Services
Everything betweenthe encounter andthe deposit.
Take one discipline or hand us the whole revenue cycle. Every engagement comes with certified coders, a named account manager, and monthly reporting written for a practice owner.
Medical Billing
Charge to deposit, handled end to end. Claims go out clean, get tracked to adjudication, and get posted the same week they pay.
How it works
- 1Charge capture reviewed against the encounter documentation
- 2Demographics and insurance validated before submission
- 3Claim built, scrubbed against payer edits, and transmitted via clearinghouse
- 4277CA acknowledgement confirmed — not assumed
- 5ERA/EOB posted, variances flagged against expected allowable
- 6Patient balances statemented and worked with clear, non-aggressive follow-up
What's included
- Electronic and paper claim submission
- Payment posting and reconciliation
- Secondary and tertiary claim coordination
- Patient statements and balance support
- Credit balance and refund review
Outcomes
- Fewer rejections at the clearinghouse
- Shorter gap between date of service and deposit
- One reconciled source of truth every month
Medical Coding
Certified CPC/CPB coders read your documentation and assign codes at the specificity payers require — no upcoding, no leaving money on the table.
How it works
- 1Documentation reviewed for medical necessity and specificity
- 2ICD-10-CM diagnosis coding to the highest supported character
- 3CPT and HCPCS procedure coding with correct units
- 4Modifier assignment (25, 59, 24, 51, XS/XU, laterality) applied deliberately
- 5NCCI and MUE edit checks before the claim is built
- 6Coder queries sent back to the provider when documentation won't support the level
What's included
- Specialty-assigned certified coders
- Modifier and bundling review
- E/M level validation against 2021+ guidelines
- Annual code-set update handling
- Provider documentation feedback
Outcomes
- Undercoding surfaced and corrected
- Compliance exposure reduced
- Denials from coding errors substantially reduced
Revenue Cycle Management
The whole loop, owned by one accountable team: front-desk verification through final reconciliation and monthly reporting.
How it works
- 1Eligibility and benefits verified before the visit
- 2Prior authorizations initiated and tracked to approval
- 3Charge capture and coding
- 4Claim submission and payer follow-up
- 5Denials and underpayments worked to resolution
- 6Monthly financial reporting and trend review with your account manager
What's included
- Dedicated account manager
- Eligibility and prior-auth management
- Full billing and coding
- A/R management by aging bucket
- Monthly KPI reporting and review call
Outcomes
- Predictable cash flow instead of month-to-month surprises
- Staff time returned to patients
- Clear line of sight into what each payer is actually paying
Provider Credentialing & Enrollment
Getting in-network is a paperwork war of attrition. We fight it for you and keep the flank covered with revalidations and CAQH upkeep.
How it works
- 1Document collection: licenses, DEA, malpractice, board certifications, W-9
- 2CAQH ProView profile built, attested, and kept current
- 3Payer applications submitted per plan and per state
- 4Weekly status follow-up with a live tracker you can see
- 5Contract and fee schedule review at approval
- 6Revalidation and expirable calendar maintained ongoing
What's included
- Medicare (PECOS) and state Medicaid enrollment
- Commercial payer applications and re-credentialing
- CAQH attestation management
- Group and individual NPI linkage
- EDI, ERA, and EFT enrollment
Outcomes
- New providers billing sooner after start date
- No revenue lost to a lapsed revalidation
- One tracker instead of a dozen payer portals
Denial Management & A/R Recovery
Denials are worked, not filed. Every remark code gets a root cause, a corrected claim or appeal, and a note in the pattern log.
How it works
- 1Denial logged with CARC/RARC code and dollar value
- 2Root cause classified: eligibility, coding, auth, documentation, or payer error
- 3Corrected claim or formal appeal built with supporting documentation
- 4Refiled inside the payer's appeal window and tracked
- 5Escalated to provider relations or a second-level appeal when warranted
- 6Pattern reported monthly so the same denial stops recurring
What's included
- Aged A/R inventory and triage by filing deadline
- Appeal letter drafting with clinical documentation attachment
- Underpayment detection against contracted rates
- Payer trend reporting by denial reason
- Timely-filing risk alerts
Outcomes
- Recoverable dollars pulled out of aged buckets
- Repeat denial reasons eliminated at the source
- Nothing quietly adjusted off
Billing Audits
A retrospective look at what your current process is actually doing — before you decide to change anything.
How it works
- 1Sample of encounters pulled across providers and payers
- 2Documentation compared line by line against submitted codes
- 3Modifier, bundling, and E/M level accuracy scored
- 4Payment variance checked against contracted fee schedules
- 5Write-off and adjustment patterns reviewed for leakage
- 6Written findings delivered with prioritized remediation steps
What's included
- Coding accuracy scorecard
- Revenue leakage estimate
- Compliance risk flags
- Fee schedule variance analysis
- Prioritized remediation plan
Outcomes
- You learn what you're losing and where
- Documented baseline before any transition
- Defensible position if a payer audits you first
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Not sure which pieceyou actually need?
Tell us what's breaking — slow deposits, stacked denials, a new provider who can't bill yet — and we'll tell you honestly which service solves it.
Mon–Fri, 8:00 AM – 6:00 PM CT · Nationwide, remote-first service