Revenue Cycle Management

Revenue Cycle Management Services

End-to-end healthcare revenue cycle management services for independent practices and groups. From patient registration and eligibility to coding, claims, denials, payment posting and patient collections, we run the whole revenue cycle and report the KPIs that show it is working.

Medical billing and claims paperwork on an office desk

The Problem

Where the Revenue Cycle Breaks Down

Revenue cycle problems rarely start in billing. They start at the front desk with an unverified insurance plan, continue with incomplete documentation, and end as a denial three weeks later.

RCM services fix the whole chain, not just the claims at the end of it, so cash comes in faster and less of it is written off.

01

Front-end errors.

Registration and eligibility mistakes cause a large share of denials.

02

Documentation and coding gaps.

Undercoding leaves money on the table; overcoding creates audit risk.

03

Slow follow-up.

Unworked denials and aged A/R turn into write-offs.

04

No visibility.

Without KPIs, leaders cannot see which stage of the cycle is leaking.

What We Do

Our Revenue Cycle Management Solutions

01

Patient Access

Registration, eligibility and benefits verification and prior authorizations.

02

Charge Capture and Coding

Complete charge capture and CPT, ICD-10-CM and HCPCS coding.

03

Claims Management

Scrubbing, submission and clearinghouse rejection handling.

04

Denial Management

Denials worked, appealed and prevented through root-cause fixes.

05

A/R Management

Follow-up by payer and age bucket until claims are resolved.

06

Payment Posting and Reconciliation

ERA/EOB posting, underpayment detection and reconciliation.

07

Patient Financial Experience

Clear estimates, statements, payment plans and online payment.

08

RCM Analytics

Clean claim rate, denial rate, days in A/R and net collection rate by payer and provider.

The Process

How Our RCM Engagement Works

01

RCM Assessment

We benchmark your KPIs and map where revenue leaks.

02

Roadmap

A prioritised plan with expected impact on collections.

03

Transition

System access, workflows and a parallel run.

04

Run the Cycle

Our team handles each stage, front to back.

05

Prevent Denials

Root causes fed back to registration, documentation and coding.

06

Report and Improve

Monthly KPI review and quarterly strategy.

FAQ

Revenue Cycle Management Questions

Revenue cycle management (RCM) is the process of managing every financial step of a patient visit, from scheduling and insurance verification through coding, claims, payment and collections, so the practice is paid fully and promptly for the care it provides.

Pre-registration and scheduling, eligibility and benefits verification, prior authorization, charge capture, coding, claim submission, payment posting, denial management, A/R follow-up, patient collections and reporting.

Key RCM KPIs include clean claim rate (aim for 95%+), first-pass resolution rate, denial rate (under 5 to 10%), days in A/R (under 30 to 40), percentage of A/R over 90 days, and net collection rate (95%+).

Verify eligibility before every visit, capture complete documentation, code accurately, scrub claims before submission, work denials within days, follow up A/R by age, and track KPIs monthly.

Most RCM companies charge 4% to 9% of collections depending on scope, specialty and volume.

Medical billing focuses on creating and following up claims. RCM covers the whole financial journey, including front-end steps like eligibility and authorization and back-end analytics.

Compare healthcare revenue cycle management companies on KPIs, scope and transparency. A revenue cycle management company should show you its results for practices like yours.

Revenue cycle management for healthcare practices decides how quickly and completely you get paid for the care you deliver.

Latest Insights

Related Reading

Find Out Where Your Revenue Cycle Is Leaking

Book a free RCM assessment. We will benchmark your KPIs and show you the three fixes with the biggest impact on collections.