Introducing Secreta RCM
Healthcare organizations deliver extraordinary care every day and fail to collect full payment for a significant portion of it — not because of poor clinical quality, but because of claim errors, missed charges, delayed submissions, and denial management processes that cannot keep pace with payer complexity. Secreta Revenue Cycle Management closes every gap between the care your team delivers and the revenue your organization collects — with end-to-end automation, real-time visibility, and the analytical intelligence to turn your revenue cycle from a cost center into a competitive advantage.
Not because of poor clinical quality — but because of claim errors, missed charges, expired authorizations, and reactive denial management that can't keep pace with payer complexity.
Claims submitted with incorrect or missing diagnosis codes, procedure codes, or documentation — rejected by payers with no obligation to explain how to fix them.
Charges for procedures, medications, and bedside investigations never captured in billing because no one manually entered them and no automated capture exists.
Prior authorizations expire before the procedure is performed, claims are submitted without a valid auth, and the payer denies on a technicality that should never have arisen.
Denials sit in a queue, get worked weeks later, some are resubmitted, many are written off because the appeal window has already closed.
By the time leadership sees a revenue problem in the data, the causes are weeks old and the financial impact has already accumulated.
Every function of the revenue cycle, connected and automated — from the front desk to the final dollar collected.
Capture complete demographics and verify insurance eligibility in real time against the payer's active policy database. Lapsed coverage, exclusions, and pending authorizations are flagged at the front door — not weeks later when claims are denied.
Authorization requests are generated automatically from clinical orders. Status is visible to clinical and admin teams in real time. Expired authorizations trigger renewal alerts before service delivery. Claims are never submitted without a valid authorization.
Every billable event — procedures, medications, investigations, bed days — flows from the clinical record to billing without manual entry. Missed-charge detection identifies documentation that suggests a billable service was delivered but not captured.
ICD-10, CPT, and DRG coding with NLP-assisted code suggestions from clinical documentation. Coders work from a structured interface with codes, guidelines, and the clinical record side by side. Coding accuracy tracked by coder, department, and service line.
Every claim passes through a validation engine checking for missing fields, invalid combinations, authorization mismatches, and known payer-specific denial triggers. Only clean claims reach the payer. First-pass acceptance rates improve immediately.
Claims submitted electronically to insurance companies, government programs, self-pay, and corporate accounts through certified channels. NPHIES (KSA), DHA eClaims (Dubai), and DOH (Abu Dhabi) integrations included. Paper claims eliminated.
Denied claims are captured, categorized by reason, and routed automatically. Appeal letters are generated from configurable templates with clinical documentation and authorization evidence attached. Appeal deadlines are tracked and escalated before windows close.
Electronic remittance is processed automatically — payments matched, adjustments categorized, contractual allowances applied. Actual payer payments are compared against contracted rates to flag systematic underpayments that would otherwise go undetected.
Patient liability is calculated at the point of service. Payment plans are offered and documented digitally. Automated statements and structured collections workflows balance revenue recovery with patient financial experience.
Live dashboards for gross charges, net collections, days in A/R, denial rates by payer and reason, first-pass acceptance, and cash flow forecasts. Problems are identified and acted on the week they emerge — not the month after.
Manage every payer contract — fee schedules, reimbursement rates, bundled payments, capitation. Performance analytics show what each payer is actually paying versus what was contracted, exposing underpayments and informing renegotiation.
Native ZATCA Phase 2 e-invoicing for Saudi Arabia: every invoice formatted to Fatoora specifications, cryptographically stamped, and cleared in real time. NPHIES, DHA, and DOH submission pathways pre-configured.
From first contact to final payment — every step automated, tracked, and reconciled.
The patient registers. Insurance eligibility is verified in real time. Coverage, authorization requirements, and patient liability are confirmed before the first clinical interaction.
Average first-pass claim acceptance rate vs. 75% GCC industry average
Reduction in days in accounts receivable within the first six months
Denial overturn rate on appeals with automated documentation and evidence
Average increase in net collections per patient encounter
9% average charge leakage identified and recovered in the first 90 days of automated charge capture deployment. 100% of underpayment variances above threshold flagged automatically for payer audit.
Secreta RCM connects with your clinical systems, national health platforms, payer portals, and financial management infrastructure — creating a revenue cycle that flows automatically from clinical activity to collected cash, without manual bridges between disconnected systems.
National Platforms
Most clients see measurable improvement in first-pass claim acceptance within the first two to three billing cycles after go-live — typically 4 to 8 weeks. The pre-submission validation engine begins catching errors immediately. Coding errors respond quickly to validation and NLP assistance; authorization-related denials improve as the tracking workflow becomes embedded in practice.
Charge capture is driven by integration between the clinical record and billing. When a physician documents a procedure, a pharmacist dispenses a medication, or a lab validates a result, the associated charge is generated automatically and routed to billing. Integration with your HIS, EMR, pharmacy, and lab systems is established during implementation, and charge rules are configured by your teams.
Yes. Secreta RCM maintains pre-configured submission profiles for all major GCC and international payers — including payer-specific claim formats, required documentation, code set requirements, and electronic submission pathways. The correct format and channel are applied automatically. New payers can be added as your contract portfolio evolves.
Each remittance line is compared against the contracted rate for that service, code, and payer. When actual payment is below the contracted rate by more than a configurable threshold, the variance is flagged automatically. Flagged underpayments are queued with the contract reference, claimed amount, paid amount, and variance presented together — ready for a formal dispute with system-generated documentation.
Yes. Every invoice is formatted to Fatoora specifications, cryptographically stamped, and submitted for real-time clearance through the ZATCA portal automatically. Cleared invoices are archived for the mandatory retention period. B2C simplified and B2B standard tax invoices are handled through separate compliant workflows. No manual intervention is required for compliance.
Standalone RCM implementation — without replacing an existing HIS — typically takes 6 to 12 weeks depending on payer integrations, charge capture configuration, and contract data volume. For facilities deploying Secreta HIS alongside, RCM modules go live as part of the integrated HIS program. A dedicated revenue cycle specialist manages the entire process through go-live and first-cycle review.
Your clinical teams work too hard and your patients receive too much value for your revenue cycle to be the place where that value leaks away. That ends today.
Revenue cycle baseline assessment included. Implementation and training support from day one.
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