End-to-End Revenue Cycle Management

Our certified billing specialists manage the entire claims lifecycle — from charge entry and claim scrubbing to submission, tracking, and payment posting. We know the payer rules, the specialty-specific nuances, and the follow-up cadence that gets claims paid the first time.

What's included

• Charge capture review and entry
• Electronic claim submission (EDI)
• Real-time claim status tracking
• ERA/EOB posting and reconciliation
• Patient statement generation
• Payer contract analysis

Our CPC- and CCS-certified coders translate every clinical encounter into the most accurate, highest-specificity ICD-10, CPT, and HCPCS codes. We don't just code — we optimize, ensuring you capture every dollar you've earned while staying fully compliant with payer and regulatory requirements.

What's included

• ICD-10-CM/PCS, CPT, HCPCS Level II coding
• Specialty-specific coding expertise
• Hierarchical Condition Category (HCC) coding
• Modifier application and review
• Coding audits and education
• Query management for clinical documentation

Aging accounts receivable is money you've already earned sitting idle. Our AR specialists work every bucket — from 30-day follow-ups to 120+ day recoveries — with persistent, payer-specific strategies that dramatically reduce your days in AR and bring cash in faster.

What's included

• Systematic payer follow-up by aging bucket
• Insurance verification and eligibility checks
• Secondary and tertiary billing
• Credit balance resolution
• Write-off analysis and approval workflows
• Monthly AR aging reports and dashboards

Denials are not just lost revenue — they're a signal that something in your revenue cycle needs fixing. We appeal every recoverable denial, track overturn rates by payer and denial reason, and implement root-cause corrections so the same denials don't recur month after month.

What's included

• Denial categorization and root-cause analysis
• Timely appeal filing with supporting documentation
• Peer-to-peer review coordination
• Payer-specific appeal strategies
• Denial trend reporting and prevention
• Prior authorization management

Beyond day-to-day billing, we offer strategic revenue cycle consulting to identify systemic gaps, benchmark your performance against industry standards, and build a roadmap for sustainable revenue growth. Whether you're onboarding a new EHR, expanding services, or preparing for a payer audit — we've got you covered.

What's included

• Revenue cycle assessment and benchmarking
• EHR/PM system optimization
• Fee schedule analysis and optimization
• Payer contract negotiation support
• Compliance program development
• Staff training and workflow redesign

We bring enterprise-grade robotic process automation and artificial intelligence to your revenue cycle. Using Power Automate and UiPath, we eliminate the manual, repetitive tasks that slow down billing teams — eligibility verification, claim status checks, prior auth follow-up, payment posting, and more — so your staff focuses on work that actually requires human judgment.

What's included

• Automated eligibility & benefits verification
• Claim status follow-up bots (UiPath)
• Prior authorization workflow automation
• Payment posting & ERA reconciliation automation
• Power Automate integration with EHR/PM systems
• AI-assisted denial pattern detection