Before the claim
Check demographics, coverage and authorization information against the services being billed. Clinical documentation remains the provider’s responsibility; missing information is returned for clarification.
Billing & RCM
A claim needs follow through all the way to payment.
End to end billing support for independent practices, connecting eligibility, claim preparation, payment posting, denial follow up and reporting. Your dedicated biller works within a defined scope and keeps outstanding work visible.
From an aging total to an actionable queue.
A clearinghouse acceptance is not a payment. Rejections, missing enrollment details and unresolved balances can sit in different systems while the practice sees only an aging total. We connect those records so each outstanding item has a reason, an owner and a next action.
WHAT IS INCLUDED
A defined scope.
Connected responsibilities.
Agree on the work before it begins.
Add services when your practice needs them.
Claim preparation and submission
Review charge information and coding alignment, submit through the agreed clearinghouse and distinguish front end rejections from payer adjudication denials. Track acceptance rather than assuming transmission was enough.
Payment posting and reconciliation
Post remittances, adjustments and patient responsibility using the payer response. Match EFT records to ERA information and investigate missing remittances or payments that do not reconcile.
Denials, appeals and aging A/R
Group balances by denial reason, payer and filing deadline. Track corrected claims and appeals separately, document follow ups and escalate issues requiring practice input. Recovery depends on the facts and payer decisions.
Patient balances and statements
Review payer assigned responsibility before statement processing. Route disputed amounts and coverage questions to the correct owner under your approved communication policy.
Operational reporting
Report claim status, aging balances and recurring issues. Separate unpaid work waiting on a payer from work waiting on documentation or an internal correction.
WHAT YOUR PRACTICE RECEIVES
Work you can see
and questions you can act on.
- A named biller and clearly assigned billing responsibilities
- A working queue for rejections, denials, appeals and aged claims
- Payment posting and reconciliation records
- Reports explaining open balances and the next priorities
HOW THE WORK MOVES
From handover to an active revenue cycle.
Map the starting position
Identify the payer mix, clearinghouse, current claims, aging report and payment posting process. Establish what belongs in the new work queue and what needs separate historical review.
Agree on access and ownership
Sign the mutual agreement and BAA before PHI access. Use approved role based access and decide who supplies charges, answers documentation queries and approves patient balance actions.
Work the queue and review patterns
Submit, track, post and follow up. Use recurring denial reasons to identify upstream issues in eligibility, authorization, documentation or enrollment rather than repeatedly correcting the same claim.
PRICING AND EXPECTATIONS
Know what drives your quote.
A percentage of total monthly collections. Monthly practice revenue and the billing workload shape the quotation. No setup fees; responsibilities and month to month terms are agreed in writing.
BEFORE WE BEGIN
Details to clarify together.
No documents or practice information are required before a mutual contract is signed. Onboarding follows the agreement and, before PHI access, a BAA.
No. Coverage, documentation, contractual terms and payer decisions control payment. We track the work and explain outstanding issues without promising a collection outcome.
We assess your current EHR, practice management system and clearinghouse first. Access and supported workflows are confirmed before the service starts.
Yes, the scope can include an aging A/R review. Filing windows, appeal rights, documentation and prior claim history determine which balances have a viable next step.
CONNECT THE DETAILS
Start with your practice, not a generic proposal.
A Free Practice Review connects billing, credentialing, enrollment and payment setup. We agree on scope first, with a signed agreement and BAA before practice data moves.