Your data is ready. Get paid.
LastMileRCM connects the case-management and EMR systems you already use to the health plans that pay you.
Eligibility, claims, remittances, contracts and reporting in one place, with rules that stop denials before they happen and a team that watches the feeds with you.
- 1Your case-management system or EMRpatients, services, authorizations
- 2LastMileRCMeligibility, rules, claims, remittances, contracts
- 3Health plans and payers5,000+ payers, electronic and paper
- 4Back to youstatus, payments, reports and what needs attention
See it before you book a call
The core path, screen by screen: check coverage, build and validate the claim, submit it, post the remittance and reconcile to the bank. Every screen below is the live product on a demo workspace.
Check coverage
Search the patient, pick the coverage, and the plan confirms eligibility in real time. The answer is saved to the record.
Everything you need. Nothing you don't.
The whole claims lifecycle, from verifying coverage to reconciling the check, with the parts that usually live in spreadsheets and inboxes brought inside.
A scorecard that explains itself
HFMA-aligned metrics with the owner and the calculation behind each number, plus metrics you define for your own contracts.
Works with what you already use
No migration, no second system for staff. Send us a file, connect through the partner API, or embed LastMile inside your own platform with single sign-on.
Monthly or daily exports from your system, mapped once and validated on every load.
Create patients and claims, read status back, and receive eligibility and claim errors as they happen. OpenAPI documented.
Your platform signs the user in; LastMile appears inside it with the right organization and permissions.
Pay less. See more.
EMR billing add-ons charge premium prices for basic functionality and lock your numbers away. We charge less per claim, include the whole lifecycle, and show you everything, live, inside the platform.
- Lower cost per claim, no hidden fees
- Every report live in the app, shared by secure link
- Metering you can reconcile line by line
What you get
- Real-time and batch eligibility, written back to the patient record
- Claims to 5,000+ payers with acknowledgments and status tracking
- Electronic and paper remittances posted and reconciled
- Contract pricing with underpayment detection
- Prior authorization and timely-filing deadlines watched for you
- Rules that catch coding and payer errors before submission
- RCM status, scorecard and revenue recognition, live in the app
- Partner API, webhooks and single sign-on for your platform
- Community health worker and program billing support
Up and running, in the open
We do the heavy lifting with the health plans. You see every step, and exactly what is waiting on you, in your own onboarding tracker.
Connect your system
We map your case-management or EMR export, or wire the partner API, so patients and services arrive without re-keying.
Enroll with your health plans
We handle claim, eligibility and remittance enrollment with each plan, and you watch every step in the onboarding tracker.
Load contracts and rules
Your fee schedules, program rules and payer quirks go in once, so every claim is priced and checked the same way.
Test, then go live
Test claims through live rails with your go-ahead, then first production submissions with us watching.
Ongoing monitoring
Feeds, denials and collections are watched against your own baseline. If something goes quiet, we notice before you do.
Built for organizations that actually bill
Keep your existing systems
Already on a case-management system, an EMR or your own platform? We integrate with what you have. No rip-and-replace, no retraining.
Made for Medicaid programs
Community health worker, enhanced care management and county program billing, with the program rules built in rather than bolted on.
Your numbers, explained
Every metric on the scorecard says who owns it and how it is calculated. Every rule says where it came from. No black boxes.
Real support, real people
Questions get answered by the people who run your feeds. Problems get noticed by us, often before you see them.