The average practice denies 5–7% of claims. Each rework costs $25. For a 10-doctor practice, that's $40,000 in recoverable revenue sitting in a queue your staff never reaches. RCM Billing catches denials before they go out — claims that would bounce don't get submitted, and claims that go out get paid.
4-step guided claim entry with CPT/ICD-10 autocomplete. Track every claim from draft → submitted → paid with full audit history.
Denied claims surface with ANSI X12 reason codes, actionability scores, and one-click resubmit with corrected data.
Upload or auto-fetch Electronic Remittance Advice files. Auto-match payments to claims. Flag underpayments and post adjustments.
Collection rates, AR aging buckets (0–30/31–60/61–90/90+ days), denial rates, and days-to-payment trends on one screen.
Track authorization requirements per payer and procedure. Flag missing auth numbers before claim submission — not after denial.
Select multiple denied claims and resubmit in bulk. Batch ERA posting. Export to CSV for external reconciliation.
Patient, CPT code, ICD-10 diagnosis, payer, and billed amount. CPT autocomplete with scrub rules.
Clean claim check flags missing fields. Submit to payer via clearinghouse or direct 837 EDI.
Acknowledgement (277), pending, paid, or denied — every status update captured automatically.
ANSI X12 reason code parsed, actionability scored. Correct and resubmit or escalate to appeal.
Upload ERA 835. Auto-match to claims. Post payments and adjustments. Flag underpayments.
AR aging, collection rate, denial rate, and days-to-payment updated in real time.
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