Stop overspending on in-house billing departments. High overhead and delayed payments undermine hospital financial stability. We provide customized, end-to-end revenue cycle management solutions tailored to your hospital’s operational goals.
From AR recovery to advanced EHR integration, our expert team handles the complexities of hospital billing so you can focus on patient care.
Key Performance Indicators (KPIs) that Drive Growth. Whether you run a rural hospital or a large inpatient facility, our track record proves we reduce administrative burden and improve revenue.
With our hospital billing and revenue cycle management services, you can expect:
We offer customized billing services for a broad range of providers, ensuring specialty-specific compliance: Our company conducts thorough compliance audits to ensure your practice meets all regulatory requirements.
Acute Care Hospitals
Community and Regional Hospitals
Long-Term Acute Care Hospitals (LTACHs)
Specialty and Surgical Hospitals
Cancer Treatment Centers
Children’s and Pediatric Hospitals
Rehabilitation and Long-Term Care Facilities
Government and Public Health Hospitals
Rural and Critical Access Hospitals
If your hospital handles billing in-house, each resubmitted claim adds to your administrative costs. Even minor errors lead to denials that consume valuable resources.
We process over 65,000 claims daily. Our specialists review every claim thoroughly and submit it within 48 hours.
Medicare rules alone span more than 130,000 pages. We handle these complexities for you. Below is how we support your revenue cycle across all care settings.
| Process Step | Inpatient Billing Services | Outpatient Hospital Billing Services | |
|---|---|---|---|
| 1 | Registration & Scheduling | Schedule admissions, confirm identity, and verify coverage limits for extended stays. | Schedule visits, verify insurance, and provide upfront cost estimates to collect co-pays. |
| 2 | Insurance Verification & Prior Authorization | Verify eligibility for admission, check limits, secure prior authorization for surgeries or extended care, and confirm medical necessity to prevent coverage denials. | Confirm coverage for procedures, imaging, and obtain prior authorization as needed. |
| 3 | Charge Capture & Revenue Integrity | Record all inpatient services accurately, update the CDM and CMI to prevent missed charges, and collaborate closely with providers to ensure accurate CDI and DRG grouping. | Record all outpatient services clearly, match charges accurately to CPT/HCPCS codes, and double-check entries to prevent missed charges and speed up reimbursement. |
| 4 | Medical Coding | Assign ICD-10-CM for diagnoses, ICD-10-PCS for inpatient procedures, and group cases into DRGs for Medicare billing. | Assign ICD-10-CM codes for diagnoses and CPT/HCPCS codes for procedures; apply the correct modifiers for compliance. |
| 5 | Claim Submission | Generate UB-04 claims with proper DRG codes; scrub for errors and submit within timely filing limits. | Prepare UB-04 or CMS-1500 claims, verify them with claim scrubbers, and submit clean claims promptly to minimize denials. |
| 6 | Payment Posting & Reconciliation | Post payments from ERA/EOB, match deposits, apply adjustments, and handle secondary claims for inpatient charges. | Post payments and patient co-pays quickly, reconcile deposits, and manage follow-ups on partial payments. |
| 7 | Denial Management & Appeals | Use the IMMP (Identify, Measure, Manage, Prevent) process for inpatient claim denials, resubmit corrected claims, and file appeals or peer-to-peer reviews. | Analyze the root cause for outpatient denials, correct coding or documentation issues, and manage appeals efficiently to recover revenue. |
| 8 | A/R Follow-Up & Collections | Focus on high-value inpatient accounts, track aging buckets, and follow up on unpaid balances to reduce AR by up to 35%. | Monitor large volumes of outpatient accounts, utilize automated reminders, and follow up promptly on overdue balances. |
| 9 | Reporting & Insights |
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We guarantee full compliance with U.S. hospital billing laws. Our experts undergo continuous training to ensure your process is audit-ready.
We offer comprehensive enterprise billing solutions to streamline large-scale healthcare operations
Find out exactly what’s slowing down your cash flow. Our free assessment identifies root causes of delays.
Our Assessment Workflow:
We combine hospital billing expertise with advanced automation, delivering your facility the precision, speed, and control that today’s revenue cycle demands.
Stop revenue leaks from DRG downgrades and POA errors. Our AAPC-certified coders specialize in complex hospital billing. We work fluently with UB-04 forms, MS-DRG coding, and ICD-10-CM/PCS.
Many billing companies struggle when hospitals operate across multiple departments. We don't. From oncology to orthopedics, we understand the full picture:
We combine hospital billing expertise with Robotic Process Automation (RPA), delivering the precision and speed your revenue cycle demands..
Integrated with Epic, Cerner, & Meditech: We integrate directly with your hospital systems using HL7 and FHIR protocols. This ensures accurate, secure, and real-time data flow between clinical and billing platforms.
Our hospital billing software enables your staff to manage appointments, demographics, and billing securely all-in-one place. You can keep your current system or switch to ours—we support both.
Request a free demo to see how we can simplify hospital billing and improve accuracy.
Over a decade of zero HIPAA breaches. Our operations are certified to the highest industry standards:
Our company provides accurate inpatient coding services to ensure proper documentation and billing.
Achieve up to 35% more revenue. We manage front-end, mid-cycle, and back-end processes to increase clean claim rates, reduce A/R days, and support sustainable growth.
