Custom RCM Architecture for
Every Healthcare Sector.

Hospitals & Acute Health Systems

Managing acute hospital revenue requires mastery of complex DRG validation, UB-04 institutional charges, facility fee structures, and multi-tier payer contracts. Our specialized hospital billing division stops revenue leakage before it happens.

• ✕ High dollar claim denials stuck in complex payer medical reviews
• ✕ Ballooning 90+ day uncollected AR dragging down institutional liquidity
• ✕ DRG documentation gaps leading to millions in annual unbilled revenue leakage
• ✕ Cross-department coordination gaps between clinical charts and billing

• Dedicated Hospitalist and Inpatient Charge Capture & Billing Pods
• Automated clearinghouse rules scrubbed against UB-04 institutional edits
• High-Dollar Claim Triage resolving 6-figure denials within 72 hours
• Top EHR & PMS platforms: eClinicalWorks, Cerner, Epic, NextGen Healthcare, Meditech, plus majority of EPMs

Physician Groups & Specialist Practices

From solo practitioners to 50+ provider multi-specialty groups, clinical practice margins depend on error-free charge entry, modifier optimization, and active pre-visit eligibility.

• ✕ Front-desk staff overwhelmed by repetitive prior authorization calls
• ✕ Frequent denial rejections on Modifier 25, 59, and bundling edits
• ✕ Delayed payment posting causing misleading patient statements
• ✕ Uncollected patient co-pays and deductibles turning into bad debt

• 48-hour pre-visit insurance eligibility & deductible confirmation
• Dedicated charge entry, claim scrubbing & denial recovery (no medical coding)
• Same-day electronic 835 ERA posting and bank reconciliation
• Direct PMS integration: eCW, Cerner, NextGen, Epic, and Meditech

Dental Practices & Multi-Location DSOs

Dental billing demands specialized CDT claim knowledge, dental frequency tracking, breakdown of benefits, and surgical cross-billing for sleep apnea and oral surgery procedures.

• ✕ CDT rejections due to missing radiographic narratives or periodontal charts
• ✕ Dental insurance maximum limits and frequency limitations overlooked
• ✕ Complexity of billing medical insurance for oral surgery procedures
• ✕ Slow manual payment posting delaying secondary dental claims

• Exhaustive pre-visit dental breakdown of benefits and history
• Specialized CDT narrative preparation and electronic attachment dispatch
• Medical-dental cross-billing maximizing reimbursement for surgical cases
• Direct expertise in Dentrix, Eaglesoft, Open Dental, and Curve Dental

Healthcare BPO, Diagnostic Labs & Payers

Scale your administrative throughput overnight with our dedicated offshore BPO delivery centers specializing in medical chart indexing, transcription, lab orders, and virtual front-office support.

• ✕ Backlog of unstructured incoming e-faxes, referrals, and lab requisitions
• ✕ High domestic administrative staffing costs and unpredictable turnover
• ✕ Difficulty achieving overnight turnaround for next-day clinical visits
• ✕ Maintaining strict HIPAA compliance with remote contractor staff

• Secure biometric delivery centers with strict SOC 2 Type II data controls
• Overnight 12-hour turnaround for clinical chart indexing and digitization
• Scalable elastic capacity adapting immediately to seasonal volume spikes
• Virtual administrative receptionists for patient booking and credentialing