Provider and payer readiness
Coordinate provider enrollment and billing setup, including payer EDI, ERA and EFT requirements where included in the engagement.
End-to-end revenue cycle management
Connect every stage.
Keep the whole cycle in view.
Medical billing is a connected process. Bring claim preparation, payment follow-up and operational reporting into one defined engagement, with credentialing and MIPS support where needed.
Service scope to discuss
From the first administrative step to the final follow-up.
Patient and coverage information
Demographic review, eligibility checks and authorization coordination help establish what is needed before claim preparation.
Coding and charge preparation
Align available documentation, code review and charge entry. Identify questions that need the practice’s attention before submission.
Claim review and submission
Review claim information, track submission and address rejections through a defined exception workflow.
Payment and denial posting
Record payer responses and payments, identify denials and route items that need further action.
Patient billing support
Coordinate patient statements, balance questions and follow-up under the practice’s approved policies and communication process.
A/R and denial follow-up
Prioritize outstanding accounts, research payer responses and coordinate corrections or appeals within the agreed scope.
Reconciliation and exceptions
Review posting discrepancies, potential underpayments and credit balances, and coordinate the practice’s decisions on adjustments or refunds.
Reporting and workflow review
Review aging, recurring denial reasons and open issues so the practice can understand priorities and make decisions.
A practical engagement
Define the work. Agree on the evidence.
Your engagement should make ownership visible across the practice, CREDENT and any other system or service partners.
- A documented service scope and responsibility map
- A transition checklist and exception-handling process
- A/R aging and agreed operational reports
- A review cadence and a list of actions and owners
A connected service model
Credentialing supports billing readiness. MIPS adds a related quality-reporting workstream. Discuss both alongside your billing priorities so that dependencies and responsibilities are clear.
The service scope, deliverables, access and responsibilities are agreed with your practice before work begins.
Focused RCM services
Find support for each part of your workflow.
Explore a focused service or discuss how these workflows fit into complete medical billing support.
Charge Entry
Organize encounter details, enter approved charges and resolve missing information before claim preparation with CREDENT charge entry support.
Coding
Discuss medical coding support for documentation review, code selection, clarification and billing handoff with CREDENT RCM SERVICES.
Cash Posting
Record payer and patient payments, review remittance details and track posting exceptions with CREDENT cash and payment posting support.
AR Coding
Review coding and documentation causes within unresolved or denied claims, organize clarifications and guide the billing handoff with CREDENT.
AR Billing
Organize outstanding claims, investigate billing and administrative issues and track follow-up actions with CREDENT AR billing support.
AR Calling
Discuss payer phone follow-up for outstanding claims, including call notes, reference numbers, required actions and escalation tracking with CREDENT.
Questions practices ask
Clarity before
the next step.
Can we begin with a specific RCM problem?
Discuss your immediate need, such as aged A/R or recurring denials, alongside your overall workflow. Any focused engagement should have explicit boundaries, handoffs and reporting.
Will we need to change our EHR or billing system?
System access and compatibility must be reviewed before any proposal. Confirm the actual platforms and authorized workflows; do not assume a new system or a supported integration.
Which performance measures should we track?
Agree on the definitions and baselines for measures such as days in A/R, aging mix, denials and collections. Comparisons should use consistent periods and account for payer mix and scope.
Can you promise a specific increase in collections?
A reliable proposal should assess the practice’s baseline and opportunities. Results depend on factors including payer policies, documentation, contracts and existing balances; a specific improvement should not be assumed.
Start with your revenue cycle.
Discuss your practice’s workflow, current challenges and the support you need.