Practice Partnership Principles: RevoCentra operates on simple, predictable fee models with zero hidden software costs. We succeed only when your practice collects its legitimate clinical earnings. The following terms outline our mutual operating standards.
1. Scope of Engagement & Services
These Terms & Conditions, together with your individual Service Order and executed Business Associate Agreement, govern the provision of medical billing, certified coding review, clearinghouse submission, payment posting, denial resolution, and accounts receivable management services by RevoCentra Medical Billing Services LLC ("RevoCentra") to the contracting medical practice or healthcare organization ("Client").
RevoCentra provides outsourced administrative and revenue cycle management services. RevoCentra does not practice medicine, render clinical judgments, or direct patient care.
2. Client Practice Responsibilities
To ensure timely claim filing and regulatory compliance, the Client practice agrees to:
- Accurate Clinical Documentation: Provide complete, legible provider encounter records, clinical charting, and medical decision-making documentation supporting all assigned diagnostic and procedural codes.
- Patient Demographic & Insurance Accuracy: Collect and transmit accurate patient identifying data, current insurance subscriber IDs, primary/secondary policy details, and active pre-authorization records.
- Timely Superbill Transmission: Submit clinical encounters and superbills to RevoCentra within 72 hours of patient service completion.
- Payer Credentialing Maintenance: Maintain active state medical licensure, DEA registrations, malpractice coverage, and commercial/government payer enrollments.
3. RevoCentra Service Commitments & SLAs
In delivering professional revenue cycle management, RevoCentra commits to the following operating benchmarks:
- 24–48 Hour Claim Submission: Complete electronic scrubbing and submit ANSI ASC X12 837 batches within 24 to 48 hours of receiving complete clinical data from the Client.
- Certified Coding Review: Review charges under the supervision of AAPC (CPC) and AHIMA (CCS) certified medical coders to verify AMA CPT guidelines, ICD-10-CM specificity, and modifier compliance.
- 5-Day Denial Resolution Guarantee: Review, investigate, correct, and resubmit or appeal all actionable claim rejections and payer remittance denials within 5 business days of payer receipt.
- Line-Item ERA Posting: Reconcile Electronic Remittance Advices (835) and manual EOBs to the bank penny within 24 hours of payer deposit verification.
- Zero Software Disruption: Perform billing operations directly inside the practice's existing EHR/PM system wherever feasible, requiring zero software replacement.
4. Billing Models, Fees & Invoicing
Fees are established in the Client Service Order under one of three transparent pricing structures:
- Performance-Based Percentage: A competitive percentage (typically 3.9% to 5.9%) applied exclusively to net collections actually received by the practice from payers and patients. If you do not collect, RevoCentra earns nothing.
- Per-Claim Fixed Rate: A flat fee per submitted clean claim encounter (typically $4.50 to $7.00 per claim), ideal for high-volume urgent care or diagnostic imaging centers.
- Dedicated Full-Time Specialist: A fixed monthly retainer for dedicated, named revenue cycle analysts and coders assigned exclusively to your practice.
Setup Fee Waiver: Initial implementation and onboarding fees are completely waived on standard 12-month service agreements.
Payment Terms: Monthly RevoCentra invoices are generated on the 1st of each month for the preceding calendar month's collections and are payable within 15 calendar days via ACH or major credit card.
5. Disclaimer on Reimbursement & Collection Guarantees
While RevoCentra employs certified industry methodologies, electronic clearinghouse scrubbing, and aggressive denial appeals to maximize practice revenue:
RevoCentra cannot legally or contractually guarantee specific dollar collection amounts, clean claim percentages, or reimbursement timelines. Ultimate claim adjudication and payment determinations rest solely with third-party insurance payers, Medicare Administrative Contractors, and state Medicaid authorities based on patient plan deductibles, non-covered service exclusions, provider network status, and medical necessity determinations.
6. Business Associate Agreement & Confidentiality
The parties acknowledge that RevoCentra will have access to Protected Health Information (PHI). Concurrent with the execution of these Terms, the parties enter into a formal Business Associate Agreement (BAA) pursuant to 45 CFR Parts 160 and 164.
Both parties agree to treat all proprietary financial metrics, fee rates, provider documentation, and practice operational information as strictly confidential commercial information.
7. Term, Renewal & Termination
Service agreements remain active for the initial term specified in the Service Order (standard 12 months) and automatically renew for successive 12-month periods unless either party provides written notice of non-renewal.
Standard 60-Day Notice: Either party may terminate the agreement at any time, for any reason, by providing sixty (60) days advance written notice. During the 60-day transition window, RevoCentra continues billing active encounters, posting ERAs, and working open A/R to prevent cash flow interruption.
Termination for Cause: Either party may terminate immediately upon written notice if the other party commits a material breach (such as a severe HIPAA violation or non-payment) and fails to cure such breach within 30 days of written notification.
8. Limitation of Liability & Indemnification
To the maximum extent permitted by applicable law, neither party shall be liable to the other for indirect, incidental, consequential, special, or punitive damages arising from the provision of services.
RevoCentra maintains comprehensive Errors & Omissions (E&O) and Cyber Liability insurance. RevoCentra's total cumulative liability arising out of or related to this Agreement shall not exceed the total fees paid by Client to RevoCentra during the six (6) months immediately preceding the event giving rise to liability.
9. Governing Law & Dispute Resolution
These Terms and the related Service Agreement shall be governed by and construed in accordance with the laws of the State of Delaware, without regard to conflicts of law principles.
In the event of any controversy or claim arising out of this Agreement, the parties agree to first engage in good-faith executive mediation for a period of not less than thirty (30) days prior to initiating formal arbitration or litigation.
10. Contact Information & Legal Notices
Formal legal notices, contract modifications, or termination communications must be delivered in writing to:
Toll-Free Phone: (800) 518-REVO (7386)
Email: info@revocentra.net
Hours: Monday – Friday, 8:00 AM – 7:00 PM EST