FAQ
Getting Started
You send us a recent accounts receivable aging report and, where possible, a denial export. We review them and give you a written breakdown: where recoverable revenue is sitting, which denial reasons are costing you most, what your timely-filing exposure looks like, and the fixes we would make in priority order. It is yours to keep whether or not you work with us. Please do not include patient health information — we only need claim-level financial data.
Most of the timeline is payer enrollment and EDI setup, and neither is fully in our control — that is the honest answer. Practices already enrolled with their payers typically start seeing claims go out within two to three weeks. Where new enrollments or revalidations are needed, budget longer, because the payer sets that pace. We tell you which of the two you are in after looking at your current setup.
Solo practitioners are often the strongest case for it, not the weakest. A one-person billing office has no redundancy — a vacation or a resignation stops your revenue cycle, and the cost is not the temp, it is the AR that ages and the claims that pass their filing deadline while nobody is working them.
Access to your existing EMR/PMS, your payer list and contracts, your fee schedule, and a recent AR aging report. If you are moving from another biller, we also need clarity on who works the open AR at transition — that is the single most commonly mishandled part of a billing switch.
Services & Scope
Eligibility verification, charge entry, coding review, claim submission, clearinghouse rejection handling, payment and adjustment posting, denial management and appeals, patient statements, and AR follow-up. Credentialing and billing audits are separate services — see the Services pages for scope on each.
We list the specialties we have real coding depth in on the Specialties page rather than claiming universal coverage — that is easy to disprove and costs trust on the first call. If yours is not listed, ask. We would rather tell you honestly than take work we cannot code well.
Both are possible. We can bill from your coded charges, or our coders can assign and review codes against your documentation. Where we code, review runs in both directions — consistent under-coding is a revenue loss and a compliance problem, not a safe default.
Yes, and it is usually where the fastest recovery is. We triage aged AR by timely-filing deadline first rather than by age, because the oldest claim is not always the most urgent one. Write-off recommendations come to you with a documented rationale — we do not absorb them silently.
Claim-level visibility of what was billed, collected, denied and still open, plus denial grouping by root cause and payer, AR aging by bucket and payer, and net collection rate against contracted allowables. If a report cannot be tied back to individual claims, it is not reporting — it is a summary.
Pricing & Contracts
Revenue cycle management is priced as a percentage of collections rather than a flat fee, which aligns the incentive: we are paid when you are paid. The rate depends on provider count, specialty mix and claim volume, so we quote it after the free audit rather than publishing a number that would be wrong for most practices. One thing worth asking any billing partner: whether their percentage is calculated on collections or on charges. Those are very different numbers.
No multi-year lock-in. TEMP — confirm the exact notice period. What matters more than the length is what happens to open AR at termination: we continue working claims already submitted through their adjudication rather than dropping them the day notice is given, so you are not left with an unworked book. Get that commitment in writing from any billing partner, including us.
TEMP — confirm. State plainly whether there is a setup or transition fee and exactly what it covers, because the answer buyers fear is a fee that appears after signature.
You do. The practice owns its data — claims, payments, patient demographics, all of it. On termination you receive a usable export, not a PDF dump, and access is not withheld as leverage. Ask for that in writing from any billing partner.
Ready to see what you're leaving behind?
Book your appointment today and take the first step towards a clearer picture of your revenue. Our team is ready to help.