AI-Powered healthcare
Maximus is AI-powered medical billing and practice management software that connects billing, coding, claims, payments, and reporting. Its rule engine scrubs claims before submission, posts ERA payments, and surfaces stalled claims for follow-up, cutting the manual work behind every paid claim.
Automated ERA
Posting
Claim Scrubbing by
Rule Engine
Denial
Management
The Problems with Traditional PMS
Maximus gives your team one place to see the whole cycle and act on it, instead of switching between systems to get a single claim paid.
Still checking insurance eligibility and benefits one patient at a time?
Still relying on your team to spot claim issues, check statuses, and decide what happens next?
Still spending staff hours posting and reconciling payments manually?
Still waiting on a report to find out how the practice is performing?
AI, automation, analytics, workflows, and interoperability working together in a single PMS.
Not Your Regular PMS
Traditional PMS software stores the transaction. Maximus executes it.
Passive data repository
Manual 270/271 eligibility inquiries
Post-submission error discovery
Claims batched and uploaded by hand
Manual 276/277 status inquiries
Line-by-line manual ERA posting
Appeals assembled by hand
Routing by staff discretion
Static, scheduled reports
KPIs siloed across systems
Flat-file exports and manual rekeying
Rules-driven execution layer on the same data
Automated 270/271 eligibility and benefits verification
Pre-submission claim scrubbing against payer edits
Automated 837P and 837I submission with acknowledgment tracking
Automated 276/277 polling with agentic AI follow-up
AI-driven 835 remittance and payment posting
One-click AI-assisted appeal generation
Conditional rule engine with automated task routing
Real-time BI and financial analytics
Unified KPI monitoring across the revenue cycle
HL7, FHIR, REST APIs and RPA connectivity
Start the Revenue Cycle Right
Maximus runs real-time eligibility and benefits inquiries before the appointment, putting coverage details in the patient record ahead of the encounter.
Real-time 270/271 inquiries replace manual portal lookups.
Copay, deductible, and coverage details the payer returns are saved to the patient record.
Run an entire day's schedule in a single pass.
Smarter Claims Start Before Submission
Maximus checks every claim against your payer rules before it is transmitted, then sends each exception to the person responsible for resolving it.
You define the conditions, routing logic, and actions, and Maximus applies them across claims, payments, eligibility, and workflows.
Maximus checks each claim for missing fields, code and modifier mismatches, and payer-specific edits before it is transmitted.
Maximus runs automated status inquiries with your payers and surfaces claims that have stalled or gone unanswered.
Maximus triggers the task, routes the exception to the right queue, and moves the claim to its next action without manual handoffs.
Performance Visibility
Maximus updates collections, A/R, and denial metrics as claims move, so the numbers on screen match the numbers in the system.
Collections
$842K
Payments
+18%
A/R
$1.12M
Denial Rate
4.8%
Maximus builds operational and financial dashboards from live claim, payment, and A/R data.
Maximus tracks your revenue cycle metrics in one place, with no exports or system switching required.
Maximus gives owners, CFOs, and billing leads their own view, each built from the same underlying data.
Give CFOs, CEOs, practice owners, and RCM leaders a clearer view of what is happening across the business.
One connection point for every system in your stack.
Connected by Design
Maximus connects to the systems your organization already runs, including HealUS, our own EHR, so data from connected systems is not keyed in twice.
Exchanges data with the hospital, lab, and legacy systems still built on the standard.
Supports modern API-based exchange with EHRs and platforms that have migrated to it.
Direct connection to external applications and services, without middleware in between.
Automates work in payer portals and systems that offer no integration to connect to.
Built for Healthcare Operations
200+
Physicians
Running daily billing and practice operations on Maximus.
HITRUST
Certified
Validated against a framework that goes beyond HIPAA and SOC 2 alone.
13+
Years
MedCare MSO has managed revenue cycles since 2012.
50+
Specialties
Billing workflows configured for the way different practices actually code.
Trusted by
200+ Physicians
Why Maximus
It should remove it.
The rule engine runs on your payer requirements and your workflows, not a generic template.
The team behind the platform runs revenue cycles for a living, so implementation questions go to people who do this work.
Software, support, and billing expertise from a single partner instead of three.
The same platform serves a solo provider and a multi-site group, with no migration between tiers.
See Maximus in Action
Thirty minutes against your own workflows. Not a feature tour.
We map how a claim moves through your practice today and where it stops.
We configure a scrubbing rule against the payers and denials you actually deal with.
We confirm what connecting your current systems involves and what it takes to migrate.
Tell us a little about your organization.
See it running against your own payer mix before you decide.
