Everything your revenue cycle needs, in one team.
From the first claim to the last dollar collected — billing, coding, credentialing, and everything that keeps a practice's cash flow healthy.
Our Services
End-to-end medical billing & practice support
Specialized revenue cycle solutions designed to accelerate reimbursements and minimize claim denials.
Medical Billing
Comprehensive medical billing services that shorten payment lifecycles, eliminate front-end claim errors, and maintain steady, predictable cash flow.
- High-Rate Clean Claims: Multi-tier clearinghouse scrubbing targeting a 98%+ clean claim rate.
- Rapid Electronic Transmission: Direct EDI 837 claim submission to commercial payers, Medicare, and Medicaid within 24–48 hours.
- Secondary & Patient Statements: Automated secondary crossover filing and balance reconciliation.
Prior Authorization
Dedicated prior authorization specialists managing clinical documentation and payer approvals to prevent care delays and retro-denials.
- Pre-Certification Processing: Rapid submission for high-cost diagnostics, surgeries, and specialty drugs.
- Clinical Coordination: Gathering chart notes, letters of medical necessity, and peer-to-peer scheduling.
- Authorization Tracking: Monitoring validity dates, approved unit thresholds, and re-authorizations.
Payment Posting
Daily electronic and manual payment posting with exact balance reconciliation to keep accounts receivable 100% transparent.
- Automated ERA/EFT Posting: Direct 835 Electronic Remittance Advice posting into your PM software.
- Write-Off Verification: Accurate logging of contractual allowances, co-pays, and deductible allocations.
- Zero-Balance Reconciliation: Daily matching of posted payments against bank deposits to eliminate revenue gaps.
Provider Credentialing & Enrollment
End-to-end provider enrollment and re-credentialing to ensure seamless network participation and uninterrupted reimbursement.
- CAQH & NPI Management: Complete profile setup, quarterly attestations, and NPPES registry maintenance.
- Payer Enrollment: Direct credentialing with Medicare (PECOS), state Medicaid, and commercial panels.
- Re-Credentialing Tracking: Proactive tracking of license expirations, malpractice renewals, and re-attestations.
Medical Coding
Certified AAPC & AHIMA coders providing compliant, accurate ICD-10-CM, CPT, and HCPCS Level II code assignments.
- Precise Code Assignment: E/M leveling and operative report coding with correct modifier usage (25, 59, 78, 51).
- Audit-Proof Compliance: Real-time validation against NCCI edits and LCD/NCD medical necessity rules.
- Regular Chart Audits: Specialty-specific audits to eliminate under-coding leakage and audit exposure.
Charge Entry
Rapid entry of patient charges and fee schedule validation to capture every billable service without administrative delay.
- 24-Hour Turnaround: Rapid entry from EHR super-bills, digital encounter forms, and rounding sheets.
- Demographic Scrubbing: Validating rendering provider NPI, taxonomy, place of service (POS), and pointers.
- Fee Schedule Auditing: Cross-referencing contracted payer fee schedules to ensure no underbilled fee caps.
Denial Management
Root-cause denial analysis, rapid claim correction, and assertive multi-level clinical appeals to recover lost revenue.
- CARC & RARC Root-Cause Analysis: Categorizing denial reason codes to fix recurring administrative issues.
- Multi-Level Clinical Appeals: Comprehensive appeal packages backed by chart notes and payer policy citations.
- Denial Prevention Loop: Continuous operational feedback to intake and coding staff to eliminate repeat denials.
Revenue Cycle Management (RCM)
Full-spectrum revenue cycle management uniting front-desk intake, certified coding, billing, and analytics into one seamless pipeline.
- End-to-End Coordination: Synchronizing patient intake, charge entry, coding, claim filing, and collections.
- Lower Days in A/R: Streamlined workflows reducing Days in A/R (DAR) to industry benchmarks (< 32 days).
- Seamless EHR Integration: Full interoperability across AthenaHealth, eCW, Epic, Kareo, NextGen, and more.
Insurance Verification
Proactive verification of patient coverage and benefits before appointments to prevent front-end rejections and surprise patient balances.
- Real-Time 270/271 Checks: Instant verification of active coverage, copays, coinsurance, and deductibles.
- Network Scoping: Clear breakdown of in-network vs. out-of-network benefits and out-of-pocket maximums.
- Coordination of Benefits (COB): Resolving primary vs. secondary payer order disputes before service delivery.
Claims Submission
Automated electronic claim scrubbing and transmission ensuring rapid adjudication and maximum first-pass acceptance.
- Custom Clearinghouse Rules: Pre-submission rule engines catching missing modifiers and policy ID errors.
- Instant Rejection Resolution: Real-time 999 and 277 electronic acknowledgment tracking to fix errors within hours.
- Paper Claim Filing: CMS-1500 and UB-04 filing for specialized worker’s compensation and auto payers.
Accounts Receivable (A/R) Follow-Up
Disciplined, proactive aging A/R follow-up ensuring no unpaid claim quietly slips past timely filing limits.
- Aging Bucket Prioritization: Daily follow-up on 30, 60, 90, and 120+ day unpaid claims by payer specialists.
- Payer Escalation: Direct insurer portal inquiries, phone follow-ups, and supervisor-level escalations.
- Old A/R Project Clean-Up: Revitalizing aged accounts receivable from previous backlogs to recover cash.
Reporting & Performance Analytics
Executive-level financial dashboards and KPI reporting delivering total visibility into practice revenue and payer behavior.
- Key KPI Dashboards: Monthly breakdown of Net Collection Rate, Clean Claim Rate, and Days in A/R.
- Payer Reimbursement Auditing: Comparing actual payer reimbursement rates against contracted fee schedules.
- Provider Productivity: Detailed RVU tracking and physician-specific financial performance insights.
How It Works
A simple handoff, then we take it from there
1. Onboarding & system setup
We connect to your EHR/PM system and review your current billing workflow for gaps.
2. Daily claim processing
Charges are coded, scrubbed, and submitted within 24–48 hours of the visit.
3. Follow-up & denial resolution
Our team chases unpaid and denied claims so nothing quietly falls off the aging report.
4. Monthly reporting
You get a clear breakdown of what was billed, collected, and outstanding — every month.
Ready to see what's slowing your reimbursements?
We'll review your current billing setup and show you exactly where revenue is being lost.