R1 RCM

v1.0.0

Last updated Apr 25, 2026

A comprehensive n8n community node for R1 RCM revenue cycle management providing 22 resources and 200+ operations for patient access, eligibility, claims, denials, payments, and intelligent automation. Includes Epic EHR integration.

15 Weekly Downloads

58 Monthly Downloads

View on NPM GitHub Repository

Included Nodes

R1 RCM

R1 RCM Trigger

Description

n8n-nodes-r1rcm

> [Velocity BPA Licensing Notice]
>
> This n8n node is licensed under the Business Source License 1.1 (BSL 1.1).
>
> Use of this node by for-profit organizations in production environments requires a commercial license from Velocity BPA.
>
> For licensing information, visit https://velobpa.com/licensing or contact licensing@velobpa.com.

A comprehensive n8n community node for R1 RCM revenue cycle management platform, providing 22 resources and 200+ operations for healthcare revenue cycle automation. Includes patient access, eligibility verification, prior authorization, claim lifecycle management, denial management, payment posting, Epic EHR integration, and intelligent automation.

!n8n
!TypeScript
!License
!Node.js

Features

Patient Access & Registration – Patient search, demographics, financial clearance, coverage discovery
Eligibility Verification (270/271) – Real-time and batch eligibility checking, benefits lookup
Prior Authorization (278) – Submit, track, and manage prior authorizations
Charge Capture & Coding – Charge creation, coding workflows, code validation, CCI edits
Claim Lifecycle (837P/I/D) – Create, submit, track, correct, and void claims
Claim Status (276/277) – Real-time claim status inquiries
Denial Management – Denial analysis, root cause, appeals, prevention recommendations
Payment Posting (835) – ERA processing, payment reconciliation, variance detection
A/R Management – Aging analysis, follow-up queues, collection workflows
Epic Integration – HL7/FHIR data synchronization with Epic EHR
Work Queue Management – Task assignment, SLA tracking, productivity metrics
Analytics & Reporting – KPIs, dashboards, trend analysis, scheduled reports
Intelligent Automation – AI/ML-powered automation rules and predictions
SFTP File Transfer – Secure EDI file upload/download with validation
Webhooks – Real-time event subscriptions for RCM events

Installation

Community Nodes (Recommended)

1. Open n8n
2. Go to Settings > Community Nodes
3. Click Install
4. Enter n8n-nodes-r1rcm
5. Click Install

Manual Installation

Navigate to your n8n installation directory
cd ~/.n8n
Install the package
npm install n8n-nodes-r1rcm

Development Installation

1. Extract the zip file
unzip n8n-nodes-r1rcm.zip
cd n8n-nodes-r1rcm
2. Install dependencies
npm install
3. Build the project
npm run build
4. Create symlink to n8n custom nodes directory
For Linux/macOS:
mkdir -p ~/.n8n/custom
ln -s $(pwd) ~/.n8n/custom/n8n-nodes-r1rcm
For Windows (run as Administrator):
mklink /D %USERPROFILE%.n8ncustomn8n-nodes-r1rcm %CD%
5. Restart n8n
n8n start

Credentials Setup

R1 RCM API Credentials

R1 RCM Integration Credentials (Epic)

R1 RCM SFTP Credentials

Resources & Operations

Patient Access (11 operations)

Get Patient Info, Search Patients, Create/Update Patient
Get Demographics, Verify Identity
Get Insurance Coverage, Financial Clearance
Patient Responsibility Estimate, Coverage Discovery
Propensity to Pay

Registration (8 operations)

Create/Get/Update Registration
Get Status, Complete, Cancel
Pre-Registration Info, Registration Queue

Eligibility (9 operations)

Check Eligibility (270/271), Real-Time Eligibility
Batch Check, Benefits Summary
Coverage Details, Deductible Info, Copay Info
Prior Auth Requirements, Eligibility History

Prior Authorization (9 operations)

Submit/Get/Update/Cancel Prior Auth
Auth Reference, Requirements
Track Request, Auth Queue, Auth History

Charge Capture (10 operations)

Create/Get/Update/Delete Charge
Charges by Encounter/Patient
Unbilled Charges, Charge Lag
Review Charge, Coding Queue

Coding (10 operations)

Get Encounter for Coding, Submit Codes
Coding Status, Query Codes
Code Suggestions, Validate Codes
CCI Edits, LCD/NCD
Coding Queue, Productivity

Claim (12 operations)

Create/Get/Submit Claim (837P/I/D)
Get Status (276/277), Update/Void
Resubmit, Correct
Claim History, Lifecycle
Claims by Patient, Claim Errors

Denial (11 operations)

Get Denial/Denials, Analyze
Denial Reason, Root Cause
Create/Get/Track Appeal
Denial Trends, Prevention Recommendations
Denial Queue

Payment (11 operations)

Get/Post/Apply Payment
Get ERA (835)
Payment by Check/Payer
Unapplied Payments
Reconcile, Payment Variance
Contract Variance, Underpayments

A/R Management (10 operations)

A/R Aging, A/R by Payer/Facility
High Balance Accounts
Follow-Up/Collection/Bad Debt Queue
Assign Work, Work Status
Update A/R Status

Work Queue (9 operations)

Get Work Queues, Queue Items
Assign/Complete/Transfer Work Item
Queue Metrics, Queue by Type
User Work, Queue SLA

Analytics (13 operations)

Revenue/KPI Dashboard
A/R Metrics, Days in A/R
Collection Rate, Clean Claim Rate
Denial Rate, Net Collection Rate
Revenue Trends
Payer/Provider/Facility Performance
Export Analytics

Reporting (11 operations)

Generate/Get/List Reports
Schedule Report
A/R/Production/Denial/Payment Report
Executive Summary
Custom Report, Export Report

Epic Integration (8 operations)

Get Epic Patient/Encounter/Charges
Sync Patient Data (bidirectional)
Send to Epic (FHIR)
Get Epic Status
Reconcile Data, Epic Queue

Contract (8 operations)

Get Contract/Contracts
Fee Schedule, Expected Payment
Compare to Contract
Contract Variance, Underpayment Analysis
Contract Terms

Provider (7 operations)

Get/Search Providers
Provider Credentials, Performance, Productivity
Validate NPI, Enrolled Providers

Facility (5 operations)

Get Facility/Facilities
Facility Performance, Metrics, A/R

Payer (7 operations)

Get Payer/Payers
Payer Rules, Performance, Trends
Payer Contacts, Check Status

Automation (7 operations)

Get/Create/Update Automation Rules
Automation Status, Bot Performance
Automation Queue, Intelligent Automation

SFTP (5 operations)

Upload/Download File
List Files, Get Status, Delete File

Webhook (7 operations)

Create/Get/Update/Delete Webhook
List Webhooks, Test Webhook
Get Webhook Events

Utility (7 operations)

Validate NPI, Validate Tax ID
Code Lookup, CARC/RARC Codes
Place of Service Codes
Test Connection, API Status

Trigger Node

The R1 RCM Trigger node enables real-time event-driven workflows:

Event Categories

Patient Events – Registered, Updated, Merged, Coverage Verified, Financial Clearance
Registration Events – Created, Completed, Pre-Registration Done
Eligibility Events – Verified, Failed, Benefits Updated
Authorization Events – Submitted, Approved, Denied, Pending, Expiring, Expired
Charge Events – Created, Updated, Review Required, Lag Alert
Coding Events – Complete, Review Required, Validation Error, DRG Assigned
Claim Events – Created, Submitted, Accepted, Rejected, Paid, Denied, Status Changed
Denial Events – Received, Appeal Due, Appeal Submitted, Appeal Decision, Overturned
Payment Events – Received, Posted, Underpayment, Variance, ERA Received
Work Queue Events – Assigned, Due, SLA Warning, SLA Breach, Threshold
Analytics Events – KPI Alert, Threshold Exceeded, Trend Alert, Report Ready
Epic Events – Sync Complete, Sync Error, Message Received

Usage Examples

Patient Registration Workflow

{
  "nodes": [
    {
      "name": "Create Patient",
      "type": "n8n-nodes-r1rcm.r1Rcm",
      "parameters": {
        "resource": "patientAccess",
        "operation": "createPatient",
        "firstName": "John",
        "lastName": "Doe",
        "dateOfBirth": "1980-01-15",
        "gender": "male",
        "ssn": "123-45-6789"
      }
    }
  ]
}

Eligibility Verification

{
  "nodes": [
    {
      "name": "Check Eligibility",
      "type": "n8n-nodes-r1rcm.r1Rcm",
      "parameters": {
        "resource": "eligibility",
        "operation": "checkEligibility",
        "patientId": "{{ $json.patientId }}",
        "payerId": "BCBS",
        "serviceType": "professional",
        "dateOfService": "2024-01-15"
      }
    }
  ]
}

Prior Authorization Submission

{
  "nodes": [
    {
      "name": "Submit Prior Auth",
      "type": "n8n-nodes-r1rcm.r1Rcm",
      "parameters": {
        "resource": "priorAuth",
        "operation": "submitPriorAuth",
        "patientId": "{{ $json.patientId }}",
        "payerId": "AETNA",
        "serviceType": "MRI",
        "diagnosisCodes": "M54.5",
        "procedureCodes": "72148",
        "requestedUnits": 1,
        "urgency": "routine"
      }
    }
  ]
}

Claim Submission (837P)

{
  "nodes": [
    {
      "name": "Submit Claim",
      "type": "n8n-nodes-r1rcm.r1Rcm",
      "parameters": {
        "resource": "claim",
        "operation": "submitClaim",
        "claimType": "837P",
        "patientId": "{{ $json.patientId }}",
        "encounterId": "{{ $json.encounterId }}",
        "diagnosisCodes": "J06.9",
        "procedureCodes": "99213",
        "chargeAmount": 150.00
      }
    }
  ]
}

Denial Management

{
  "nodes": [
    {
      "name": "Analyze Denial",
      "type": "n8n-nodes-r1rcm.r1Rcm",
      "parameters": {
        "resource": "denial",
        "operation": "analyzeDenial",
        "denialId": "{{ $json.denialId }}",
        "includeRootCause": true,
        "includeAppealRecommendation": true
      }
    }
  ]
}

Payment Posting (835)

{
  "nodes": [
    {
      "name": "Process ERA",
      "type": "n8n-nodes-r1rcm.r1Rcm",
      "parameters": {
        "resource": "payment",
        "operation": "getEra",
        "eraId": "{{ $json.eraId }}",
        "autoReconcile": true,
        "flagVariances": true
      }
    }
  ]
}

Epic Integration

{
  "nodes": [
    {
      "name": "Sync Patient from Epic",
      "type": "n8n-nodes-r1rcm.r1Rcm",
      "parameters": {
        "resource": "epicIntegration",
        "operation": "syncPatientData",
        "epicPatientId": "E12345",
        "syncDirection": "epictor1rcm",
        "dataTypes": ["demographics", "insurance", "encounters"]
      }
    }
  ]
}

Healthcare RCM Concepts

EDI Transaction Types

| Transaction | Purpose |
|————-|———|
| 270 | Eligibility Inquiry |
| 271 | Eligibility Response |
| 276 | Claim Status Inquiry |
| 277 | Claim Status Response |
| 278 | Prior Authorization |
| 835 | Electronic Remittance Advice (ERA) |
| 837P | Professional Claims |
| 837I | Institutional Claims |
| 837D | Dental Claims |

CARC/RARC Codes

CARC – Claim Adjustment Reason Codes explain why a payment differs from the billed amount
RARC – Remittance Advice Remark Codes provide additional explanation

Key Metrics

Work Queue Types

Eligibility Verification
Prior Authorization
Charge Review
Coding Review
Claim Edits
Denial Follow-up
Payment Posting
A/R Follow-up
Patient Collections
Bad Debt

Error Handling

The node provides comprehensive error handling with healthcare-specific context:

try {
  // Operation execution
} catch (error) {
  // Error includes:
  // - errorCode: Healthcare-specific code
  // - errorMessage: Human-readable description
  // - resource: Resource being accessed
  // - operation: Operation attempted
  // - suggestions: Recommended resolution steps
}

Security Best Practices

1. HIPAA Compliance – All PHI is handled securely; sensitive data is not logged
2. Credential Security – Use n8n’s credential management; never hardcode secrets
3. TLS/mTLS – All API communications use TLS; Epic integration supports mTLS
4. Audit Trail – All operations include request IDs for traceability
5. Data Minimization – Request only necessary data fields
6. Access Control – Use least-privilege API credentials

Development

Install dependencies
npm install
Build
npm run build
Run tests
npm test
Run tests with coverage
npm run test:coverage
Lint
npm run lint
Fix linting issues
npm run lint:fix
Watch mode for development
npm run dev

Author

Velocity BPA

Website: velobpa.com
GitHub: Velocity-BPA

Licensing

This n8n community node is licensed under the Business Source License 1.1.

Free Use

Permitted for personal, educational, research, and internal business use.

Commercial Use

Use of this node within any SaaS, PaaS, hosted platform, managed service,
or paid automation offering requires a commercial license.

For licensing inquiries:
licensing@velobpa.com

See LICENSE, FAQ.md”>LICENSINGFAQ.md for details.

Contributing

1. Fork the repository
2. Create a feature branch (git checkout -b feature/new-operation)
3. Commit your changes (git commit -am 'Add new operation')
4. Push to the branch (git push origin feature/new-operation)
5. Create a Pull Request

All contributions must comply with BSL 1.1 licensing.

Support

Documentation: velobpa.com/docs/n8n-nodes-r1rcm

Issues: GitHub Issues

Email: support@velobpa.com

Acknowledgments

n8n – Workflow automation platform

R1 RCM – Revenue cycle management platform

Healthcare industry standards: HL7, FHIR, X12 EDI