Frequently Asked Questions

Revenue Cycle Management (RCM) is the financial process...

• Maximizes revenue by reducing claim denials
• Improves cash flow with faster reimbursements
• Reduces administrative burdens
• Ensures compliance with changing regulations

Our RCM services typically help practices:

• Increase collections by 15–25%
• Reduce claim denial rates to under 5%
• Shorten average days in A/R to under 30 days
• Identify under-coded or missed billing opportunities

Our RCM team stands out because we:

• Provide dedicated account managers for each client
• Use AI-based claim scrubbing for accuracy
• Offer transparent monthly performance reports
• Have specialists in multiple healthcare specialties

Yes, we integrate with most major EMR/EHR systems such as:

• eClinicalWorks
• Athenahealth
• Kareo
• AdvancedMD
• DrChrono

Our onboarding process is smooth and includes:

• Initial discovery and needs assessment
• System setup and EMR/EHR integration
• Staff training and handover sessions
• Go-live with real-time support

We offer flexible pricing models including:

• Percentage of monthly collections (most common)
• Flat-rate billing for small practices
• Customized packages for large groups

Yes, we have extensive experience managing out-of-network billing:

• Verify benefits and inform patients of coverage
• Maximize reimbursement through correct coding
• Negotiate directly with insurance companies
• Appeal underpaid or denied claims efficiently

Yes, our credentialing team ensures timely and accurate enrollment with payers:

• Provider enrollment and recredentialing
• CAQH profile setup and maintenance
• NPI registration and updates
• Tracking application status and follow-ups

We offer complete end-to-end medical billing support including:

• Charge entry and coding review
• Claim submission and follow-up
• Denial management and appeals
• Payment posting and reconciliation

Yes, our AR team actively follows up on aging claims:

• Timely follow-up with payers on unpaid claims
• Identification of root cause of denials
• Resubmissions with corrections as needed
• Monthly AR aging reports and insights

Absolutely, we assist with prior authorizations to avoid delays in care:

• Verification of procedure codes and payer guidelines
• Submission of authorization requests
• Regular follow-up with insurance providers
• Real-time updates to your staff on status

Yes, we provide compassionate and clear patient billing services:

• Patient statements and balance collection
• Support via phone/email for billing inquiries
• Setting up payment plans if needed
• Ensuring HIPAA-compliant communication

We strictly follow federal and state compliance standards to protect your practice:

• HIPAA-compliant data handling
• Regular audits and process checks
• Staying up-to-date with CMS and payer policies
• Staff training on security and regulatory updates

Yes, we offer detailed monthly reporting that gives you full visibility into your revenue cycle:

• Claim success and denial rates
• Collections and reimbursements breakdown
• Accounts Receivable aging
• Custom reports tailored to your practice goals

Yes, our team has RCM specialists experienced in:

• Primary care and internal medicine
• Cardiology, orthopedics, and neurology
• Behavioral health and psychiatry
• OB/GYN, dermatology, and more

Absolutely! Our RCM solution is designed to scale efficiently:

• Support for multi-location practices and groups
• Adaptable staffing and resources
• Integrated tools for workflow optimization
• Real-time dashboards to track multiple providers

Data security is our top priority. We implement:

• HIPAA-compliant systems and encrypted storage
• Role-based access control
• 24/7 monitoring of infrastructure
• Regular vulnerability assessments and audits