Patient Demographics & Insurance Verification
We start by ensuring accuracy at the source. Our team verifies patient demographics and performs
real-time insurance eligibility checks for every patient, preventing front-end denials and registration
errors that delay payment.
- Reduce registration-related denials by over 90%.
- Improve patient satisfaction with a smoother intake process.
- Ensure accurate co-pay and deductible collection upfront.
Medical Coding (ICD-10, CPT, HCPCS)
Our AAPC and AHIMA certified coders meticulously review clinical documentation to assign the most
accurate and specific codes. This maximizes reimbursement, ensures compliance, and reduces the risk of
audits from under- or over-coding.
- Maximize revenue with 99.5% coding accuracy.
- Stay compliant with all payer and federal regulations.
- Access specialty-specific coding expertise you can't find in-house.
Charge Entry & Reconciliation
We ensure every billable service is captured and charged correctly. Our team reconciles charges against
clinical documentation and schedules, identifying and correcting any missed revenue opportunities before
the claim is created.
- Capture up to 5% more revenue from previously missed charges.
- Accelerate the billing cycle with faster charge posting.
- Maintain a clear audit trail between services rendered and billed.
AI-Powered Claim Scrubbing & Submission
Before submission, every claim goes through our proprietary AI engine and an expert review to 'scrub' for
errors. We check against thousands of payer-specific rules to ensure a 98%+ first-pass clean claim rate,
leading to faster payments.
- Get paid faster by submitting error-free claims the first time.
- Reduce denial rates by up to 30% from day one.
- Free your staff from tedious manual claim reviews.
Payment Posting & Reconciliation
We post all electronic and manual payments accurately and promptly. Our team identifies underpayments,
denials, and other discrepancies at the time of posting, immediately routing them for resolution and
ensuring your financial records are always up-to-date.
- Gain real-time visibility into your cash flow.
- Quickly identify and address payer underpayments.
- Automate the reconciliation of payments to patient accounts.
Accounts Receivable (A/R) Follow-up
This is where we recover your money. Our dedicated A/R team relentlessly follows up on all unpaid claims,
prioritizing accounts by age and value. We engage with payers via phone, portals, and formal
correspondence to resolve issues and secure payment.
- Reduce A/R days by an average of 30-40%.
- Improve cash flow by accelerating collections on aged claims.
- Eliminate the burden of A/R follow-up from your team.
Denial Management & Appeals
We don't just report denials; we resolve them. Our specialists analyze the root cause of every denial,
correct the issue, and submit compelling appeals with supporting documentation to overturn the decision
and recover your revenue.
- Increase revenue by successfully appealing denied claims.
- Identify and fix root causes to prevent future denials.
- Leverage our expertise in complex, clinical appeals.
Patient Billing & Inquiries Support
We provide clear, easy-to-understand patient statements and offer professional, empathetic support for
all patient billing questions. This improves the patient financial experience and accelerates the
collection of patient-responsible balances.
- Increase patient payments and reduce bad debt.
- Improve patient satisfaction and protect your practice's reputation.
- Offload time-consuming patient calls from your front desk.
Physician Credentialing Services
We manage the entire credentialing and provider enrollment process with all government and commercial
payers. We handle the paperwork, follow-ups, and re-credentialing to ensure your providers are properly
enrolled and can be reimbursed for their services.
- Prevent payment delays caused by credentialing issues.
- Onboard new providers faster and more efficiently.
- Ensure all provider information with payers is current.
Old A/R & Bad Debt Recovery
Have aged accounts receivable you've written off? Our specialized recovery team can often collect on
claims that are 180, 365, or even 730 days old. This is a risk-free way to inject a significant amount of
cash back into your practice.
- Recover lost revenue you had considered uncollectible.
- No upfront cost - we only get paid if we collect.
- Clean up your balance sheet and improve financial health.
Financial Reporting & Analytics
Go beyond basic reports. We provide a custom analytics dashboard with deep insights into your practice's
financial health. Track KPIs like net collection rate, A/R days, denial trends, and payer performance to
make data-driven business decisions.
- Get actionable insights, not just data.
- Identify negative trends before they impact your bottom line.
- Measure financial performance against industry benchmarks.
EMR/EHR System Optimization
We help you get the most out of your technology investment. Our experts can configure your EMR/EHR to
streamline billing workflows, automate tasks, and improve data capture, enhancing the efficiency of the
entire revenue cycle.
- Improve the efficiency of your existing technology.
- Reduce manual data entry and potential for errors.
- Ensure your system is set up for optimal billing performance.
HIPAA & Security Management
Our service includes ongoing management of security and compliance. We conduct regular risk assessments,
provide staff training resources, and maintain a robust, audited security infrastructure to protect your
patients' ePHI and your practice.
- Ensure you are always 'audit-ready'.
- Protect your practice from costly data breaches and fines.
- Leverage our enterprise-grade security infrastructure.
Telehealth Billing Services
The rules for telehealth billing are constantly changing. Our team is expert in the nuances of telehealth
modifiers, place-of-service codes, and payer-specific policies to ensure you are reimbursed correctly for
all virtual care services.
- Maximize reimbursement for your telehealth visits.
- Stay compliant with evolving telehealth regulations.
- Avoid common telehealth billing errors and denials.
Value-Based Care (VBC) Model Support
As healthcare shifts from fee-for-service to value-based care, we help you navigate the transition. We
support billing and reporting for models like MIPS, MACRA, and Alternative Payment Models (APMs) to help
you succeed in the new landscape.
- Optimize performance in quality payment programs.
- Accurately track and report on value-based metrics.
- Future-proof your revenue cycle for the shift to VBC.
