MEDICAL REVENUE CYCLE SERVICES

This is your core “done-for-you” service. It typically includes patient registration support, eligibility checks, claim submission, charge entry review, payment posting, denial management, AR follow-up, appeals, and reporting. This is your highest-value, recurring monthly service.

Short-term engagement focused on aged accounts receivable. You go in, identify aging buckets (90/120/180+ days), work denials, reprocess claims, and recover lost revenue. This is great for onboarding new clients or one-time cash infusions.

Real-time or pre-visit verification of benefits, eligibility, copays, deductibles, and authorization requirements. Often sold as a per-visit or per-provider monthly service.

Focused service line where you only handle denials, underpayments, and appeals. Includes root cause analysis (timely filing, auth issues, coding, eligibility, etc.) and payer follow-up.

ERA/EOB posting, balancing deposits, identifying underpayments, and reconciling payer remits against expected reimbursement. Often bundled with RCM or offered separately for practices that already have billing staff.

Provider enrollment, CAQH maintenance, payer updates, and new payer setup. This is a strong add-on service because it’s project-based and high demand.

You review their entire billing process, EMR setup, charge capture flow, denial patterns, and staff workflow. Then you provide a corrective action plan. This is more consulting-heavy and high margin.

Patient statements, balance follow-up, payment plan setup, and patient billing inquiries. Useful for small practices that don’t want front desk staff handling financial conversations.

Teaching staff how to properly use systems like Athena, NextGen, AdvancedMD, Epic workflows, charge entry, and billing best practices. This differentiates you because it’s not just billing—you’re building competency.

Covers things like backlog clearing, system transitions (EMR migrations), staffing gaps, or temporary billing coverage.