How is this different from your Eligibility, Coding, and Billing & AR services?

Those services each cover one part of the cycle, so you can hand us just the piece that keeps breaking. Revenue Cycle Management combines them, adds prior authorization and revenue leakage analysis, and puts one lead in charge of the whole result.

Are your coders specialty-trained?

Yes. Coders are matched to your specialty and trained on its payer rules, modifier conventions, and documentation patterns. Every code carries a reference to the note that supports it.

How do you reduce prior authorization denials?

Authorization requirements are checked per payer, procedure, and diagnosis at scheduling. We submit with the clinical evidence each payer expects, follow up to a decision, and escalate to peer-to-peer review when medical necessity is contested.

Which systems do you work with?

We connect into the record system, practice management system, and clearinghouse you already run, including Epic, athenahealth, Oracle Health, NextGen, eClinicalWorks, Veradigm, and ModMed, using FHIR R4 where supported and HL7 v2 elsewhere.

How do you measure success?

Initial denial rate, first-pass resolution, days in AR overall and by aging bucket, net collection rate, denial overturn rate, and revenue leakage found, compared with your own baseline and with HFMA MAP Keys definitions so the comparison is honest.

Do we keep our existing tools?

Usually, yes. We run inside your current stack. If a tool is not earning its keep, we will tell you and help you retire it.

All services

Revenue Cycle Management

Managed Service

Run the revenue cycle as one accountable operation.

Request a demo What it does

Revenue cycle work is usually split across systems, vendors, and teams. Denials pile up, AR ages, and the people closest to the work cannot see why. Revenue Cycle Management puts the whole cycle under one team: patient intake, eligibility, prior authorization, coding, claim submission, payment posting, denial recovery, and account follow-up. It combines our Eligibility Verification, Coding, and Billing & AR services, adds prior authorization and revenue leakage analysis, and runs it all on the same record with one lead accountable for the result. Payer-aware automation handles the predictable work; specialty-trained operators handle the calls that need judgment.

The full revenue cycle, run as one operation. Not five disconnected ones.

The problem

Revenue cycle work is fragmented across systems and teams. Denials accumulate, AR ages, and the people closest to the work cannot see why.

How we solve it

One accountable operation for eligibility, prior authorization, coding, claims, and AR, with payer-aware automation on the predictable work and people on the rest.

What it does

Inside Revenue Cycle Management

Every capability below exists because a practice asked for it. Nothing here is a roadmap item.

1.1

Eligibility & benefits verification

Real-time and batch checks across your payers. Members verified before the visit, exceptions routed to a person.

1.2

Prior authorization

Requirements checked per payer and procedure at scheduling, packets assembled with the clinical evidence each payer expects, and tracked to a decision.

1.3

Medical coding & coding audits

CPT and ICD-10 assigned from the note with the supporting line attached, validated before release, and audited on a schedule.

1.4

Claims and claim status

Claims scrubbed against payer edits, submitted in clean batches, and tracked through acknowledgment to adjudication.

1.5

Denials & appeals

Root cause on every denial, ranked by what is recoverable, with appeal letters that cite the record and the policy.

1.6

Posting, AR, and leakage analysis

ERAs reconciled to claims, insurance and patient AR worked by cash impact, and underpayments and missed charges found.

The cycle

From patient intake to cash applied.

Our team runs every stage of the revenue cycle inside the systems you already use, with automation for the repeatable work and people for the calls that need judgment. Pick a stage to see what it looks like.

Patient Access · eligibility, estimates, and intake, before the visit

Patient intake.

Pre-registration, demographics, and a No Surprises Act–compliant Good Faith Estimate land before the visit ever starts.

Intake checklist

Demographics captured
Patient A · BCBS PPO · today 2:30p
Done
Insurance card verified
BCBS PPO 84120
Done
Photo ID on file
Driver’s license
Done
Good Faith Estimate signed
GFE delivered 2 days ago · NSA compliant
Done
Financial counseling
Optional · not requested
Skipped

Illustrative example · not real patient data

How it works

From the schedule to the signed record

First

Connect

We plug into your record system, practice management system, and clearinghouse. No rip-and-replace.

Then

Validate

Eligibility, prior authorization, and coding checks run before a claim leaves the door.

Then

Submit

Claims scrubbed, submitted, and tracked across your payer mix, with risk flags before they go out.

Finally

Recover

Denials worked, appeals filed, payments posted, and AR resolved by a named owner.

By design

Facts, not promises.

These are properties of how Revenue Cycle Management is built, not projected savings. Results in your practice depend on your payers, your panel, and your documentation.

0 team

Accountable for the cycle

One lead from intake to payment, not separate vendors with separate logins

0 record

Behind every claim

Every stage observable on the same data, nothing retyped

0 reviews

Every year

Denials, AR, and leakage reviewed with you, with fixes ranked by cash impact

How we run it

Built where the work actually happens.

Each part runs inside the same operation, against the same data, with the same service levels. No four vendors, four logins, and four versions of the truth.

Catch denials before they happen.

Pre-submission edits applied per payer and procedure, with a risk flag on every claim before it leaves your clearinghouse.

Coding tuned to your specialty.

Coders matched to your specialty, audited on every sample, and working from payer-specific rules and modifier conventions.

Work the denials that actually pay.

Every denial ranked by recoverability and dollar value. Appeals assembled with cited evidence and policy references, sent by a person.

Follow-up that does not stall.

Status checks, corrections, and balance outreach handled every day. People step in wherever judgment is needed.

Implementation

Stage-by-stage cutover. No big-bang switch.

We take over one stage at a time while claims keep moving, then tune the operation with you.

Kickoff & access

BAA, system access, and a named lead. Your team keeps working while we connect.

Discovery & baseline

AR aging, denial reasons, payer mix, and current workflows measured, so progress is judged against your own starting point.

Stage cutover

Eligibility, authorization, coding, claims, posting, and follow-up handed over one stage at a time.

Full operation

Our team runs the cycle daily, with every worklist visible to you.

Tuning & governance

Monthly reviews turn repeat denials into upstream fixes, with coding audits on a set schedule.

Who it is for

A good fit when…

Practices and groups juggling separate vendors for eligibility, coding, and billing
Organizations carrying aged AR and denials nobody can explain
Specialty groups that need coders who know their payer rules
Management services organizations standardizing the cycle across practices

Continue exploring

CPMA Audit ProgramEnd-to-end coding, documentation, billing, and compliance audits by CPMA-certified auditors, twice a year.Eligibility Verification ServicesEvery schedule verified before the day starts, and every exception worked by our team on Eligibility & Benefits.Coding ServicesYour encounters coded, validated, and returned by our team, running on Coding Intelligence.Billing & AR ServicesClaims built, sent, followed up, and paid by our team, from charge capture to the last dollar posted.

Questions

The questions leaders ask first.

Don’t see yours? Bring it to a working session and we’ll walk it through with your data.

Eligibility and benefits, prior authorization, medical coding and coding audits, claim scrubbing and submission, payer follow-up, denial management and appeals, payment posting and reconciliation, AR follow-up, patient billing, and revenue analytics. Every stage runs on the same data with the same service levels, not as separate vendor integrations.

See Revenue Cycle Management on your own workflow.

Tell us what your organization is fighting (open care gaps, documentation, denials, coverage) and we will walk you through the part of the platform that closes it.

Request a demo All services