Revenue Cycle Management Services
Front-to-back RCM for independent practices: eligibility, coding, claims, denials, and AR managed as one cycle and reported in numbers you can verify.
- HIPAA-Compliant
- U.S.-Based Experts
- Free Practice Audit
One Cycle, Zero Leaks
Revenue doesn't leak in one place. It leaks at check-in, when eligibility isn't verified. It leaks at coding, when undercoded encounters leave money on the table. It leaks after submission, when denials sit unworked and claims quietly expire against timely-filing deadlines. Fixing only one stage moves the leak. It doesn't stop it.
Our revenue cycle management service runs the entire cycle as one accountable process: eligibility and prior authorization before the visit, certified coding and same-day claim scrubbing in the middle, and denial appeals, AR follow-up, and patient collections at the back. All of it happens inside your existing EHR under a signed BAA, reported monthly against the four KPIs that actually run a practice.
The targets we manage to are the industry benchmarks: a 95%+ clean claim rate, days in AR under 40, and a net collection rate above 96%.
The Full Revenue Cycle, Managed
Front End
Before the Visit
- Insurance eligibility & benefits verification
- Prior authorization management
- Patient demographics & coverage checks
- Copay and deductible estimation
Most denials are born here. Bad eligibility data and missing authorizations cause them before a claim is ever coded.
Mid Cycle
Coding & Claims
- CPT / ICD-10 coding by certified coders
- Charge entry & charge capture review
- Claim scrubbing against payer rules
- Electronic submission within 24 hours
Clean coding and scrubbing are what push first-pass acceptance above the 95% benchmark.
Back End
Getting Paid
- Payment posting & underpayment recovery
- Denial management & appeals
- AR follow-up on every claim over 30 days
- Patient statements & balance collection
This is where unworked claims expire against timely-filing deadlines, and where we recover them first.
The Four KPIs We Manage To
Every engagement is reported monthly against the same industry benchmarks. No vanity metrics.
| Metric | Healthy Benchmark | Warning Zone | Free Tool |
|---|---|---|---|
| Clean claim rate | 95%+ | Below 90% | Check yours |
| Days in AR | Under 40 days | Over 50 days | Check yours |
| Net collection rate | 96%+ | Below 92% | — |
| Denial rate | Under 5–10% | Over 10% | — |
What's Included in Our RCM Service
Eligibility & Benefits Verification
Coverage, copays, and deductibles verified before every visit, so claims aren't doomed at check-in.
Prior Authorization
Authorizations tracked and secured before procedures, protecting both the schedule and the reimbursement.
Medical Coding
Certified coders assign CPT and ICD-10 codes that hold up to payer scrutiny, maximizing legitimate reimbursement without compliance risk.
Claim Scrubbing & Submission
Every claim checked against payer rules and filed electronically within 24 hours; rejections corrected the same day.
Payment Posting
ERAs and EOBs posted daily and reconciled against contracted rates, with underpayments flagged for recovery.
Denial Management
Denials categorized by root cause, appealed when winnable, and eliminated at the source through front-end fixes.
AR Follow-Up
Systematic payer follow-up prioritized by dollar value and timely-filing deadlines, keeping days in AR under 40.
Patient Collections
Clear statements, payment plans, and respectful balance follow-up that collect patient responsibility without friction.
From Assessment to Accountable Results
01
Revenue Cycle Assessment
We benchmark your clean claim rate, AR aging, denial rate, and net collections against industry standards and show you where the cycle is leaking.
02
Onboarding & Integration
EHR access, clearinghouse setup, payer enrollment verification, and a signed BAA, with a full transition in 30 to 60 days and no cash-flow gap.
03
Full-Cycle Operations
Eligibility checks before visits, claims out within 24 hours, payments posted daily, denials and AR worked continuously.
04
Measure & Improve
Monthly KPI reporting with denial root-cause analysis and payer trends, so every quarter collects more than the last.
Benchmark Your Revenue Cycle
RCM FAQs
What do revenue cycle management services include?
Full-cycle RCM covers everything between the moment a patient books and the moment the account is paid in full: insurance eligibility verification, prior authorization, medical coding, charge capture, claim scrubbing and submission, payment posting, denial management and appeals, accounts receivable follow-up, patient statements, and monthly performance reporting.
What is the difference between RCM and medical billing?
Medical billing is the middle of the cycle: coding claims, submitting them, and posting payments. Revenue cycle management is the whole cycle, including the front end (eligibility, benefits verification, prior authorization) where most denials are actually born, and the back end (denial appeals, AR recovery, patient collections) where unworked claims quietly expire. Practices that only fix billing still leak revenue at both ends.
How much do RCM services cost?
Like medical billing, RCM services are usually priced as a percentage of monthly collections, typically 3% to 8% depending on specialty, claim volume, and how much of the cycle you hand off. Because fees scale with collections, an RCM partner only does well when your practice gets paid.
Which RCM metrics should my practice track?
Four numbers tell most of the story: clean claim rate (target 95%+), days in accounts receivable (target under 40), net collection rate (target 96%+), and denial rate (target under 10%, ideally under 5%). We report all four every month, and you can benchmark your current numbers right now with our free AR days and clean claim rate calculators.
Do RCM companies work with small practices?
Yes. Small and mid-size practices are exactly who benefits most. A solo or small group practice can't staff separate people for eligibility, coding, denials, and AR, so those jobs compete for the same hours. Outsourced RCM gives a small practice the same division of labor a hospital revenue department has, priced in proportion to collections.
Will you work inside our existing EHR?
Yes. We manage the revenue cycle inside your existing EHR and practice management system (Athenahealth, Kareo/Tebra, AdvancedMD, eClinicalWorks, DrChrono, Office Ally, and most major platforms), so your data stays in your system and you can audit our work in real time.
Related Services
Medical Billing Services
End-to-end billing for independent practices
Outsource Medical Billing
Compare in-house vs outsourced billing costs
AR Management
Aged AR recovery and payer follow-up
Denial Management
Denial analysis, appeals, and prevention
Eligibility Verification
Stop denials before the patient visit
Prior Authorization
Faster approvals, fuller schedules
Provider Credentialing
Payer enrollment handled end to end
MIPS / MACRA
Maximize quality payment adjustments
Get a Free RCM Assessment
We'll benchmark your clean claim rate, AR days, and net collections against industry standards and show you where the cycle is leaking. No commitment required.