The comprehensive & flexible RCM solution

Our flexible consultative approach, combined with our end-to-end services and specialized back-office team, meet your needs head-on. Let us help your medical group improve profitability and eliminate administrative burdens.

Patient appointment

Revenue Cycle Management (RCM) begins with a patient appointment. A patient can get an appointment on call by giving necessary information such as patient demographics and insurance information.

Eligibility & benefits verification

After the appointment, the patient eligibility and benefits are checked with patient insurance to verify that the services will be covered or not by the insurance.

Medical transcription

Recorded services convert into medical records. These medical records support the services, and insurance companies may also ask for medical records to check the medical necessity of the services.

Medical coding

Medical coders review the complete medical records and convert them into codes for diagnosis. ICD coding system, procedures, CPT and HCPCS are used. A medical coder handles these codes.

Charge entry & billing

Once all the information needed to complete the claim has been gathered, it is time to file the claim form.

Claim submission

After the charge entry, it’s time to send the claim form to the insurance Company for payment.

Paper claim submission Electronic claim submission Online claim entry

Claim rejections
The claim rejection can occur due to several reasons. Medical billing experts review and correct claim rejection and re-submit claim to insurance.

Payment and posting

A claim follows all guidelines approved for payment. When the claim gets approved, insurance sends paid EOB or ERA along with payment.

Secondary claim submission

Patient primary insurance usually does not pay 100% of the allowed amount. The medical biller submits the claim to the secondary insurance of the patient.

Denial management

The revenue management cycle looks very smooth, but it is not. Many claims got denied due to different reasons fixing those denials is the responsibility of medical billing experts.

Medical appeals

When an insurance company denies a claim, the medical biller acts under the rules and regulations on refusal. Many insurers also offer second-level appeals.

Refunds (insurence & patient)

In medical billing, a refund is giving the money back to the patient or insurance company.

Patient Refund
Insurance Refund

Where we can help you?

We handle everything from the process of submitting and following up on claims with health insurance companies to receive payment for services rendered by a healthcare provider or medical billing company.

tick State Medicare & Mediciad enrollment including RR Medicare, Tricare, BWC
tick Commercial payers' enrollment (UHC, Aetna, Cigna, etc)
tick Re-validation & Re-credentialing (Fedral & Commercial Payers)
tick NPI New Application & NPI Update
tick Contact's ADDITION & Negotiation
tick Fee Schedule Request
tick EDI, ERA EFT setups
tick CAQH creation & maintenance including re-attestation & documents
tick State Medicare & Mediciad enrollment including RR Medicare, Tricare, BWC
tick Hospital Privileges
tick Insurance Portal Creation
tick State License Appplication & Renewal