Revenue cycle management & billing
From payer and clearinghouse setup to claims, denials, payment posting and accounts receivable follow-up, we run the parts of your revenue cycle you hand to us and report on them every month.
Services within billing & rcm.
- 01
Full revenue cycle management
Day-to-day billing operations in your own billing system: claims, rejections, denials, posting and follow-up, with a monthly report.
- 02
Claims preparation and submission
Claims built from your completed charges, checked against payer edits and sent through your clearinghouse, with acceptance tracked separately from payment.
- 03
Denial management and appeals
Each denial sorted by cause and worked to the right fix: corrected claim, reconsideration or appeal, inside the payer's deadlines.
- 04
Payment posting and reconciliation
Remittances posted to the right claims, with deposits reconciled and underpayments and credit balances flagged.
- 05
Accounts receivable follow-up and cleanup
Working aging balances by payer and age, or a one-time cleanup of old accounts with an agreed inventory and cut-off date.
- 06
Eligibility and authorization tracking
Coverage checks and prior authorization tracking before visits, so fewer claims are denied after the fact.
- 07
Coding review
Coding and modifier review by appropriately qualified reviewers, with questions sent back to your clinicians rather than guessed.
- 08
Billing setup and payer onboarding
Getting the billing side ready: payer and clearinghouse enrollment, electronic remittance and funds transfer, and the ready-to-bill check for each new provider.
- 09
Billing audits and reporting
A review of how your revenue cycle performs, with defined metrics such as denial rate, days in AR and net collection rate.
Your billing system stays your system of record. Work involving patient health information starts only after a business associate agreement is signed. Your clinicians own clinical documentation and coding decisions, and payers make every payment decision.
Other services.
- 01
Credentialing & payer enrollment
Individual providers, group practices and facilities joining commercial plans, Medicare or Medicaid.
- 02
Licensing
New and growing agencies, facilities and programs: behavioral health, home care, outpatient and other licensed healthcare businesses.
- 03
Accreditation
Organizations preparing for CARF, The Joint Commission or another accrediting body.
- 04
Healthcare consulting
Founders, administrators and leadership teams who need an experienced partner for a defined project.
- 06
Staffing & workforce readiness
Agencies, facilities and practices hiring clinical or support staff, or preparing staff files for a survey or audit.
- 07
Ongoing managed services
Organizations that want renewals, revalidations and recurring reviews handled on a schedule.
Tell us what you're working on.
Share a few details and we'll follow up to talk through scope, timing and next steps. There's no obligation.