RCM Cycle
Ten steps.
One seamless cycle.
Each step can break. We know where, and why.
Before the visit
Demographics Entry
The RCM cycle
Ten steps.
One seamless cycle.
Each step can break. We know where, and why. Choose a step to see what goes wrong there and how we handle it.
01 · Demographics Entry
A misspelled name, a transposed member ID or a stale address is enough to reject a claim before anyone looks at the clinical detail. We capture and validate patient and subscriber data at registration, and correct what comes in wrong rather than passing it downstream.
- 01Before the visit
Demographics Entry
Patient and subscriber details captured correctly the first time.
A misspelled name, a transposed member ID or a stale address is enough to reject a claim before anyone looks at the clinical detail. We capture and validate patient and subscriber data at registration, and correct what comes in wrong rather than passing it downstream.
- 02Before the visit
Eligibility Verification
Coverage confirmed before the visit, not discovered after the denial.
Every scheduled patient is checked ahead of the appointment: active coverage, plan type, network status and effective dates, plus coordination of benefits where a secondary payer exists. Your front desk gets the answer before the patient arrives.
- 03Before the visit
Benefits Verification
What the plan actually covers, and what the patient owes.
Eligibility says the policy is active. Benefits say what it pays for. We confirm deductible met, copay, coinsurance, visit limits and out-of-pocket remaining, so patient responsibility is known before the encounter rather than argued about after it.
- 04Around the encounter
Charge Entry
Everything performed gets entered, daily.
Charges are entered daily against the schedule. Work that was performed and never billed never shows up as a denial — it simply isn't there — so we reconcile the day's appointments against posted charges and flag what is missing while the documentation is still fresh.
- 05Around the encounter
Charge Validation
ICD and CPT codes verified against the documentation.
Your clinical team assigns the codes. We verify them: diagnosis supports the procedure, the E/M level matches the documented decision-making, modifiers are correct, and nothing is unbundled that shouldn't be. We validate — we do not supply certified coders.
- 06Around the encounter
Claim Creation
Clean claims assembled to each payer's rules.
Claims are built to the specific payer's requirements, with the right place of service, referring provider, authorization number and secondary details attached before submission rather than after a rejection.
- 07Around the encounter
Claim Submission
Scrubbed, submitted, and rejections fixed same-day.
Claims are scrubbed against payer-specific edits before they leave. Clearinghouse rejections are corrected and resubmitted the same day, so nothing sits in a queue while the timely filing clock runs down.
- 08After the claim goes out
Payment Posting
Posted within 24 hours, checked against the contract.
ERAs and manual EOBs are posted at line level within 24 hours, with your contracted rates loaded so every payment is compared to what the contract actually owed. Underpayments become a worklist instead of a rounding error.
- 09After the claim goes out
AR Follow-up
Worked by value and age, on a fixed cadence.
Aged balances are worked by balance and age rather than alphabetically, with payer follow-up on a set schedule, timely-filing protection on at-risk claims, and defined escalation for anything stuck in review.
- 10After the claim goes out
Denial Management
Root-caused, appealed, and prevented from recurring.
Every denial is categorized to a root cause, appealed with the supporting documentation attached, and reported back upstream — so the same denial reason stops arriving next month.
Get a Free Revenue Cycle Assessment
Send us a sample of your denials and aged AR. We'll come back with where the money is going, what it's worth to fix, and how long it takes.