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The RCM Factory

Four precision-engineered lanes.
Zero revenue left behind.

Most billing companies handle claims. We operate a full revenue cycle factory — a systematic, stage-by-stage pipeline where every dollar is tracked, validated, and collected.

01 · Front-End 02 · Mid-Cycle 03 · Back-End 04 · Recovery
The Pipeline

How the factory works

98.6%
Clean Claim Rate
↓ 38%
A/R Days Reduction
94%
Denial Recovery Rate
24hr
Claim Submission SLA
Lane 01

Front-End RCM

Prevention is the most cost-effective strategy in revenue cycle management. Our front-end team intercepts revenue risk before a single claim is submitted — verifying eligibility, securing authorizations, and confirming benefits with surgical precision.

1
Real-Time Eligibility Verification270/271 transactions across all major payors. Verified before every appointment.
2
Prior Authorization ManagementHBOT and wound care auth workflows — peer-to-peer reviews when required.
3
Benefit Analysis & CoordinationDeductibles, co-pays, out-of-pocket maximums analyzed and communicated upfront.
4
Patient Financial CounselingTransparent cost communication reduces post-care disputes and bad debt.
1.9%
Front-end denial rate
↓ vs 8–12% industry avg
Lane 02

Mid-Cycle RCM

The mid-cycle is where clean claims are made. Our certified coders and claim scrubbing technology ensure every charge is captured, every code is accurate, and every claim is validated before it ever reaches a payor.

1
Charge Capture & EntryAccurate charge entry with specialty-specific CPT/ICD-10/HCPCS coding for HBOT, wound care, and clinic services.
2
Multi-Layer Claim ScrubbingAutomated + manual review catches errors before submission. Modifier validation, LCD/NCD compliance checks.
3
Electronic Claim Submission837P/I transmission with clearinghouse validation. 24-hour submission SLA from date of service.
4
Real-Time Claim TrackingEvery claim tracked from submission to adjudication with proactive follow-up queues.
Claim Validation Score
Code Accuracy99.2%
Modifier Compliance98.7%
Clean Claim Rate98.6%
24hr Submission Rate97.4%
98.6%
First-Pass Clean Claim Rate
Lane 03

Back-End RCM

Payment is only half the equation. Our back-end team ensures every remittance is accurately posted, reconciled against expected reimbursement, and that secondary billing maximizes total collections.

1
ERA/EOB Payment PostingElectronic remittance posted within 24 hours of receipt. Manual EOBs processed same day.
2
Contractual Adjustment ReconciliationEvery payment validated against contracted rates. Underpayments flagged and appealed automatically.
3
Secondary & Tertiary BillingAutomatic crossover to Medicare Supplement, Medicaid, and secondary payors maximizes collection per claim.
4
Patient Balance ManagementClear, compliant patient statements with payment portal integration and structured follow-up.
Monthly Reconciliation Summary
100%
ERAs Reconciled
24hr
Posting SLA
96%
Secondary Billed
0%
Unposted Funds
Lane 04

Recovery

Denials are not a dead end — they're a revenue opportunity. Our denial management and AR recovery team works every aged claim, every appeal, and every outstanding balance with a structured, data-driven approach.

1
Denial Root Cause AnalysisEvery denial categorized, analyzed, and fed back into upstream prevention. The loop closes.
2
Appeals & ReconsiderationsTimely, well-documented appeals with clinical documentation support. Peer-to-peer coordination for complex cases.
3
AR Aging ManagementSystematic follow-up buckets: 30/60/90/120+ days. Nothing ages out without action.
4
Trend Reporting & Prevention LoopMonthly denial trend reports identify systemic issues. We fix upstream problems, not just symptoms.
94%
Denial Recovery Rate
Avg appeal turnaround 48 hrs
Claims 90+ days < 4%
Write-off rate < 1.2%
Get Started

Ready to engineer your revenue?

Schedule a Revenue Performance Review and we'll show you exactly where your current cycle is leaking — and what we'd do about it.

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