizetto · Experian Health · ZirMed · athenahealth · Epic Resolute · AdvancedMD, etc.
How we operate
The following delivery standards are applied uniformly across every Healthcare engagement, regardless of scope, engagement model, or team size.
Who we serve
Workflows, operational pressures, and priority outcomes differ meaningfully across client segments. Engagements are structured to reflect the specific context of each organization.
Margin compression, persistent denial rates, A/R days creep, and chronic vacancies in mid-cycle roles forcing premium contract staffing.
Coding & CDI, denial workdown, complex claim follow-up, payer escalations, vendor consolidation across mid-cycle.
Stabilize cash position, reduce dependency on contract labor, free internal teams to focus on the highest-complexity work.
Practice-by-practice variance, payer-mix complexity, EHR sprawl across acquired practices, and inconsistent patient-pay performance.
End-to-end billing across practices, eligibility & prior auth, patient pay & collections, consolidated KPI reporting.
Standardized workflows across the group, consolidated reporting up to leadership, lower per-encounter cost.
Specialty-specific coding (behavioral health, ortho, radiology, ASC), heavy authorization burden, small in-house teams stretched thin.
Specialty-trained coders, prior-auth teams, denials by specialty, after-hours patient pay support.
Coders who already know your codes; predictable monthly cash without hiring more in-house staff.
Provider data accuracy issues, claim adjudication backlogs, member services overflow during enrollment surges.
Provider data management, claims adjudication support, appeals & grievances ops, member services overflow.
Backlog reduction, regulatory turnaround compliance, lower per-claim handling cost.
How it works
Engagements begin with a defined initial scope, demonstrating operational fit before expansion. Contract structures are aligned to the pace at which the client organization wishes to scale.
Free 30-minute call. We map your current revenue cycle, KPIs, and pain points and leave you with a written assessment.
Initial scope on one workflow with measurable success criteria, named team leads, and a BAA in place.
Recruit and train the team, integrate with your EHR/RCM stack, complete HIPAA training, and run shadow cycles before going live.
Weekly KPI reviews, monthly QBRs, quarterly scope expansions. You scale at your pace. We don’t push for ARR.
AI + Human accountability
We use AI where it removes drudgery and beats human accuracy at scale - claim scrubbing, denial categorization, prior-auth triage, propensity scoring. We use senior healthcare operators where judgment matters - complex appeals, payer escalations, anything that touches a patient relationship.
Every AI output is reviewed and signed off by a credentialed team member on your team. No black boxes, no “the model said so.”
Security & compliance
The CX Horizon Services operating environment was architected around the compliance requirements of U.S. healthcare, not adapted after the fact.
Every engagement runs under a Business Associate Agreement. Our Philippines operations are built to U.S. healthcare standards - HIPAA-compliant access controls, encrypted data flows end-to-end, no PHI on local machines, and full audit trail on every claim touched.
*SOC 2 Type II ready; ISO 27001 target Q4 2026.
Tell us what your team is stuck on. 30 minutes, no pitch deck. We’ll give you a straight answer on whether we can help.
