20+ Executive RCM Services
Tailored medical billing, credentialing, and revenue management designed to reduce administrative tasks and maximize practice cashflow.
Medical Billing & Scrubbing
Our seamless medical billing process enhances efficiency by scrubbing code errors 24/7, enabling precise claim submissions and accelerating payer reimbursements.
Key Deliverables
- 98%+ Clean Claim Rate
- Daily Electronic Claims
- 24-hr Denial Appeals
Accounts Receivable Recovery
We boost practice cashflow by aggressively following up on unpaid 30-90+ day claims, resolving payer rejections, and minimizing revenue leaks.
AR Deliverables
- 45% AR Days Reduction
- Aged 90+ Day Claims Audit
- Dedicated Appeals Specialist
Insurance Verification
Real-time pre-appointment patient eligibility and benefit verification, preventing denied claims due to terminated coverage or copay errors.
Verification Deliverables
- 24-hr Advance Verification
- Copay & Deductible Tracking
- Prior Auth Confirmation
Provider Credentialing
Our team navigates Medicare, Medicaid, and private commercial payer enrollment, ensuring physicians meet standards to bill in-network.
Credentialing Deliverables
- Fast-Track Payer Enrollment
- CAQH & NPI Maintenance
- Contract Fee Schedule Audit
Re-Validation Services
Timely payer re-validation documentation and credential maintenance to avoid network dropouts and hold-backs.
Re-Validation Deliverables
- Medicare PECOS Sync
- Zero Payment Hold-back
- Expiration Alert Tracking
EFT & ERA Setup
Direct electronic funds transfer and electronic remittance advice setup for direct bank deposit payments without paper check delays.
EFT/ERA Deliverables
- Automated Auto-Posting
- Instant Direct Bank Deposit
- 835 ERA Reconciliation
MIPS Reporting Compliance
Data-driven MIPS compliance management to optimize quality scores and maximize CMS incentive payments for eligible clinicians.
MIPS Deliverables
- Quality Measure Selection
- Positive Payment Adjustments
- Penalty Avoidance Guarantee
CCM & RPM Programs
Turn-key Chronic Care Management and Remote Patient Monitoring workflows adding substantial monthly recurring practice income.
CCM/RPM Deliverables
- CPT 99490 & 99453 Billing
- Recurring Monthly Revenue
- 20-min Clinical Logging
Telehealth Billing
Specialized virtual care coding (CPT 99421-99423, GT modifiers) ensuring full reimbursement for digital health encounters.
Telehealth Deliverables
- GT/95 Modifier Scrubbing
- E-Visit & Tele-consult Claims
- Full Payer Parity Support