User Guide

AI drafts in the revenue cycle

On six revenue-cycle screens ArkCloud prepares a first draft for you with the deployment's language model: an appeal letter, call preparation, a reply to a patient's dispute, an authorization request, an explanation of a revenue-integrity finding, and a short summary of your denial figures. Each is labelled AI draft - review before use. A person reads and edits every one; nothing is sent, submitted or saved by the AI.

Written for: Billing staff · Collectors · Utilization review · Supervisors

The drafts and where they appear

Field or control	What it means
Denial appeal letter	Claims → Denials → a denial → Create Appeal. The dialog opens with the letter already in the text box, with a list of what it relies on (the reason codes, the claim line, the signed note, the authorization, the certified plan of care, your organisation's appeal template for the code if one is set) and a list of gaps to fill. Redraft with AI asks again.
Call preparation	Patient AR → an account → Script. When the tab opens, a short pre-call summary and a script whose balance discussion and payment request are tailored to the account. The opening, verification, debt-collector disclosure (when your organisation has it on), consent request and closing are the standard script's wording, unchanged; the disclosure is inserted by the software, and a tailored script that does not keep it word for word is not shown.
Account assistant	Patient AR → an account → AI. Answers questions about the account from its balance, claim statuses, open denial codes, what payers assigned to the patient, any payment plan, recent contact outcomes and notes. It does not see the patient's name or any clinical record.
Dispute reply	Patient AR → Disputes → View. The reply editor opens with a plain-language explanation of the balance from the latest statement, what insurance decided (deductible, coinsurance, copay) and the patient's payments.
Authorization request	ArkCloud Access → Prior authorizations → Draft request with AI (authorizations linked to an episode). The request from the episode's diagnoses, plan of care, current authorization use and any booked visits it will not cover.
Finding explanation	ArkCloud Rehab → Revenue integrity → Explain with AI under a finding. Why the rule flagged it and what would clear it, in plain words.
Today's denial brief	Insights → Denial analytics, under the figures, as "Today's denial brief (AI summary of the figures above)"; also added to the work-queue triage agent's daily brief. A few sentences over counts and amounts, with the figures listed beneath it.

What the AI never does

It never sends, submits, files or saves anything. Create Appeal, Save reply, Record submission and Save Disposition are your clicks.
It never suggests a procedure, diagnosis or modifier code, and never decides whether to bill, appeal or write off.
It never states a figure the records do not. Every amount, date, count and code in a draft is checked against the records it was given; a draft that states anything else is withheld (the appeal and authorization request then show the rule-built text from the same records instead, and say so).
Call scripts never threaten or mention legal action, collections agencies, credit reporting or garnishment; a draft that does is withheld. The AI does not write the debt-collector disclosure; a draft carrying debt-collector wording of its own is withheld.
It does not receive the patient's name, date of birth, member id or address. Those are added to letters by ArkCloud after drafting; notes passed to it have the patient's name replaced.
The denial brief sees counts and amounts only - no claim, account or patient.
It does not forecast whether a patient or payer will pay, and gives no scores or percentages.

Who reviews what

Field or control	What it means
Appeal letter	The biller who creates the appeal (billing staff with payment permission). Check it against the enclosures and fill the gaps listed.
Call preparation	The collector making the call reads it; nothing is recorded until they save the disposition.
Dispute reply	The staff member answering the dispute edits it, saves it as a patient-facing note, and sends it by your usual channel. Saving does not resolve the dispute or change the balance.
Authorization request	Utilization review edits it, submits it on the payer's portal, form, fax or phone, and records the submission.
Finding explanation	The finding's owner. The rule's own action stays the instruction.
Denial brief	The billing manager, against the figures shown beneath it.

When AI is unavailable

Each screen keeps working without the model and says why there is no AI text: AI is switched off, the hourly limit is reached, no model answered, the model endpoint is not approved for patient information, the draft stopped short, or the draft was withheld because it stated something the records do not support.

Settings → AI Configuration → RCM account assistant and AI drafts

An administrator can switch every RCM AI draft and the account assistant off for the organisation there. Each draft type has its own hourly limit per person and per organisation.

Where the data goes, and what is recorded

Drafts use this deployment's own model endpoint only, and only when that endpoint passes the check for patient information; tenant-configured and external providers are never used for these drafts. Each request is recorded in the audit log with the model, the prompt version and the class of endpoint - never the text sent or received.