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Revenue Cycle Management

Get paid for every visit — and know where every dollar of AR stands.

Medical billing, credentialing and collections for medical, dental and behavioral health practices with 1–25 providers. Claims out within 48 hours. Denials appealed within 5 business days. HIPAA-compliant, BAA signed before we see a single record.

Get my free 90-day AR & denial audit See billing pricing →

HIPAA-compliant · BAA signed before any PHI is exchanged · Works inside the EHR and clearinghouse you already run · Certified Medical Biller on every account

Insurance claims software on a monitor at a medical practice front desk

A complete revenue cycle, engineered end to end

Provider credentialing and payer enrollment

We file the panel applications, chase the payers, and handle revalidations, so a new provider can bill from their first day instead of their fourth month.

Eligibility and authorization checked before the visit

Coverage, deductible status and authorization requirements confirmed ahead of the appointment — the cheapest denial is the one that never happens.

Coding reviewed against the documentation

We check the codes and modifiers against what was actually documented, so you are not down-coding out of caution or exposed on an audit.

Claims out daily, denials appealed on the clock

Scrubbed claims go out every business day, rejections are corrected same-day, and every denial is appealed inside the payer window — never written off silently.

Compliance & security matrix

Enterprise-Grade Security & Medical Billing Compliance

Your revenue cycle shouldn't come with compliance risks. We protect your practice's cash flow and data integrity with equal precision.

  • 100% HIPAA & HITECH Compliant

    Every member of our team undergoes rigorous annual HIPAA certification. All Patient Health Information (PHI) is handled strictly within encrypted, compliant channels.

  • 98%+ Clean Claim Rate Target

    Our internal auditing workflow scrubs every claim for coding accuracy and modifier errors before submission, drastically minimizing clearinghouse rejections and denials.

  • Secure Cloud Architecture

    We integrate directly with your existing EHR/PM systems via secure, encrypted VPNs or multi-factor authenticated portals. We do not store unprotected patient records on local devices.

  • Transparent Audit Trails

    Gain full visibility into your billing cycle with comprehensive reporting, tracking every claim from submission to final patient responsibility collection.

The money isn't missing. It's stuck.

In most practices we review, the problem isn't volume — it's what happens to a claim after it's submitted, and who follows up when it doesn't pay.

Denials nobody works

A denied claim that isn't appealed inside the payer window is simply revenue you gave away. Most practices never see the aggregate.

Coding that undersells the visit

Chronic down-coding out of caution costs more over a year than the occasional audit risk it's meant to avoid.

Patient AR that quietly ages

Higher deductibles moved a large share of collections to patients. Statements sent late collect far less.

Eligibility checked too late

Coverage verified after the visit turns preventable rejections into write-offs.

Everything from the encounter to the deposit

Charge capture & coding review

Every code is checked against the note before the claim leaves. Under-coding and modifier errors get fixed at the source, not after the denial.

Eligibility & benefits verification

Coverage, deductible status and prior authorization confirmed before the patient is seen.

Clean claim submission

Claims go out every business day through your clearinghouse. Rejections are corrected the same day they come back.

Denial management & appeals

Every denial is categorized, appealed inside the payer window, and the cause is fixed upstream so it stops repeating.

Payment posting & reconciliation

ERAs and EOBs posted and reconciled against your contracted rate, so underpayments surface instead of quietly becoming normal.

Patient AR & statements

Statements go out on schedule and patient calls are answered in the tone you would use yourself. Late statements collect far less.

Credentialing & payer enrollment

Panel applications, revalidations and roster maintenance so a new provider bills from day one.

Monthly collections reporting

One weekly AR report and a monthly summary: collections, days in AR, denial rate by payer and reason, net collection rate — in plain language.

Specialties & practice types served

Transitioning billing without dropping a single claim

  1. 01

    Revenue review

    We analyze recent claims, denials, and AR aging and show you where the leakage is — before you sign anything.

  2. 02

    Scope & agreement

    A written rate, defined scope, and a signed Business Associate Agreement.

  3. 03

    System & payer access

    Read/write access in your existing EHR, clearinghouse connections, and payer portal credentials.

  4. 04

    Parallel run

    We take over new claims while working your legacy AR, so nothing drops during the handoff.

  5. 05

    Steady state

    Daily submission, active denial work, and monthly reporting with a standing review call.

Free audit

Free 90-day AR & denial audit

We review your last 90 days of AR and denials and return a written findings list: denial patterns by payer and reason, days in AR against specialty norms, and the specific fixes we would make first. No cost, no obligation, and the findings are yours either way.

Two steps, in this order: we sign the BAA first, then you send the reports. Nothing containing PHI is exchanged before the agreement is executed.

Written findings delivered within five business days, reviewed by a senior RCM specialist — not an automated tool. We sign the BAA before you send anything.

Encrypted in transit and at rest. We sign a BAA before any PHI is shared. No spam, ever. What you send is used only to respond to your request and is stored in our access-controlled systems — never sold or shared with advertisers. See our privacy notice.

What it costs

Outsourced Medical Billing & Collections

  • 5% of collections — single specialty, one location, 1–5 providers, EHR with integrated clearinghouse
  • 6% of collections — multi-provider or multi-location, or legacy AR clean-up in first 90 days
  • 7% of collections — behavioral health / SUD programs with utilization review and authorization tracking

Floor: $950/month. The floor is not an extra fee — you pay the percentage or $950, whichever is higher.

Included at every tier: eligibility checks, coding review, daily claim submission, denial appeals, patient statements, weekly AR report.

Free 90-day AR & denial audit before you sign — delivered in writing within 5 business days.

Catch-up & cleanup

$375 per month of books behind

$1,500 minimum engagement · flat quote confirmed in writing before work starts

  • Every month rebuilt and reconciled to the bank, card and loan statements
  • Chart of accounts cleaned up and mapped for tax
  • Prior-year comparatives restated so the returns tie out
  • A written summary of what was wrong and what changed

Built for

  • Behavioral health and substance use programs
  • Primary care, therapy, and specialty groups
  • Multi-site and multi-provider practices
  • New practices building a revenue cycle from zero

<5%

Target denial rate

96%+

Clean-claim submission rate

<35 days

Target days in AR

How engagements work — Percentage of collections or flat per-claim pricing, depending on volume and specialty. Free 90-day AR and denial audit before you commit.

The problems we solve

Denials pile up and never get worked.

Every denial is worked within 48 hours, categorized by root cause, and fed back into front-end edits so it stops repeating.

You don't know what's actually collectible.

Weekly AR aging by payer and bucket, with a written plan for anything past 60 days.

Claims go out with documentation gaps.

Pre-submission scrubbing against payer rules, plus coding and documentation reviews with your clinical team.

Underpayments go unnoticed.

Contracted fee schedules loaded and every remit compared against expected reimbursement.

Full scope of work

Front end

  • Eligibility and benefits verification
  • Prior authorization tracking and renewals
  • Charge entry and CPT/ICD-10 code review
  • Clean-claim scrubbing before submission

Back end

  • Electronic claims submission and clearinghouse management
  • ERA/EOB posting and reconciliation to the ledger
  • Denial resolution, corrected claims, and appeals
  • Patient statements, payment plans, and collections handoff

Oversight

  • Weekly AR aging and collection rate reporting
  • Payer mix, reimbursement, and underpayment analysis
  • Utilization review support for behavioral health
  • HIPAA-aligned workflows and documentation audits

Where the money comes back

Every engagement is scoped against a return: cost removed, margin recovered, cash pulled forward, or exposure closed.

Clean-claim rate lift

Front-loading eligibility checks and coded charge review cuts payer rejections before submission. On $3M in annual charges, moving clean-claim rate from 85% to 96% is roughly $60,000 in avoided rework and delayed reimbursement.

Denial leakage recovery

Most practices write off 3-5% of charges to denials that were never appealed. On $3M in annual charges, recovering three points of denial leakage is $90,000 that would otherwise disappear into an adjustment code.

Faster days in AR

Working AR by aging bucket instead of by memory shortens the average collection cycle. Pulling days in AR from 55 to 40 on $3M in charges frees roughly $164,000 in cash tied up in unpaid claims.

Underpayment and contract drift

Payer fee schedules change without notice and underpayments blend into normal variance. A quarterly contract comparison against posted allowables catches systematic underpayment before it compounds across a full fee schedule cycle.

What actually lands in your inbox

  • Clean-claim submission batch

    Daily

    Charges entered, coded, and eligibility-checked claims submitted through the clearinghouse within 48 hours of the encounter closing.

  • Denial worklist and appeals filed

    Weekly

    Every denial triaged by reason code, corrected or appealed within five business days, with a running log of outcomes by payer.

  • AR aging report by bucket

    Weekly

    Claims sorted into 0-30, 31-60, 61-90, and 90+ day buckets with the dollar amount and next action attached to each.

  • Patient statement run

    Monthly

    Statements generated for patient-responsibility balances after insurance posts, with a defined dunning cadence for unpaid balances past 60 days.

  • Payer contract and fee-schedule review

    Quarterly

    Posted allowables checked against contracted rates for your top five payers, flagging any systematic underpayment for renegotiation or appeal.

  • Documentation and compliance audit

    Quarterly

    Sample chart-to-claim review confirming code selection matches documentation, reducing audit exposure and downstream takeback risk.

What working with us feels like

Named billing specialist, not a queue

One person owns your account, knows your payer mix, and answers directly. No ticket routing through a shared inbox or a different rep every time you call.

48-hour claim submission window

Charges entered and eligibility-verified claims go out within two business days of visit close, not batched at month end when timely-filing deadlines are already tight.

Weekly denial and AR touchpoint

A standing 30-minute call or async summary each week covers denials worked, appeals filed, and AR movement, so nothing sits unaddressed for a full billing cycle.

Low-lift onboarding

We pull historical claims data and payer contracts directly from your existing PM system and clearinghouse; your staff spends under two hours on the transition, not weeks.

Benchmarked against the usual option

  • Claim submission timingBatched weekly or at month close, risking timely-filing missesSubmitted within 48 hours of visit close, daily
  • Denial handlingWritten off after one rejection or left unworkedTriaged and appealed within five business days, every time
  • AR visibilityAggregate AR total reported monthly, no bucket detailWeekly aging by bucket with a named next action
  • Account ownershipRotating reps or offshore claims mill with no single contactOne named specialist who knows your payer mix
  • Contract oversightFee schedules assumed accurate, rarely checkedQuarterly allowable-versus-contract review on top payers

Your first 90 days

  1. Week 1

    Data pull and clearinghouse setup

    Historical claims, payer contracts, and PM system access transferred; clearinghouse connections tested with a sample batch before live submission begins.

  2. Day 30

    Baseline denial rate established

    First full cycle of claims run through the new workflow; denial reasons categorized to identify the top three recurring rejection codes in your payer mix.

  3. Day 60

    Aged AR backlog worked down

    Pre-existing 90+ day claims triaged and either collected, appealed, or written off with documentation, clearing the backlog inherited from the prior process.

  4. Day 90

    Clean-claim rate and days-in-AR review

    First quarterly performance review comparing clean-claim rate and days in AR against the Day 1 baseline, with adjustments to charge-entry or coding workflow.

Platforms included

Configuration, integration, and day-to-day administration are part of the fee — you are not billed to keep your own systems running.

The cost of leaving it alone

  • Denials written off instead of appealed

    Unworked denials become permanent revenue loss; on $3M in charges, a 3% unappealed denial rate is $90,000 gone every year.

  • Timely-filing deadlines missed

    Late submission past a payer's filing window forfeits the claim entirely, regardless of medical necessity or documentation quality.

  • Fee-schedule underpayment goes unnoticed

    Without a periodic allowable check, systematic underpayment on a common CPT code compounds silently across every claim for that service.

How we run it

  1. 01

    Audit

    We review 90 days of claims, denials, and AR to quantify what is being left on the table.

  2. 02

    Stabilize

    Aged AR is worked and front-end edits are installed to stop new denials.

  3. 03

    Operate

    Daily claims, daily posting, weekly AR review with your practice manager.

  4. 04

    Optimize

    Contract, fee schedule, and payer-mix analysis to raise reimbursement per visit.

Why clients choose us over the firm down the street

Billing and books together

Most billing companies stop at the remit. We post it straight into your financials — one source of truth.

Behavioral health depth

Kipu, TheraNest, Avea, ICANotes, BestNotes — we know the systems and the payer behavior.

Credentialing under the same roof

Enrollment delays are a billing problem; we fix both instead of pointing at each other.

Root-cause denial loop

We report why denials happened and change the intake process, not just resubmit.

Talk through your situation

Medical billing questions

Find out what your billing is leaving behind.

Thirty minutes with an RCM specialist who will look at your actual denial and AR data and tell you what's fixable.

Get my free 90-day AR & denial audit
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