Works with your ecosystem
What we handle
- Eligibility & benefits verification
- Charge entry & coding QA (CPT/ICD-10 modifiers)
- Claim scrubbing & submission via clearinghouse
- Denial management & corrected claims
- Payment posting (ERA/EOB) with adjustments
- AR follow-up & patient balance outreach
- Month-end reporting & analytics
- Optional: provider credentialing & enrollments
What you keep
- Clinical documentation & coding decisions
- Patient financial policies & pricing
- Final approval on appeals & write-offs
- Bank accounts & merchant services
We’ll sign a Business Associate Agreement (BAA) and use your logins and payer enrollments.
Your revenue cycle, made simple
Enrollment & Access
Payer enrollments, clearinghouse linking, role-based access in Tebra.
Eligibility
270/271 checks and patient responsibility estimation.
Charge Entry
CPT/ICD-10 capture, modifiers, units; missing info resolution.
Claim Scrub & Send
Edits, NPI/Taxonomy, clearinghouse submission (837P/837I).
Denial Management
CARC/RARC analysis, corrected claims, appeals & notes.
Payments & Posting
ERA/EOB posting, CO-45/CO-97, secondary billing, patient bills.
AR Follow-up
Work queues by aging, payer, and value; call logs and outcomes.
Reporting
Month-end KPIs, payer mix, charge lag, denial trends, cash forecast.
What success looks like
Targets vary by specialty and payer mix. We’ll baseline and set clinic-specific goals.
Starter (per-encounter)
Best for solo/small clinics.
- Eligibility, charge entry, claims, posting
- Denials & AR follow-up (lite)
- Monthly KPI report
Growth (percent of collections)
End-to-end RCM for growing groups.
- Full denials/appeals & AR work queues
- Patient statements & payment plans
- Weekly status + month-end review
Enterprise (custom)
Multi-specialty and multi-location.
- Dedicated team & SLAs
- Credentialing & payer contracting
- Custom BI dashboards & automations
FAQ
Do you work inside our Tebra account?
Yes. We use your Tebra organization with role-based access. You retain full ownership of data and payer enrollments.
How do you charge?
Either per encounter, hourly, or a percentage of monthly collections—whatever aligns best with your volume and mix.
HIPAA compliance?
We sign a BAA, restrict PHI to least-privilege access, and follow secure communications & audit trails.
US time zones & phones?
Yes—US support numbers and coverage aligned to your clinic hours. We can use a shared inbox and recorded lines.
Let’s improve collections and lower denials
We’ll audit your Tebra reports, baseline KPIs, and present a 90-day RCM improvement plan.