Revenue · 1 of 7 services
Revenue cycle management
Denials down, clean claims up.
Assessment or ongoing · Denials, coding, collections · Your systems
What you receive.
Denials are usually written off as a billing problem. Most of them start at order entry, before a claim exists. Fixing the front end is cheaper than appealing, and it is the part a billing vendor cannot fix for you.
- A denial analysis by payer, by code and by reason, with the dollars attached
- A clean claim rate baseline and the specific edits that move it
- Coding review against your test menu and current payer policy
- A front-end fix list, because most denials start at order entry
- A collections and appeals workflow your staff can run
- Monthly reporting on the measures that changed
Where the money leaks
Six places we look first.
Order entry
Missing diagnosis, wrong payer, no authorization.
Coding
Panels, modifiers, and codes that changed this year.
Medical necessity
Coverage policy applied before the test runs.
Claim edits
What the clearinghouse catches and what it does not.
Denials and appeals
Worked, tracked, and closed rather than written off.
Patient balances
Estimates, statements, and the write-off rule.
The engagement
Assessment first, then a fix list with owners and dates.
Data and access
Week 1
Assessment
Weeks 2 to 4
Fix list and owners
Week 5
Execution or handover
Week 6 onward
Before you engage
Price: fixed fee for the assessment. Ongoing work quoted monthly.
Lead: a named partner, in your proposal.
How it starts: a 20-minute call, then a written scope and fee before any work begins.
Questions
Do you take a percentage of collections?
No. Percentage fees push a billing partner toward the easy dollars. We charge a fee that does not change with what you collect.
Do you replace our billing company?
Not usually. We measure them, fix what sits upstream of them, and give you the language to hold them to a standard.
How far back do you look?
Twelve months of claims data if you have it. Patterns need a year to be visible.
Cited on this page
- 42 CFR Part 414 Subpart G, clinical laboratory fee schedule (ecfr.gov)
- OIG Compliance Program Guidance for Clinical Laboratories (oig.hhs.gov)
Citations link to the official text. Nothing here replaces the current checklist issued by your accrediting body, and we read that checklist with you rather than in place of you.
Find the dollars already earned.
Twenty minutes, then a written scope. Nothing starts until you sign it.