Revenue cycle management services for healthcare practices
Revenue cycle management (RCM) covers every step from scheduling a patient to collecting the last dollar. We run the whole cycle as one process, measure it monthly and fix the stage that is slowing your cash flow.
What revenue cycle management includes
Medical billing is one part of the revenue cycle. RCM also covers what happens before the claim, like eligibility and authorizations, and after it, like denials, appeals, A/R follow-up and reporting. When different people own each step, problems fall between them. We own the whole cycle, so we can trace a denial back to the step that caused it.
Front end
Scheduling support, patient registration, insurance eligibility checks and prior authorizations.
Mid cycle
Medical coding, charge capture and entry, claim scrubbing and electronic submission.
Back end
Payment posting, denial management, appeals, A/R follow-up and patient collections.
Oversight
KPI dashboards, fee schedule reviews, underpayment checks and monthly review calls.
The KPIs we report every month
You can't improve what you don't measure. Every client gets the same core metrics each month, with trends and a short note on what is driving them:
| Metric | What it tells you |
|---|---|
| Days in A/R | How long, on average, it takes to get paid after a visit. |
| A/R over 90 days | How much money is aging and at risk of never being collected. |
| First-pass acceptance rate | The share of claims accepted on the first submission. |
| Denial rate | The share of claims denied, broken down by reason and payer. |
| Net collection rate | How much of the money you are owed you actually collect. |
| Charge lag | How long it takes from the visit until the charge is entered. |
How an RCM engagement starts
- Baseline. We pull recent claims, payments and A/R aging to measure where you stand today.
- Findings. We show you the biggest leaks, such as a denial reason that keeps repeating or a payer that consistently underpays.
- Takeover. We sign a BAA, get system access and take over new claims while we work your existing A/R.
- Monthly review. KPIs, trends and a short action list, reviewed with you every month.
When outsourced RCM makes sense
- Days in A/R or the 90-plus-day bucket keep growing.
- Denials are rising and nobody has time to find out why.
- Your billing depends on one person, and the work stops when they're away.
- You're adding providers or locations faster than your back office can keep up.
Frequently asked questions
What is the difference between medical billing and RCM?
Medical billing is the claims and payments part of the process. Revenue cycle management covers the full cycle, including eligibility, authorizations, coding, denials, A/R follow-up, patient collections and reporting.
How long before we see results from RCM?
Clean-claim and rejection improvements usually show within the first month or two. Reductions in older A/R take longer, because aging claims have to be worked payer by payer.
Will we still have access to our data?
Yes. All work happens in your own EHR and PM system. You keep full ownership of and access to your data at all times.
Can you take over RCM from our current billing company?
Yes. We plan the handover so new claims switch to us on a set date while we work through the A/R your previous biller left behind.
Often paired with revenue cycle management
Find out where your practice is losing revenue
Book a free, no-obligation practice review. We look at your claims, denials and A/R and send you a written summary of what we would fix first.