Frequently Asked Questions

Complete end-to-end revenue cycle management including:

• Insurance eligibility verification
• Medical coding (CPT, ICD-10, HCPCS)
• Charge capture and entry
• Claim creation and scrubbing
• Claims submission (electronic/paper)
• Payment posting
• Denial management and appeals
• Accounts receivable follow-up
• Patient billing and collections
• Monthly reporting and analytics

100% human expertise — no AI. Our billers have 8+ years average experience and have worked in actual healthcare practices. Every claim gets manual review by someone who understands medical nuances.

Simple and transparent: percentage-based or flat fee options available. No hidden fees, no long-term contracts. Month-to-month agreements with straightforward pricing.

We investigate every denial, identify root causes, appeal when appropriate, and track patterns to prevent future denials. Our team has seen every denial reason and knows payer-specific requirements.

Our typical timelines:

• Commercial payers: 70-100 days (industry: 90-150)
• Medicare: 45-60 days
• Medicaid: 50-70 days
• Demographic updates: 20-35 days

We handle everything:

• CAQH, PECOS, NPPES portal management
• Proactive re-credentialing before deadlines
• New payer additions
• Demographic updates
• Monthly status reports
• Expiration alerts

Yes, we provide fee negotiation services. Our team analyzes your current contracts, benchmarks against industry rates, and negotiates with payers for better reimbursement.

98% success rate across all 50 states. We credential providers in 60+ specialties and 25+ facility types.

Yes — completely included at no additional cost when you sign up for any RCM package. We handle all system integrations as part of your onboarding.

We support all major platforms including Epic, Cerner, athenahealth, NextGen, eClinicalWorks, Allscripts, Meditech, Greenway, Practice Fusion, AdvancedMD, Kareo, and DrChrono.

All major clearinghouses: Change Healthcare, Availity, Zelis, Waystar, Office Ally, Trizetto, Gateway EDI, SSI Group, Optum, and more.

Most setups are completed within 2-4 weeks, depending on system complexity and payer requirements.

Real-time verification — typically within minutes. We check patient coverage, benefits, copays, deductibles, and out-of-pocket maximums instantly.

Average 24-hour turnaround for most auths. Timelines vary by service:

• Radiology: 24-48 hours
• Surgery: 3-5 days
• Specialty meds: 2-7 days
• Behavioral health: 24-72 hours

Yes — we proactively track expiring authorizations and handle renewals before they lapse, preventing claim denials.

500+ payers including Medicare, Medicaid, Aetna, Cigna, UnitedHealthcare, Blue Cross, Humana, Kaiser, and all major commercial plans.

• EDI: Electronic claim submission (837 files)
• EFT: Electronic funds transfer — payments go directly to your bank
• ERA: Electronic remittance advice (835 files) that auto-post to your system

We manage 50+ portals including Zelis, Echo, PaySpan, Availity, PayerEnrollServices, Change Healthcare, Waystar, Optum Pay, InstaMed, Office Ally, Navinet, and Passport.

Yes — we monitor all portals daily, handle re-enrollments, update banking/demographic info, and provide monthly status reports. You never have to log in.

Most EFT/ERA setups are completed within 24-48 hours. EDI enrollment may take 2-3 weeks depending on payer.