Eligibility & Benefits Verification
We ensure insurance status is active and accurately determine the patient's financial responsibility — co-pay, deductible, co-insurance — before the appointment. Our authorization team proactively handles complex prior authorization processes, preventing costly claim rejections downstream.
- Real-time eligibility checks for every patient
- Accurate co-pay, deductible, and co-insurance determination
- Prior authorization submission and tracking
- Peer-to-peer review coordination for complex cases
- Authorization appeals management
Claim Management & Payment Posting
From precise charge entry and accurate coding to clean claims submission and relentless A/R follow-up, our full-service approach ensures every stage of your revenue cycle is optimized for maximum reimbursement with minimal lag.
- Charge entry with 99%+ accuracy
- CPT/ICD-10 coding review and scrubbing
- Electronic and paper claim submission
- ERA/EOB payment posting
- Secondary claim filing and coordination
Aggressive A/R Management & Denial Resolution
This is our core strength. Unpaid claims are lost revenue. Our dedicated A/R team works tirelessly to recover every dollar you are owed — analyzing aging A/R, appealing complex denials, and maintaining consistent follow-up to significantly reduce outstanding accounts.
- Systematic aging A/R analysis and stratification
- Root cause denial analysis and trend reporting
- First-level and second-level appeals
- Payer-specific follow-up protocols
- Underpayment identification and recovery
Patient Billing & Support
Our professional and user-friendly patient billing services simplify the payment process. We handle statements and patient inquiries with care, enhancing patient satisfaction while significantly improving your private-pay collections.
- Clear, patient-friendly statement generation
- Dedicated patient billing support line
- Payment plan setup and management
- Online payment portal integration
- Bad debt identification and write-off processing
Financial Analytics & RCM Strategy
We provide clear, detailed analytics and reporting, offering deep insights into your practice's financial health. Track key metrics, monitor A/R performance, and make data-driven decisions to optimize revenue cycle performance.
- Real-time revenue cycle dashboards
- Monthly and quarterly performance reports
- KPI tracking: collections, denials, A/R days
- Payer mix analysis and contract optimization
- Custom reporting for practice management
Provider Credentialing & Enrollment
Let our credentialing experts manage the complex and time-consuming enrollment process with payers. We ensure your providers are properly enrolled and maintained, so you can focus on patient care without billing interruption.
- New provider payer enrollment
- Re-credentialing and maintenance
- Medicare and Medicaid enrollment
- CAQH profile management
- Group and individual credentialing