We handle the entire billing lifecycle—from patient registration and eligibility verification to charge entry, clean claim submission, and aggressive denial appeals.
We operate directly inside your preferred software with zero data migration or workflow disruption. We hold specialized operational mastery across leading specialty and multi-practice platforms.
Deep operational expertise in WebPT billing queues. We manage Medicare 8-minute rule calculations, Plan of Care (POC) 90-day tracking, KX modifier thresholds, and Workers' Comp/No-Fault billing schedules.
Complete mastery of Unlimited Systems / Unlimited Financials. Protecting high-cost chemotherapy margins with rigorous J-code unit validation, mandatory JW/JZ drug waste compliance, and multidose vial reconciliation.
Expert cloud billing and clearinghouse management across Adult Day Care, rehabilitation clinics, and multi-provider ambulatory practices. Rapid claim generation and automated 835 ERA posting.
Up to 40% of claim denials originate at the front desk. We stop errors before patient encounters occur with proactive verification.
Verification of coverage status, active copays, deductibles, coinsurance percentages, and out-of-pocket maximums before the patient is seen.
Precise demographic capture and address verification inside your EHR/PM to prevent returned statements and claim clearinghouse rejects.
Comprehensive prior authorization requests, clinical document submission, and payer follow-up for diagnostic testing, surgeries, and therapies.
Initial payer enrollment and continuous CAQH re-attestation to ensure your physicians remain active in-network with all commercial and government payers.
Guidance and daily reporting for your front desk staff on expected patient collections and deductible collection thresholds.
Validation of HMO referral rules, physician order validity, and Medicare Local Coverage Determinations (LCD) prior to service delivery.
Automated clearinghouse scrubbers catch format errors, but only experienced certified medical coders understand clinical medical decision making, bundling rules, and specialty-specific modifier compliance.
AAPC and AHIMA-certified coders review every superbill to maximize compliant reimbursement and eliminate downcoding.
Thorough cross-examination of provider clinical notes against current AMA CPT guidelines, ICD-10 specificity, and HCPCS supply codes.
Proper application of distinct procedural modifiers (25, 59, 76, 79, RT/LT) to prevent automatic bundling denials while protecting compliance.
Daily audit of appointment schedules against posted superbills to guarantee zero encounters are missed or omitted from billing batches.
Multi-stage automated clearinghouse scrubbing engine combined with specialist oversight to achieve a target 95%+ first-pass clean claim rate.
Strict commitment to submit all electronic encounters within 24 to 48 hours of receiving complete clinical data from your practice.
Line-item posting of Electronic Remittance Advices (835 ERAs) and manual paper EOBs with daily reconciliation to the bank penny.
We treat every unpaid dollar as practice property. Our billing specialists aggressively work all denials and aging buckets.
Every rejection and remittance denial is reviewed, corrected, and resubmitted or appealed within 5 business days of payer receipt.
Systematic telephone and portal follow-up across 30, 60, 90, and 120+ day aging buckets to ensure claims are never abandoned.
Authoring customized, evidence-based appeal letters with attached medical charts for complex medical necessity and experimental procedure denials.
Targeted forensic recovery projects for claims over 120 days old left behind by prior billing companies or in-house turnover.
Clear, courteous patient billing statements sent via mail and digital portals, with dedicated billing support to resolve patient inquiries.
Regular auditing of overpayments and duplicate postings to keep patient and payer balances clean and compliant with state refund laws.
Most billing agencies let denied claims gather dust in 90+ day aging buckets until timely filing expires. At RevoCentra, every denial triggers an immediate root-cause investigation within 5 business days.
Crystal-clear visibility into where your practice money is, which payers are paying on time, and where documentation can improve.
High-level monthly reports detailing gross charges, net collections, contractual adjustments, and net collection rates (target 95%+).
Granular breakdown of denials by reason code, payer, and provider to pinpoint documentation patterns before they recur.
Clear tracking of days in A/R, showing the exact percentage of claims in 0-30, 31-60, 61-90, and 90+ day categories.
Compare yields across Medicare, Medicaid, and commercial carriers (Blue Cross, Aetna, Cigna, UnitedHealthcare), and individual provider RVUs.
A named U.S. billing specialist reviews reports with your practice leadership monthly to discuss trends and revenue optimization.
Periodic comparison of your current allowable reimbursement against regional Medicare and commercial fee schedules.
Select a clinical scenario below to see how our certified auditing engine processes encounters in real time.
Find out how much uncollected revenue your clinic may be losing each month. No software changes, no obligation.