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Revenue Cycle Management
Fix the process, not just the claims.
Denials are a symptom. The cause is almost always upstream — an eligibility check skipped at the front desk, a charge captured three days late, a payer contract nobody has read since 2019. We manage the whole cycle, end to end.
ownership
The Cycle
Nine stages. One owner.
Revenue leaks at the handoffs — front desk to biller, biller to coder, coder to A/R. When one team owns the whole cycle, those handoffs stop being where money disappears.
Patient access & scheduling
Demographics captured correctly the first time, insurance card imaged, and the appointment flagged if coverage or referral status is unresolved.
KPI · Registration accuracy 99%Eligibility & prior authorization
Coverage, copay, deductible, referral and authorisation confirmed before the visit — so the encounter is billable the moment it ends.
KPI · Verified before visit 100%Point-of-service collection
Patient responsibility calculated and collected at check-in. Money collected at the desk costs a fraction of money chased by statement.
KPI · POS collection rateCharge capture & coding
AAPC-certified coders apply current ICD-10, CPT and HCPCS with correct modifiers, and missing charges are caught against the schedule before they age out.
KPI · Charge lag <1 dayClaim scrubbing & submission
A payer-specific rules engine plus a human check before transmission. Errors are caught here, where they cost nothing, instead of in a denial letter.
KPI · Clean claim rate 98%Payment posting & reconciliation
ERA and EOB payments posted line by line, then reconciled against your contracted rates so underpayments surface instead of quietly closing the balance.
KPI · Underpayment recoveryDenial management & appeals
Worked the same week by reason code and dollar value, with the root cause traced back to whichever upstream stage allowed it through.
KPI · Denial rate <2%A/R follow-up & patient balances
Systematic payer follow-up by aging bucket, plus clear patient statements and a US-hours support line so your front desk stops fielding billing calls.
KPI · A/R >90 days under 12%Analytics & payer strategy
Monthly reporting on payer performance, denial trends and service-line profitability — and the contract conversations those numbers should trigger.
KPI · Net collection ratio 99%Transparency
You should never have to ask where the money is
The data stays in your system. You keep full access at all times. And every month you get a report that shows the numbers we are accountable for — including the ones that moved the wrong way.
A/R aging distribution · Illustrative sample
Engagement Models
Pay for outcomes, not headcount
No setup fees. No charge on money we do not collect. Month to month after a short initial term, with a clean data handover if you ever leave.
A/R Recovery
Start small · Prove it first
of recovered aged balances only
Full Revenue Cycle
End to end · Single owner
of monthly collections realised
Dedicated Team
High volume · Multi-location
fixed monthly, per assigned specialist
Rates depend on specialty, claim volume and payer mix — usually low single digits as a percentage of collections.
You get the exact number in writing after the free audit, before you commit to anything.
Case Snapshot
Six providers. Two quarters. One rebuilt cycle.
The practice was not losing claims — it was losing time. Charges sat for four days before entry, eligibility was checked only for new patients, and denials were worked whenever the office manager had a quiet afternoon. We did not replace their software or their staff. We rebuilt the sequence.
The report was the part that changed things. Once we could see which payer was denying what, the conversation stopped being about blame and started being about fixing one specific step.
Client figures, shared with permission · Identifying details withheld
RCM FAQ
What practice managers ask
Not sure which model fits?
Most practices start with the free audit and decide afterwards. The audit costs nothing and commits you to nothing.
Start With the AuditWhat is the difference between medical billing and RCM?
Do we have to give up control of our front desk?
Will you renegotiate our payer contracts?
How long before we see results?
What happens to our current billing staff?
Is our patient data safe?
Free Revenue Audit
Find out what your practice is leaving on the table
Send us a claim sample and your A/R aging report. Within 48 hours you get a written breakdown — no cost, no obligation, no sales pressure.