End-to-End Revenue Cycle Architecture
Engineered for Practice Yield
From front-end insurance verification and charges to aggressive denial appeals and aged A/R salvage, we protect every dollar of clinical revenue with 24/7 overnight operational support.
Our Core Revenue Cycle Capabilities
Tailored operational solutions aligned with AAPC guidelines, CMS standards, and commercial payer policies.
Medical Billing & Scrubbing
High-precision charge entry, automated multi-tier CCI edit rules, and daily electronic claim batch submissions.
- ✓ 24-hour charge entry turnaround
- ✓ Clearinghouse rejection triage
- ✓ Payment posting & ERA reconciliation
Medical Coding & Chart Review
Specialty-trained coders performing clinical documentation reviews, surgical modifiers, and E/M coding defense.
- ✓ CPT, ICD-10-CM & HCPCS validation
- ✓ LCD/NCD statutory compliance
- ✓ E/M documentation level optimization
Denial Resolution & Appeals
Root-cause CARC/RARC analysis, custom clinical appeal narrative letters, and aggressive payer re-determinations.
- ✓ 24–48 hour denial turnaround
- ✓ Overturning medical necessity denials
- ✓ Zero uncollected recoverable claims
Insurance & Aged A/R Recovery
Targeted liquidation of 60+, 90+, and 120+ day aged claims with dedicated outbound payer calling teams.
- ✓ Systematic aging bucket audit
- ✓ Timely filing limit salvage
- ✓ Credit balance & unapplied cash resolution
Prior Authorization Clearance
Statutory authorization management for complex surgeries, high-cost diagnostics, MRI/CT, and specialized therapeutics.
- ✓ Fast-track portal submissions
- ✓ Clinical peer-to-peer prep files
- ✓ Retroactive authorization defense
Provider Credentialing
CAQH profile management, commercial payer panel enrollment, Medicare/Medicaid revalidations, and hospital privileges.
- ✓ Payer contract enrollment tracking
- ✓ NPI & PTAN application management
- ✓ Expiring document monitoring
Request A 48-Hour Service Proposal
Let our operations leads evaluate your billing workflows, denial percentages, and aged A/R balances to formulate a tailored service scope.