Services
The full revenue cycle, or just the parts you need.
Each service can run on its own or as part of a full outsourcing engagement.
Front end
Patient access
Most denials start at registration. We prevent them before a claim is ever created.
Eligibility and benefits verification
Coverage checked before the visit, with issues routed back to scheduling.
Prior authorization
Authorization requests, tracking and follow-up by payer and service line.
Patient cost estimates
Good-faith estimates and financial clearance before service.
Registration quality
Demographic and insurance audits that catch errors at the source.
Mid cycle
Coding and clinical documentation
Certified coders matched to your specialties and settings.
Inpatient and outpatient facility coding
ICD-10-CM/PCS, CPT and HCPCS coding for hospital and facility claims.
Professional fee coding
E/M, procedure and modifier coding for physician and specialty services.
Clinical documentation improvement
Documentation reviews and provider queries that support accurate coding.
Coding audits and education
Pre-bill and retrospective audits with provider and coder feedback.
Back end
Claims, denials and A/R
Daily claim work, measured against the baseline we set together.
Charge entry and claim submission
Clean-claim edits and scrubbing before submission.
Payment posting and reconciliation
ERA and manual posting, with deposits reconciled to remittances.
Denial management and appeals
Denials worked by root cause, with appeals tracked to resolution.
A/R follow-up
Aged claims worked by payer and dollar value, including backlog cleanup.
Patient billing
Statements, payment plans and patient balance support.
Provider enrollment
Credentialing and enrollment
New providers and locations billing as soon as possible.
Payer enrollment
Commercial, Medicare and Medicaid enrollment for providers and groups.
Revalidation and maintenance
Expiration tracking, CAQH upkeep and revalidations.
Clearinghouse and EDI setup
Claim, remittance and eligibility transaction enrollment.
Insight
Analytics and reporting
Clear reporting for finance leaders, practice managers and providers.
Executive dashboards
Monthly KPI reporting against your onboarding baseline.
Denial and payer analytics
Trends by payer, reason, location and provider.
Revenue cycle assessments
A fixed-scope review of your current performance and opportunities.