RCM-001
End-to-End Revenue Cycle Management
One accountable partner from patient scheduling to posted payment. We run the entire cycle as a single process — so nothing falls between vendors, and every dollar has an owner.
- Eligibility & benefits verification before the visit
- Prior authorization management
- Charge capture & entry with specialty-specific edits
- Clean-claim scrubbing & electronic submission
- ERA/835 payment posting & reconciliation
- Patient statements & balance follow-up
- Month-end close with executive-ready reporting
FULL CYCLEONE OWNERMONTH-END READY
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BIL-002
Medical Billing & Certified Coding
Specialty-tuned billing teams and certified coders who maximize compliant reimbursement — the difference between billed and collected.
- Certified professional coders (CPT, ICD-10, HCPCS)
- E/M leveling and modifier accuracy — incl. modifier 25 discipline
- NCCI/PTP and MUE edit compliance
- Charge lag monitoring and missing-charge recovery
- Payer-specific billing rules maintained per contract
CPT/ICD-10CERTIFIED CODERSAUDIT-SAFE
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DEN-003
A/R Recovery & Denial Management
Old A/R is not lost revenue — it's unworked revenue. We chase every collectible dollar and fix the root cause so the same denial never happens twice.
- Aging A/R workdown with payer-level prioritization
- Denial root-cause analysis by CARC/RARC code
- Timely, documented appeals — including timely-filing defenses
- Underpayment identification against contracted rates
- Prevention rules fed back into front-end scrubbing
CARC/RARCAPPEALSROOT CAUSE
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CRD-004
Credentialing & Payer Enrollment
Revenue can't start until enrollment is done — and it stops when re-credentialing slips. We keep both moving, proactively.
- Initial payer enrollment for new providers & locations
- CAQH profile creation and quarterly attestation
- Re-credentialing calendars with proactive alerts
- Medicare/Medicaid revalidation
- Contract & fee schedule tracking
CAQHDAY-ONE READYNO LAPSES
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PMS-005
Practice Management System
A web-based, user-friendly PM system that handles complex billing needs — with your data visible to you at all times. Easy to learn, hard to outgrow.
- Scheduling, registration, and eligibility in one place
- Integrated claim submission and clearinghouse connectivity
- Real-time KPI dashboards: collections, denials, days in A/R
- Role-based access for owners, managers, and front desk
CLOUDREAL-TIME KPIsYOUR DATA
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AUD-006
Coding Audits & Compliance Reviews
Independent chart-to-claim audits that protect revenue in both directions — undercoding costs you, overcoding risks you.
- Prospective and retrospective coding audits
- Documentation improvement feedback for providers
- Audit-ready reporting and corrective action plans
CHART-TO-CLAIMBOTH DIRECTIONSDEFENSIBLE
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STA-007
New Practice & Urgent Care Startup Consulting
We've helped launch 70+ urgent care clinics. From entity setup through first claim paid, we know every step — and every trap.
- Payer enrollment sequenced for day-one billing
- Fee schedule and CPT panel setup by specialty
- Workflow design: front desk to back office
- First-90-days revenue ramp monitoring
70+ LAUNCHESDAY-ONE BILLING90-DAY RAMP
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