Revenue Cycle Management Services That Turn Every Claim Into Collected Revenue
Most healthcare practices lose 15–20% of collectible revenue every year to billing errors, denied claims, and unworked AR. 247 Medical Billing’s RCM services fix every stage of that leak from patient registration to final payment resolution.
98.6%
First-Pass Clean Claim Rate
35%
Faster Reimbursements
5–10%
Avg. Collections Increase
25+
Specialties Supported
WHAT'S LEAKING IN YOUR REVENUE CYCLE?
- High claim denial rate (>5%)
- AR days exceeding 40 days
- Net collection rate below 95%
- Eligibility errors causing front-end denials
- Billing staff turnover disrupting cash flow
- Compliance gaps creating audit exposure
No PHI required · No obligation · Response within 1 business day
Understanding RCM
What Is Revenue Cycle Management In Healthcare?
Revenue Cycle Management (RCM) is the end-to-end financial process that healthcare providers use to manage claims processing, payment collection, and revenue generation from the moment a patient schedules an appointment until payment is fully resolved.
When RCM works correctly, every clinical service rendered converts into collected revenue with no billing errors, no unworked denials, no aging accounts receivable, and no compliance gaps.
When it breaks down even partially, the financial impact compounds quietly, month after month, until a practice is collecting a fraction of what it has earned.
At 247 Medical Billing, we manage your complete revenue cycle so you don’t have to. You focus on patient care. We make sure you get paid for every bit of it.
The Revenue Cycle Stages
Every stage we manage from first contact to final payment:
Patient Scheduling & Registration
Demographic capture, insurance information collection, and benefit eligibility verification before the visit.
Eligibility Verification & Prior Authorization
Real-time coverage checks and prior auth management to prevent front-end denials before they happen.
Medical Coding (CPT, ICD-10, HCPCS)
Certified coders apply accurate codes, modifiers, and documentation-to-code alignment for every claim.
Charge Entry & Claim Submission
Charge capture and multi-layer claim scrubbing before submission to maximize first-pass acceptance.
Payment Posting & ERA Reconciliation
Accurate payment posting, contractual adjustment tracking, and ERA/EOB reconciliation.
Denial Management & AR Follow-Up
Every denial analyzed, appealed, and tracked. Every aging AR bucket worked systematically.
$125B
Lost annually by US providers to billing errors & unworked claims
80%
Of medical claims contain at least one billing error (AMA)
65%
Of denied claims are never reworked — revenue permanently lost
90 days
After which AR collection probability drops below 20%
6 Revenue Cycle Problems That Are Costing Your Practice Right Now
These are the six most common and most expensive RCM failures in healthcare practices. Every one of them is preventable with the right revenue cycle management partner.
-
Delayed Accounts Receivable:
AR balances that age beyond 90 days have a collection probability below 20%. Without proactive follow-up, aging AR becomes permanent write-offs not just slow payments.
-
Coding Inaccuracies:
Incorrect CPT, ICD-10, or HCPCS codes result in underpayments, denials, and OIG audit exposure. Coding errors are the single largest driver of preventable claim rejections.
-
Front-End Eligibility Failures
Verification errors at patient intake create downstream denials. Checking eligibility before the appointment not after eliminates the most common category of preventable denials.
-
Denial Management Gaps
65% of denied claims are never reworked. Without a structured denial management workflow, those dollars are simply abandoned even when the appeal would succeed.
-
Billing Staff Turnover & Knowledge Gaps
In-house billing teams face constant turnover. Every time a biller leaves, institutional knowledge of your payers, codes, and workflows leaves with them — directly impacting your cash flow.
-
Compliance & Regulatory Risk
CMS, OIG, and commercial payers actively monitor billing patterns. Upcoding, unbundling, and improper modifier use can trigger audits, recoupments, and penalties that far exceed the original billing error.
Understanding RCM
Our End-To-End Revenue Cycle Management Services
We manage every stage of your revenue cycle from first patient contact to final payment
resolution. Every service below is included in our RCM engagement, configured to your
specialty, payer mix, and practice size.
01 / FRONT-END RCM
Patient Eligibility Verification & Benefits Check
We verify every patient's active insurance coverage, co-pay, deductible status, coordination of benefits, and plan-specific requirements before each appointment not after.
Real-time eligibility checks eliminate the most common category of front-end denials before a single claim is ever submitted.
- ✓ Real-time insurance eligibility verification
- ✓ Co-pay, deductible, and out-of-pocket benefit checks
- ✓ Secondary insurance and COB verification
- ✓ Prior authorization management and follow-up
PRACTICE OUTCOME
Fewer denied claims at submission. Accurate patient cost estimates. Reduced administrative rework at the front desk.
ELIGIBILITY DASHBOARD
CODING ACCURACY SCORECARD
02 / CODING ACCURACY
Medical Coding Services (CPT, ICD-10, HCPCS)
Our certified medical coders assign accurate CPT codes, ICD-10 diagnosis codes, HCPCS codes, and modifiers aligned to your specialty's documentation standards and payer requirements.
Coding errors are the single largest preventable cause of claim denials and underpayments. Our coders eliminate that risk before any claim reaches a payer.
- ✓ CPT and E/M level coding accuracy review
- ✓ ICD-10 diagnosis code specificity and accuracy
- ✓ Modifier application and compliance
- ✓ Unbundling and upcoding risk prevention
- ✓ Documentation-to-code alignment review
PRACTICE OUTCOME
Maximum reimbursement per encounter. Reduced audit exposure. Compliant coding across all payer types.
03 / CHARGE CAPTURE
Charge Entry, Capture & Claim Scrubbing
Every billable service must be captured and coded before submission. We review charge entry for completeness, accuracy, and missed charges ensuring no revenue-generating encounter goes unbilled.
Before submission, each claim passes through multi-layer scrubbing against payer-specific rules, coverage requirements, and coding logic achieving a 98.6% first-pass acceptance rate.
- ✓ Complete charge capture no billable service missed
- ✓ Multi-layer claim scrubbing before submission
- ✓ Payer-specific rule validation
- ✓ Electronic claims submission via clearinghouse
PRACTICE OUTCOME
98.6% first-pass acceptance rate. Faster payment cycles. Zero missed billable encounters.
CLAIM SUBMISSION STATUS
PAYMENT RECONCILIATION
04 / PAYMENT RESOLUTION
Payment Posting, ERA Processing & Underpayment Detection
Accurate, timely payment posting gives you real-time visibility into your financial performance. We post all payments, process ERAs and EOBs, and track contractual adjustments against your payer fee schedules.
We also systematically compare actual payments against contracted rates identifying and pursuing underpayments that most practices never catch.
- ✓ Insurance and patient payment posting
- ✓ ERA and EOB reconciliation
- ✓ Contractual adjustment tracking
- ✓ Payer underpayment detection and dispute
PRACTICE OUTCOME
Real-time financial visibility. Clean AR data. Recovery of payer underpayments your team would never catch.
05 / DENIAL MANAGEMENT
Denial Management, Claims Appeals & Root Cause Resolution
A denied claim is not a closed case. It is an appeal waiting to be filed. Our denial management team identifies the exact root cause of every denial, submits timely, fully documented appeals, and implements upstream workflow changes to prevent the same denial from recurring.
We don't just chase denials reactively we analyze denial patterns to eliminate the root causes permanently.
- ✓ Denial root cause analysis by payer and code type
- ✓ Timely appeals with complete supporting documentation
- ✓ Denial trend analysis and pattern identification
- ✓ Upstream workflow corrections to prevent recurrence
PRACTICE OUTCOME
Higher denial overturn rates. Declining denial volumes month-over-month. Revenue recovered from previously written-off claims.
DENIAL MANAGEMENT REPORT
AR AGING SUMMARY
06 / AR MANAGEMENT
Accounts Receivable (AR) Follow-Up & Aging Recovery
Accounts Receivable that ages beyond 90 days has a collection probability below 20%. Without dedicated, systematic follow-up on every aging bucket, unpaid balances quietly become permanent losses.
Our AR team pursues every balance including old, aging accounts from before you joined us through systematic payer outreach, appeals, and escalation protocols.
- ✓ Systematic follow-up on 30, 60, 90, 120+ day buckets
- ✓ Old AR recovery from prior billing periods
- ✓ Priority pursuit of high-balance and timely-filing-sensitive claims
- ✓ Patient billing statements and collections support
PRACTICE OUTCOME
Reduced AR days. Higher net collection rate. Revenue recovered from aging accounts before collection windows close.
Understanding RCM
How We Implement Revenue
Cycle Management Services
Process For Your Practice
A proven, six-step RCM implementation process designed to integrate with your existing workflow
with zero disruption and measurable results from the first billing cycle.
Free RCM Audit
Baseline assessment of your denial trends, AR aging, coding patterns, and revenue leaks.
Workflow Integration
Seamless setup with your EHR, PM system, and payer enrollment zero billing gaps.
Clean Claim Protocol
Specialty coding rules, payer-specific logic, and multi-layer scrubbing activated from day one.
Denial Reduction Plan
Front-end eligibility, coding accuracy, and documentation gaps addressed systematically.
AR Recovery
Immediate pursuit of existing aging AR including accounts from prior billing periods.
Monthly Reporting
Full KPI dashboards, denial trend analysis, and proactive optimization every month.
PERFORMANCE METRICS
The KPIs That Improve When You Partner With 247 Medical Billing
We track the metrics that matter most to your practice's financial health and we are accountable to improving every single one of them.
- ✓ First-pass claim acceptance rate >98%
- ✓ Net collection rate above 95% industry benchmark
- ✓ AR days below 35 trending to 28
- ✓ Denial rate below 5% (industry avg: 5–10%)
- ✓ 5–10% increase in collections within 90 days*
*Results vary by specialty, payer mix, and documentation completeness.
98.6%
First-Pass Clean Claim Rate
▲ ↑ vs 78% industry avg
<28
Average AR Days
▲ ↓ from typical 45–55 days
95%+
Net Collection Rate
▲ ↑ MGMA benchmark
<3%
Denial Rate After 90 Days
▲ ↓ from 9–14% on intake
Why Healthcare Providers Choose 247 Medical Billing As Their RCM Services Partner
We are not a generic outsourcing vendor. We are a dedicated healthcare revenue cycle management company built exclusively for practices that need more than a billing company. You need a strategic revenue partner.
Outsource vs. In-House
Outsourced RCM vs. In-House
Billing Team: The Real Comparison
Most practices that switch to outsourced revenue cycle management see measurable improvements
in collections, denial rates, and overhead costs within the first 90 days.
| PERFORMANCE FACTOR | 247 MEDICAL BILLING RCM | IN-HOUSE BILLING TEAM |
|---|---|---|
| Clean Claim Rate | ✓ 98.6% average first-pass | ✕ Industry avg: 75–85% |
| Denial Management | ✓ Every claim appealed — 90%+ overturn rate | ✕ 65% of denials never reworked |
| Staffing Risk | ✓ Zero — no turnover, no training costs | ✕ High — biller turnover disrupts cash flow |
| Specialty Coding Expertise | ✓ Certified specialty-specific coders | ✕ Generalist coders miss specialty nuances |
| HIPAA Compliance | ✓ Certified, BAA signed, ongoing training | ✕ Varies — often underdocumented |
| Pricing Model | ✓ Performance-based — pay when you collect | ✕ Fixed salary + benefits + software |
| AR Follow-Up | ✓ Systematic — every aging bucket worked | ✕ Often deprioritized under staff workload |
| Real-Time Reporting | ✓ Monthly KPI dashboards — full transparency | ✕ Depends on staff capacity and tools |
Specialty RCM
Revenue Cycle Management Across 25+ Medical Specialties
RCM is not one-size-fits-all. Every specialty has unique coding rules, payer behaviors, prior auth
requirements, and denial triggers. Our team brings specialty-specific RCM expertise so
nothing gets lost in the billing process.
Help & FAQ
Frequently Asked Questions: Revenue Cycle Management
Revenue Cycle Management encompasses every financial and administrative process involved in managing a healthcare provider's revenue — from patient registration and insurance verification through medical coding, claim submission, payment posting, denial management, AR follow-up, and financial reporting. A complete RCM solution ensures that every patient encounter generates the maximum compliant reimbursement in the shortest possible timeframe.
Outsourcing RCM to a specialized company improves collections by introducing dedicated expertise, advanced billing technology, and systematic processes that most in-house teams cannot consistently replicate. Professional RCM providers achieve higher first-pass claim acceptance rates, more aggressive denial appeals, and structured AR follow-up — all of which directly increase net collections and reduce revenue leakage.
RCM outsourcing is typically structured as a percentage of monthly collections — commonly ranging from 3% to 9% depending on practice size, specialty, claim volume, and service scope. This performance-aligned model means the RCM company's financial success is directly tied to yours. Contact 247 Medical Billing at (888) 860-0859 for a customized quote based on your specific practice profile.
Yes. Any reputable RCM company operates as a Business Associate under HIPAA regulations and must sign a Business Associate Agreement (BAA) with every covered entity client. 247 Medical Billing is fully HIPAA certified, operates under strict data security protocols, and executes BAAs with every practice we serve.
Most practices can expect a full onboarding and workflow integration to be completed within 2 to 4 weeks, depending on the complexity of your EHR system, payer mix, and volume. During onboarding, our team manages the transition to minimize any disruption to your claim submission cycle or cash flow.
The most directly impacted KPIs include: clean claim rate, first-pass resolution rate (FPRR), days in accounts receivable (AR days), denial rate, net collection rate, cost-to-collect ratio, and gross collection rate. Well-managed RCM typically produces measurable improvements in all of these metrics within the first 60 to 90 days.
Yes. Our team is experienced with a broad range of EHR and practice management platforms including Epic, Athenahealth, eClinicalWorks, Kareo, AdvancedMD, Nexgen, Greenway Health, and others. We integrate with your existing system — no replacement required.
We address your existing AR as part of onboarding. Our team will audit your aging AR, prioritize high-value and time-sensitive claims, and begin systematic recovery efforts immediately. Switching to 247 Medical Billing does not mean abandoning your current receivables — it means bringing professional recovery resources to bear on them.
Ready to Recover Revenue and Take Control of Your Financial Performance?
Your practice delivers exceptional care. Your revenue cycle should deliver exceptional results.
At 247 Medical Billing, we combine 5+ years of specialized RCM expertise, HIPAA-certified compliance, a 98.6% client satisfaction rate, and cutting-edge billing technology to build a revenue cycle that works as hard as you do.
Every uncollected claim. Every denied payment. Every aging AR balance. These are not just billing problems — they are obstacles between you and the financial health your practice deserves.
Let's remove them. Together.
No obligation. No long-term contracts. Just a straightforward conversation about how we can improve your revenue cycle — starting now.