Questions practices ask before starting

Revenue cycle management is everything between a patient booking an appointment and the practice being paid in full for it - eligibility, authorization, charge capture, coding, claim submission, payment posting, denials, A/R follow-up and the reporting that tells you how the whole thing is performing.

Medical billing is one part of the cycle: preparing and submitting claims and chasing payment. Revenue cycle management is the whole system around it, including everything that happens before a claim is created - which is where most denials actually originate.

Three areas, taken together or separately. Medical billing: complete billing, RCM, medical coding, eligibility and benefits verification, prior authorizations, claims, payment posting, denials, A/R and patient billing. Credentialing and enrollment: provider credentialing, insurance enrollment, Medicare and Medicaid, CAQH, re-credentialing, payer contracting and provider directories. Revenue optimization: denial prevention, A/R recovery, underpayment recovery, fee schedule review, revenue analysis and reporting. Most practices start with whatever is costing them the most, which the assessment identifies.

In most cases yes. We work inside the systems you already run rather than asking you to migrate. Tell us which system you use and we will confirm how we would work with it.

Every denial is categorized by payer, code, provider and root cause, then ranked by recoverable value and filing deadline. We appeal with the documentation the payer requires, and separately feed the cause back upstream so the same denial stops recurring.

Accounts are worked by recoverable value, age and filing deadline rather than in date order, on a defined cadence, with every touch recorded against the account and visible to you.

Yes - provider credentialing, commercial insurance enrollment, Medicare and Medicaid enrollment, CAQH ProView maintenance, re-credentialing, payer contracting support and provider directory management. Renewals and revalidations are tracked on a calendar so nothing lapses.

Yes. Single-provider practices and large multi-provider groups need the same disciplines; what changes is the scope of the engagement.

It starts with the free assessment. If you decide to proceed, we agree scope, execute a Business Associate Agreement, set up access to your systems, run a parallel period so nothing is dropped, and then transition fully. The timeline depends on the size of the practice and the systems involved, and we agree it with you up front.

Protected health information is only exchanged under a signed Business Associate Agreement, through secure channels, with role-based access and audit trails. Our website forms deliberately collect contact details only - never clinical information.

Pricing depends on the services you choose and the size of your practice, and it is set out clearly before you commit to anything. The assessment is free and carries no obligation either way.

Complete the assessment form and we will contact you to arrange a short call, review your revenue-cycle performance and send you the findings in writing. You keep them whether or not you engage us.