Intelligent RCM Solutions
Advanced technology meets human expertise.
Cash Flow
End-to-End Billing
Seamless lifecycle management from appointment to deposit.
- Demographics: Patient eligibility verification prior to visit.
- Charge Entry: Accurate capture of billable services within 24 hours.
- Claims Submission: Electronic (EDI) submission with 99% first-pass acceptance.
- Payment Posting: ERA/EFT posting and reconciliation against bank deposits.
Compliance
Coding & Audits
Certified coding accuracy to prevent audits and maximize value.
- Certification: Services by AAPC & AHIMA certified coders.
- Standards: ICD-10-CM, CPT, and HCPCS Level II compliance.
- Optimization: Modifier usage and NCCI edit validation to prevent rejections.
- CDI: Feedback to doctors on Clinical Documentation Improvement.
Recovery
Denial Management
Aggressive pursuit of unpaid claims and aging accounts.
- Root Cause Analysis: Identifying why claims are rejected (Coding vs Admin).
- Appeals: Timely filing of corrected claims and formal appeals.
- Old AR Cleanup: Dedicated team for claims aged 90+ days.
- Payer Follow-up: Direct phone calls to insurance reps to resolve stalls.
Insight
Practice Health Scorecard
Data-driven audit to reveal financial health and gaps.
- Historical Audit: 6-month retrospective analysis of your charges and payments.
- Benchmarking: Comparing your practice KPIs against MGMA standards.
- Leakage Report: Identifying under-coding or missed billable procedures.
- Action Plan: A roadmap to fix process gaps and boost collection by 20%.