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Frequently Asked Questions
Everything you need to know about Roony's AI-powered claims resolution platform.
General
What is Roony?
Roony is an AI-powered claims resolution platform that automates denial management for healthcare providers. The platform handles the full denial resolution cycle: payer outreach, status verification, reprocessing requests, appeals, and persistent follow-up. It replaces the hours of manual work and hold time that billing teams deal with every day.
How does Roony resolve denied claims?
When you upload a denied claim, Roony analyzes the denial reason code, generates a resolution strategy using its knowledge base of payer-specific rules, and initiates automated payer outreach. The AI authenticates with the payer, gathers claim status details, and determines whether to request reprocessing, file an appeal, or take another corrective action. After every interaction, Roony extracts insights that make future resolutions more effective.
What types of claims can Roony handle?
Roony handles all commercial and government payer claims, including denials for eligibility, authorization, medical necessity, coding and bundling, timely filing, duplicates, coordination of benefits, demographics, credentialing, and missing documentation. The platform supports any CPT code and works across specialties.
Does Roony replace my billing staff?
No. Roony is designed to augment your billing team, not replace it. It automates the most repetitive and time-consuming parts of denial follow-up so your staff can focus on higher-value tasks like complex appeals, patient communication, and process improvement. Many claims that go unworked due to staffing constraints can now be addressed automatically.
How is Roony different from other denial management tools?
Most denial management tools help you track and categorize denials. Roony actually resolves them. Instead of generating worklists for your staff to work through, Roony's AI works the denials itself. The platform also learns from every interaction, building a knowledge base of payer-specific behaviors, successful resolution strategies, and denial patterns that gets smarter over time.
Who is Roony built for?
Roony is built for medical practices, hospital billing departments, and revenue cycle management (RCM) companies that handle insurance claim follow-up. Whether you have a small billing team drowning in aging AR or a large RCM operation looking to scale without adding headcount, Roony helps you recover more revenue from denied and aged claims.
Security & Compliance
Is Roony HIPAA compliant?
Yes. Roony is fully HIPAA compliant with BAAs covering all infrastructure and service providers. All PHI is encrypted at rest and in transit, with comprehensive audit logging and role-based access controls. For full details, visit our Trust Center at https://trust.delve.co/roony.
How does Roony protect patient health information (PHI)?
All PHI is encrypted at rest and in transit. Database queries are scoped to individual organizations to prevent cross-tenant data access. We maintain comprehensive audit logs of all PHI access and support legal holds when required. Our logging system automatically redacts PHI to prevent accidental exposure. Visit our Trust Center for full details: https://trust.delve.co/roony.
What BAAs does Roony maintain?
Roony maintains Business Associate Agreements with all infrastructure and service providers that handle PHI. We also execute BAAs with customers before they upload any PHI to the platform. Visit our Trust Center for details: https://trust.delve.co/roony.
Technical
What EHR systems does Roony work with?
Roony is EHR-agnostic. You upload claims via CSV file export from any practice management system or EHR. Our intelligent column mapping automatically detects and maps your data fields, regardless of which system generated the export. This means Roony works with Epic, Cerner, athenahealth, eClinicalWorks, NextGen, Kareo, AdvancedMD, and any other system that can produce a CSV export.
How do I upload claims to Roony?
Export your claims or aging report as a CSV file from your practice management system. Upload the file to Roony, and our intelligent column mapper will analyze your headers and map them to the required fields. You can review and adjust the mapping, fill in any missing required fields, and submit. Claims are validated and strategies are generated automatically.
How does Roony's AI learn and improve?
After every resolution attempt, Roony extracts insights about payer behavior, successful resolution strategies, and denial patterns. These insights are stored in a knowledge base that is searchable and continuously growing. When generating a strategy for a new claim, the AI retrieves relevant past learnings to inform its approach. The result is a system that gets measurably smarter with every interaction.