Most practices do not have a revenue cycle. They have a front desk that checks some insurance, a biller who sends claims, and somebody who looks at denials when there is time. Each piece works on its own. The money gets lost in the handoffs between them: an eligibility problem nobody flagged, a code that was never going to pass, a denial that sat in a queue until the appeal window closed.
Our revenue cycle management services put every step under one team, measured against one number: what you actually collect. That is also how we are paid, as a percentage of collections, so a claim we do not get paid costs us too.
What the cycle covers
| Stage | What we do | What it prevents |
|---|---|---|
| Before the visit | Eligibility and benefit checks, prior authorization, demographic and insurance capture | Denials for inactive coverage, missing authorization or a wrong member ID |
| Coding and charges | Charge entry, coding review, modifier and bundling checks | Under-coding, unbundled services and claims that fail payer edits |
| Claims | Scrubbing, submission and clearinghouse rejection work, same week | Claims that never reach the payer, and late filing |
| Payments | Payment posting, ERA reconciliation, underpayment checks against your contracts | Short payments that nobody notices |
| Denials | Every denial read, corrected or appealed, and the cause fixed upstream | The same denial coming back every month |
| AR and patients | Aged AR follow-up, patient statements and payment plans | Balances that age past the point of collection |
| Reporting | Monthly figures on collections, denial reasons and days in AR | Finding out about a problem a quarter late |
The front end decides most of it
A large share of denials are settled before the patient is seen. Coverage that ended last month, a plan that needs a referral, a service that needs authorization, a secondary insurance nobody recorded. None of those can be fixed by a better appeal. They are fixed by checking before the visit.
So the cycle starts with your schedule, not your claims. We verify eligibility and benefits ahead of appointments, flag what needs authorization, and tell the front desk what to collect at check-in. Money collected at the visit is the cheapest money a practice ever collects.
The numbers we report
Revenue cycle work is easy to describe and hard to check. These are the figures we send every month, so you can check it:
- Clean claim rate: claims accepted on the first pass. Ours stays above 95%.
- Denial rate and denial reasons: grouped by cause, so the fix goes to the right place.
- Days in AR: how long, on average, you wait to be paid.
- AR over 90 days: the money most at risk.
- Net collection rate: what you collected against what you could have collected under your contracts.
If a number moves the wrong way, the report says why and what we are doing about it.
Who it suits
Full medical revenue cycle management suits practices that want billing off their plate entirely: solo physicians, small groups without a billing manager, and growing groups whose in-house team cannot keep up. Practices that want to keep part of the work in house can hand us only the back end, such as denial management or AR recovery.
We work in your system
No migration and no new software to buy. Our team works inside the EHR and practice management system you already use. See every system we support.
Revenue cycle management FAQs
How much do revenue cycle management services cost?
A percentage of what we collect. The rate depends on your specialty, claim volume and payer mix, and we quote it after looking at a month of your claims.
What is the difference between medical billing and revenue cycle management?
Billing usually means coding and sending claims. Revenue cycle management covers everything that affects whether you get paid: eligibility and authorization before the visit, claims, payment posting, denials, patient balances and reporting.
How long does it take to switch?
Most practices are live within a few weeks. We get access to your system, review your payer setup and open AR, and keep working the claims your previous biller left so nothing falls through during the change.
Do you also handle credentialing?
Yes. A provider who is not enrolled cannot be paid, so we often run credentialing alongside billing. It is quoted separately and discounted when you use both.
See where your revenue cycle leaks
Send us a month of claims and your current AR. We will show you what is being denied, why, and what is still recoverable.
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