Medical Billing/Revenue Cycle Management

Patients need to verify their insurance information and eligibility before every appointment.

Insurance information can change at any time, which is why you need to ask the patient if their insurance information is current or has changed since the last visit. A change in insurance information can also impact benefits or copays.

Medical Billing/ Revenue Cycle Management

Often times solo practitioners ask us if they can do their own billing? Yes, you can as long as you are very familiar with medical billing procedures, ICD/CPT code terminology, adding modifiers, familiar with EDI/ERA/EFT enrollment, have adequate time to do the billing and constantly follow the insurance updates every year. Most people (but not all) are not familiar with these rules so we strongly recommend all small to medium practices to outsource their medical billing. Working with the insurance payors can be tricky and frustrating often times. The only time you may consider bringing billing inhouse is when your high collections can support a team of over 7-8 FTE billers in your office. However for large practices, a low fee will still remain economical from a business stand point to outsource your billing.

Revenue Cycle Management is a professional name for Medical Billing Services that encompasses a cycle of additional billing services along with the process of submitting claims to the insurance payors to receive reimbursement for the services you provided to your patients.

Our Comprehensive Medical Billing Services

Daily claims entry

We offer accurate and timely daily claims entry services to streamline your billing process. Our team ensures that all claims are entered correctly to reduce denials and accelerate reimbursements.

Electronic and paper claim submission

We handle both electronic and paper claim submissions with precision, ensuring compliance with payer requirements. Our streamlined process helps reduce delays and improves the efficiency of your revenue cycle.

Dedicated follow-up

We assist healthcare providers in obtaining and maintaining hospital privileges by managing all credentialing documentation, verifications, and compliance requirements.

Monthly customized reports

Receive detailed, easy-to-understand reports tailored to your practice’s needs, offering insights into claim status, revenue trends, and performance metrics to support informed decision-making.

Patient statements

Generate and send clear, accurate patient statements to ensure timely billing and enhance communication regarding balances and payment responsibilities.

Tracking / claims management

Efficiently monitor, track, and manage insurance claims from submission to reimbursement, reducing denials and ensuring timely payment.

Trusted Over 5000 Client in the US

Testimonials

What Our Clients Say

Frequently Asked Questions (FAQ’s)

Why is RCM important in healthcare?

RCM ensures timely and accurate reimbursement for services rendered. Efficient RCM reduces claim denials, minimizes billing errors, and improves cash flow and overall operational performance.

What are the key steps in the revenue cycle?

The main steps include:

Patient registration
Insurance verification
Medical coding
Claims submission
Payment posting
Denial management
Patient billing and collections

What’s the difference between medical billing and coding?

Medical coding involves converting medical procedures and diagnoses into standardized codes. Medical billing uses those codes to create and submit insurance claims and patient invoices.

What causes claim denials?

Common reasons include incorrect patient information, invalid codes, lack of prior authorization, and missed deadlines.

How can claim denials be reduced?

By verifying insurance, ensuring accurate documentation and coding, submitting clean claims, and having a strong follow-up process.

How do you protect patient data?

We follow HIPAA regulations and implement strict security protocols to ensure the confidentiality and integrity of patient health information (PHI).

What types of reports do you provide?

We offer:

Daily claims entry
Electronic and paper claim submission
Dedicated follow-up
Claim correction and/or re-submission
Government, commercial and private billing
Monthly customized reports
Patient statements
Payment posting
Denial management
Tracking / claims management
Managing collections
Patient inquiries
A/R recovery