Increase your revenue with Prime Doc Billing’s expert Revenue Cycle Management (RCM) services. We streamline healthcare financial operations through medical coding, claim processing and denial management to ensure timely and accurate reimbursements.
Partner with Prime Doc Billing for rcm services to get real results in revenue growth (up to 25% increase in net revenue).
Prime Doc Billing focuses on improving the cashflow of your practice with smarter RCM solutions. We streamline every step of the RCM process with fewer administrative burdens. Our revenue-focused team uses proven strategies to prevent errors at the front end through accurate coding and strict adherence to the payer-specific rules. Compliance with the RCM guidelines ensures cleaner claims and faster reimbursements with a predictable revenue.
Prime Doc BIlling provides the following RCM services:
Credentialing and enrollment services are the base of the revenue cycle. Our Credentialing services ensure that the providers are accurately verified including the education, training, license and certifications. After credentialing, Prime Doc Billing enrolls the providers with payers to receive accurate reimbursements for services provided. The credentialing process includes CAHQ setup, revalidations, and renewals.
Patient Access represents the accurate capturing of the patient and insurance information. Prime Doc Billing handles every aspect of your revenue cycle management from patient registration to financial counseling support. We support patient access through accurate eligibility verification and efficient prior authorization handling.
Prime Doc Billing’s eligibility and benefits verification services ensure the validity of a patient’s insurance coverage. Our eligibility verification services include verifying coverage details, benefit limits, copays, deductibles, out-of-network status, coinsurance and plan restrictions. By understanding the financial responsibility upfront, we reduce the risk of denials caused by inactive patient’s insurance.
Prior authorization services refers to the process of obtaining payer approval before the delivery of certain services. Our prior authorization services in the RCM process includes authorization request submission, clinical documentation, status monitoring, renewal tracking, and appeals. Prime Doc BIlling’s prior authorization services prevent denials related to expired authorizations.
The process of entering coded medical services into the RCM system is called charge entry. Our precision-driven team reviews coded charts, and applies accurate CPT, ICD-10, HCPCS codes and modifiers to ensure accurate claims. We minimize billing errors and avoid undercoding or overcoding for accurate charge entry in the RCM cycle.
Prime Doc Billing’s certified coders convert clinical documentation into standardized CPT- ICD-10, and HCPCS codes to ensure maximum reimbursement. Our coding and documentation services include reviewing provider information, assigning accurate codes, and identifying documentation gaps to prevent audit risks and denials.
Prime Doc Billing’s medical scribing services ensure documentation accuracy at the time of service. Our scribes document the provider and patient encounter in real-time within Electronic Medical Record (EMR). We maintain detailed and compliant clinical notes to support accurate coding so the provider stays focused on patient care.
Medical billing is the key part of the entire Revenue Cycle Management (RCM) process. Prime Doc Billing manages everything from claim creation to payment processing to streamline your billing cycle. We focus on maximizing clean claim rates and reducing claim denials and delays to maintain predictable and healthy cash flow.
Prime Doc Billing’s accounts receivables management focuses on recovering unpaid claims to maintain a strong cash flow within the RCM process. Our A/R team reviews and manages aging reports, unpaid claims, underpayments, and appeals. We prioritize effective A/R follow up to reduce the risk of lost revenue for the practice.
Our denial management process acts as a proactive RCM service that analyzes and resolves claim denials. Prime Doc Billing investigates denials, corrects claims and submits appeals to the insurance payers. We identify the root cause of claim denials like missing data and eligibility errors to prevent future denials leading to the practice’s revenue loss.
Prime Doc Billing’s medical virtual assistants (VA) support clinical and administrative workflows remotely to improve billing efficiency. Our VA assists the providers with patient scheduling, daily reminders, insurance checks, data entry and RCM coordination. We ensure smooth practice operations while reducing the administrative burden from your front desk operators.
Workers Compensation billing services involve managing claims for workplace injuries. Our workers compensation billing experts follow strict state-regulated protocols to handle claim submission, documentation collection, employer-insurer coordination, and follow-ups. We use a specialized approach to ensure accurate reimbursement against the complex rules for workers compensation.
A Revenue Cycle Management (RCM) audit reviews end-to-end revenue cycle to identify compliance risks, inefficiencies, and the revenue leakage. Prime Doc Billing’s RCM audit includes evaluating patient access workflows, billing and documentation accuracy, denials, and A/R trends. We provide practical recommendations to improve clean claim rates and maximize financial performance.
We provide scalable RCM solutions for every kind of healthcare provider and practices. Some of them includes:
Prime Doc Billing streamlines front-end processes for individual doctors and nurse practitioners. We provide tailored Revenue Cycle Management solutions to ensure accurate billing, coding and compliant charge capture. Our goal is to reduce administrative workload and eliminate payer delays so the doctors and nurse practitioners focus directly on patient care.
Private practices struggle with staffing challenges and changing payer rules, making it hard for them to manage revenue. Our RCM solutions are tailored for private practices to improve their scheduling accuracy, coding quality and claim performance. We help the practices maintain a predictable cash flow for stronger financial health.
We provide hospital-focused RCM services to strengthen charge capture accuracy, streamline billing workflows and improve coding compliance. Our RCM experts focus on protecting revenue integrity and enhancing reimbursement outcomes at a larger scale.
Laboratory service providers face unique RCM challenges like medical necessity requirements, payer-specific coding protocols, and frequent claim rejections. Prime Doc Billing provides lab-focused RCM services to ensure each test order is supported with accurate documentation and correct coding. Our consistent follow-up on unpaid claims allows the laboratories to improve reimbursement rates while reducing claim denials.
Prime Doc Billing partners with sister medical billing companies as a back-office to help them manage billing, coding, A/R, and denial resolution. We maintain service quality to help the billing companies meet client expectations without any additional operational burden.
Prime Doc Billing’s RCM services help small practices avoid preventable denials and ensure clean claim submissions for an improved revenue reliability.
Home health agencies work within strict documentation and compliance requirements. Our RCM solutions help the agencies manage authorization workflows and ensure accurate coding for the services delivered in home. We help agencies reduce denials and improve cash flow so they stay focused on delivering compassionate in-home care.
Prime Doc Billing provides optimized RCM services for all healthcare specialties across the US. Some of them are:
Our cardiology-focused RCM services ensure accurate coding, prior authorization and proactive follow-up for complex procedures like echocardiograms and catheterizations. We handle the high-volume claims in cardiology RCM to maximize reimbursements and maintain compliance.
Our dental RCM services include verifying patient coverage, posting accurate coding and submitting claims. Our RCM specialists streamline workflows for dental offices to reduce claim rejections and improve cash flow.
Our dermatology RCM solutions ensure proper coding for both in-office procedures and cosmetic services. We verify coverage and handle prior authorizations beforehand for cleaner claim submissions.
Prime Doc Billing provides optimized RCM services for urgent care to help them maintain a steady cash flow. Predictable revenue helps the urgent care centers provide rapid and efficient patient care.
Podiatrists perform a mix of routine care and specialized procedures. Our podiatry RCM services include accurate charge entry, claim submissions and denial management, all tailored to podiatric care.
Radiology practices handle a high volume of imaging services with complex coding. Prime Doc Billing optimizes their radiology RCM solutions from patient scheduling to payment follow-ups. We help the radiology centers reduce denials so they stay focused on diagnostic accuracy.
Optometry practice provides both vision-related and medical services, involving different insurance plans. We tailor our optometry RCM services to maintain compliance with the payer rules and ensure timely payments.
Oncology practices deal with complex treatment plans and expensive medications. Prime Doc Billing’s oncology-focused RCM services focus on managing prior authorization and eligibility verification timely. We submit claims and track denials for the oncologists to focus on patient care without worrying about revenue loss.
Anesthesiologists often provide their services across multiple settings including surgery centers and outpatient clinics. Our anesthesiology RCM services ensure accurate coding and modifier application for anesthesia. We focus on timely reimbursements so the anesthesiology practices focus on patient care while maintaining compliance.
Nephrology practices deal with chronic care, and dialysis which involves complex payer rules and documentation requirements. Prime Doc Billing’s nephrology RCM services ensure accurate coding for dialysis and related treatments to optimize reimbursements.
Mental health providers face unique challenges like multiple sessional codes and patient privacy considerations. We provide mental health RCM services with strict confidentiality so the mental health practices can maintain uninterrupted patient care.
Durable Medical Equipment (DME) providers have to deal with frequent prior authorizations. Our DME revenue cycle management services include verification of patient coverage and accurate coding of supplies and equipment. Timely reimbursements help the DME providers to focus on patient access to essential equipment.
Achieve real results with our innovative RCM services that are designed to streamline your revenue cycle and maximize financial performance.
Prime Doc Billing provides proven results for healthcare providers, enabling them to experience:
Our experts identify the need for referral requirements and out-of-network rules to prevent claim denials before the patient’s cardiology visits.
Because we deliver optimized, complaint, and specialty-focused RCM solutions for your practice.
Partner with Prime Doc Billing to maximize your practice’s financial performance while reducing administrative burden with our expert Revenue Cycle Management (RCM) services.
Our RCM specialists help your practice increase revenue and cashflow by optimizing charge capture and A/R follow-ups.
Outsourcing RCM services to Prime Doc Billing will help your practice eliminate the need and cost for in-house billing staff, technology investments, and training. We help the practices allocate their resources more efficiently.
Practices are able to forecast expenses accurately with our scalable RCM service model. We help the providers avoid unexpected administrative overhead.
Prime Doc Billing takes over the time-consuming tasks of billing, and coding. Our RCM services help the providers focus more on patient care while we handle all the administrative tasks.
Our RCM experts follow standardized workflows and advanced technology to minimize errors and enhance claim accuracy and efficiency. We accelerate claim cycles to maximize reimbursements.
Whether you are a solo practitioner or a large hospital, our RCM solutions adapt to your volume and requirements. We support growth without operational bottlenecks, providing every kind of practice with scalable RCM services.
We ensure strict adherence to HIPAA compliance and regulatory requirements. Our RCM experts reduce the audit risks and protect your practice from compliance issues.
Prime Doc Billing handles all the patient and financial data securely with encrypted systems. Our RCM specialists maintain confidentiality and compliance at every step of your revenue cycle.
The process for our RCM services includes the following key steps:
The first step of our RCM service is patient registration and eligibility verification. We collect accurate patient demographics and verify coverage and benefits for a clean intake. Intake accuracy helps prevent claim denials later in the RCM cycle.
Accurate coding and charge entry is critical for getting accurate reimbursements. Our RCM specialists record all services provided through charge entry to minimize revenue leakage.
The next step is to generate and submit claims according to the payer-specific requirements. We monitor claim status for rejections and delays which ensures higher first-pass acceptance rates in the RCM process.
Our RCM experts accurately record payments received from the insurance payers and patients into the provider’s billing system. Reconciliation ensures that the payments in the billing system match the amounts on Explanation of Benefits (EOB).
Our RCM strategists analyze and resolve claims denied by the insurance payers. Our effective denial management ensures the recovery of lost revenue of your practice. Our team keeps monitoring unpaid claims to receive the entitled reimbursements, reducing revenue leakage.
We communicate the patient’s financial responsibility clearly to collect payments for the services rendered. It is a critical step of the RCM process since the patient payments often cover a significant portion of a practice’s revenue.
Prime Doc Billing providers real-time financial dashboards and trend analysis on AR. Our RCM analysts provide visibility into the financial health of your practice to make timely strategic decisions.
Prime Doc Billing ensures every claim meets payer expectations to maintain compliance and safeguard your practice’s revenue. We maintain a detailed and organized documentation so your practice is always prepared for external or payer audits.
Revenue Cycle Management (RCM) is the process healthcare organizations use to manage financial billing operations for services provided to the patients.
The healthcare revenue cycle is a financial process of managing the medical billing including patient access, eligibility verification, medical coding.
Revenue cycle management is important because the slightest errors often lead to denials, and lost revenue. Efficient revenue cycle management improves cash flow and minimizes compliance risks.
Revenue Cycle Management (RCM) services are the end-to-end management of the provider’s healthcare revenue, including appointment scheduling, medical billing, coding, claim submission, denial management, and follow-ups.
The cost of revenue cycle management services ranges from 6-12% of the total revenue and is structured around percentage-based or fixed pricing models. However, the RCM cost varies for providers depending on the practice size, claim volume and service scope.
A revenue cycle manager oversees the entire billing operations of a healthcare practice. Billing operations include ensuring clean claims, resolving denials, and monitoring AR.
Yes, RCM outsourcing is safe, secure, compliant and highly efficient when handled by a trusted partner like Prime Doc Billing.
Prime Doc Billing follows strict adherence to HIPAA guidelines and payer-specific rules. Every step is designed to protect patient information, maintaining full regulatory compliance.
Yes, Prime Doc Billing can integrate with your current EHR system. Our team adapts workflows and ensures smooth data exchange without disturbing daily operations.
Yes, we provide RCM services for small practices and growing clinics. Our RCM services are customized to deliver strong financial performance to small practices.
Many providers get faster reimbursements with optimized RCM within 15-40 days, if the clearinghouse clears the claim for reimbursement .
Technology supports Revenue Cycle Management through real-time eligibility checks, automation, denial analytics, and secure data management.
Yes, your patient data is completely secure with Prime Doc Billing. We use encrypted systems, and secure communication channels to ensure the safety of all patient and financial data.
| Medical Billing | RCM | |
|---|---|---|
| Scope | Medical billing in healthcare is limited to claim submission and payment processing. | Revenue cycle management (RCM) is the process of handling end-to-end management of the entire healthcare revenue cycle. |
| Start Point | Medical billing begins after the patient visits the healthcare provider. | RCM begins even before the patient visits the provider in their healthcare practice. |
| Primary Goal | The main goal of medical billing is to submit the medical claims. | The primary goal of the RCM process is to prevent denials and maximize revenue. |
| In-house RCM | Outsourcing RCM | |
|---|---|---|
| Staffing and Expertise | In-house RCM requires hiring and training of the RCM staff. | Outsourcing RCM gives the practice complete access to experienced RCM specialists without any hiring and training burden. |
| Operational Costs | In-house RCM has high operational costs which includes salaries, benefits, and software. | Outsourcing RCM gives a more predictable and comparatively lower costs with flexible pricing models. |
| Scalability | The in-house revenue cycle management is limited by the staff size and internal resources. | Outsourcing revenue cycle management gives the benefit of scalability according to practice growth and claim volume. |
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(347) 650-2656
(347) 650-2656
info@primedocbilling.com
