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SVC·01 · Revenue Cycle Management

End-to-end RCM. Owned by a senior partner, not a queue.

From registration to zero balance. Charge capture, coding, claim submission, payment posting, denials, AR follow-up. one accountable senior partner running the whole stack to written SLAs.

What you get
Senior-led.
SLA-backed.
No offshore handoffs.
Targets written into every contract, reviewed monthly with your CFO.
What “end-to-end” actually means

Eight functions. One P&L owner.

Most RCM vendors split the cycle across three or four offshore teams that don’t talk to each other. We run the entire revenue cycle as one operating function under a single senior partner who owns the back-office P&L. Below is the full scope, not a marketing list.

01

Patient access & eligibility

Real-time eligibility, benefits verification, prior-auth identification, and financial counseling at the front desk. before the visit happens. Coverage problems caught at registration cost a tenth of what they cost on the back end.

270/271 real-timeCOB captureAuth flaggingPre-service estimates
  • Front-end ROI: an eligibility error at registration becomes a $25-$40 rework cost downstream.
  • Coverage: 2,400+ payer connections, including state Medicaid plans most clearinghouses skip.
  • Tooling: integrated to Epic, Athena, eCW, NextGen, AdvancedMD, Kareo, and 14 other platforms.
02

Charge capture & entry

Daily reconciliation of clinical activity to billed charges. Missing charges are caught against the schedule, not against last month’s collections. We look for what should have been billed, not just what was.

Schedule reconciliationLag-day trackingMissed-charge audit
  • Lag day target: charges entered within 48 hours of service. Written into the SLA.
  • Leakage detection: monthly missed-charge report shared with the practice manager.
  • Provider feedback: documentation gaps routed back to the provider with specifics, not generic queries.
03

Coding & documentation review

CPC-, CCS-, and RHIA-credentialed coders, organized by specialty, not by client. Pre-bill audit on a stratified sample. CDI feedback loops back to the providers who need it. Quarterly external audits we publish to clients.

CPT · ICD-10 · HCPCS · DRGHCC / risk-adjustmentCDI queries
  • Coder ratio: one credentialed coder per ~8K encounters/month. Workload published to the client.
  • QA target: 95% coding accuracy on the random monthly sample. Below target triggers a remediation plan.
  • Specialty depth: dedicated benches for surgical, hospital inpatient, ED, and ABA. not a generic pool.
04

Claim scrubbing & submission

Payer-specific edits applied at submission, not after rejection. Clean-claim rate and first-pass yield are written into the SLA, with monthly trending against the contracted target.

Pre-submit scrubber837 / EDISecondary & tertiary
  • Clean-claim target: 95%+, written into SLA. Tracked daily, reported monthly.
  • Submission cadence: daily for high-volume clients, weekly minimum for everyone else.
  • Edit library: 14,000+ payer-specific edits maintained by a dedicated edit-management desk.
05

Payment posting & reconciliation

ERA and EOB posting on the same day money lands. Three-way reconciliation between bank, lockbox, and PMS. Underpayment detection against payer contracts surfaces variances your CFO can recover.

ERA / 835 postingBank reconciliationUnderpayment audit
  • Posting target: 1 business day from receipt. Tracked in the monthly scorecard.
  • Variance reports: contractual underpayments flagged weekly, dollar-weighted for recovery.
  • Audit trail: every adjustment carries a reason code; nothing is auto-written off without sign-off.
06

Denial management & appeals

Denial root cause first, then the work-down. Each denial is taxonomized (clinical, eligibility, auth, coding, registration), with a written appeal pack for the high-dollar lanes. Appeals are senior-reviewed before submission.

Root-cause taxonomyClinical appealsProvider feedback loop
  • Touch SLA: every denial worked within 5 business days of receipt. Aging tracked weekly.
  • Overturn target: 60%+ on the high-dollar appeal lane. Quarterly trending shared with CFO.
  • Prevention: top-5 root causes feed monthly upstream fixes. the goal is fewer denials, not faster appeals.
07

AR follow-up & recovery

Dollar-weighted prioritization, not count-weighted. The biggest dollars get worked first, every cycle. Payer follow-ups are scripted by line of business and tracked to a written cadence.

Dollar-weighted agingPayer-specific cadenceWorkdown reports
  • Aging target: >90-day AR ratio cut and held to a contracted ceiling. Reviewed monthly.
  • Cadence: payer-specific call/portal follow-up rhythms. not a generic 30/60/90 schedule.
  • Workdown ratio: $ resolved per FTE-hour, transparent in the monthly scorecard.
08

Reporting & monthly QBR

A CFO-grade scorecard every month. The senior partner walks it line by line with your CFO. clean-claim, denial rate, days in AR, net collection rate, plus payer-specific trends. No vanity dashboards.

4-page scorecardMonthly QBRPayer-by-payer trending
  • Cadence: monthly CFO scorecard, quarterly business review with the senior partner attending.
  • Format: 4-page narrative. what moved, why, and what changes next month. No 40-tab spreadsheets.
  • Source data: pulled directly from your PMS, not retyped. auditable and reconciled to the bank.
How we run the engagement

Day 1 to Day 90. Senior partner attends every step.

A predictable transition. Same senior partner from sales to steady state. the person who scopes the work is the person who runs it.

DAY 1-15
Discovery & baseline

Senior partner walks 90 days of denials, AR aging, and payer mix. Baseline KPIs locked in writing.

DAY 16-30
SLA & scope drafted

Clean-claim, denial rate, days in AR, NCR. turned into contractual targets. Reviewed with your CFO.

DAY 31-60
Stand-up & cutover

Pod assigned by specialty. EHR access provisioned. Edit library loaded. Parallel run on the first cycle.

DAY 61-75
Steady state & first scorecard

First monthly CFO scorecard. Variances explained line by line. Adjustments before contract Day 90.

DAY 90+
SLA in force

Targets contractually binding. Quarterly business reviews with the senior partner attending in person or live.

Who this scope is built for

Built for providers between $50M and $500M in net revenue.

Below $50M, you usually need pieces of the cycle, not all of it. talk to us about scoped engagements. Above $500M, we run the program with a multi-pod structure under a single senior partner.

SETTING 01
Hospitals & health systems

Inpatient + outpatient + facility billing under one program lead. AR remediation, denial recovery, and payer-contract underpayment audit.

SETTING 02
Multi-specialty physician groups

MSOs, IPAs, and growing groups. Specialty-aware coding benches, payer roster reconciliation, provider-level CDI feedback.

SETTING 03
Outpatient networks

ASCs, urgent care, imaging, infusion. Schedule-driven charge reconciliation, time-of-service collections, payer-mix analytics.

SETTING 04
Behavioral & ABA

Auth-heavy, modifier-sensitive specialties with state-Medicaid quirks. Dedicated specialty desk, not a general pool.

SETTING 05
FQHC & community health

PPS billing, sliding-fee, wraparound, and 340B nuance. UDS-aware reporting and federal compliance.

SETTING 06
SNF, LTC & home health

PDPM, PDGM, MDS-driven coding, and Medicare-audit defense. Triple-check workflow on PT/OT/ST units.

What we put in writing

Five SLAs. Contractual. Reviewed every month.

Most RCM contracts measure activity (claims submitted, calls made). We measure outcomes. the metrics your CFO actually cares about. Below are the five that go into every ASP-RCM contract.

METRIC TYPICAL TARGET HOW WE MEASURE IT
Clean-claim rate 95%+ % of claims accepted on first submission, by line of business. Tracked daily, reported monthly.
Initial denial rate < 5% % of submitted claims denied on first adjudication, by payer and root cause. Top-5 causes flagged in QBR.
Days in AR (dollar-weighted) 35-42 days Specialty-adjusted. Calculated weekly from PMS data, audited quarterly to bank deposits.
Net collection rate 96-98% Cash collected vs. allowable, against payer-contract terms. CFO-audited annually.
Cost-to-collect 2.5-3.5% All-in vendor cost as % of net collections. Reported in every monthly scorecard.
The structural difference

The same person scopes, signs, and runs the work.

In most RCM relationships, the people you sold to disappear after Day 30 and you end up working with a queue manager who has 27 other accounts. We’re structured to make that impossible.

THE STRUCTURAL CHOICE

One senior partner. One P&L. One phone number.

The senior partner who scopes the engagement is the same person who signs the contract, attends the monthly QBR, and owns the SLA. Their compensation is tied to your outcomes, not to claim volume processed. They’re named on every page of the contract.

WHAT THAT MEANS IN PRACTICE

The handoff problem, removed.

  • No sales-to-ops handoff. the partner who designs the SLA owns its delivery.
  • No queue manager between you and the operator. one phone number, one inbox.
  • One P&L owner, not three. coding, AR, and denials don’t live in different silos.
  • Same person at every QBR. 12-month memory of your account, not a fresh face every quarter.
  • SLAs tied to compensation. partner’s comp moves with your scorecard, in writing.
How we measure ourselves

Four metrics. Reported every month.

Clean-claim rate
Target written into your SLA
Up from pre-engagement baseline
Denial rate
Tracked by payer and root cause
Reviewed in monthly QBR
Days in AR
Dollar-weighted, not count-weighted
From go-live forward
Net collection rate
Audited annually by your CFO
Against contracted allowable

Start with a free 30-min audit.

A senior partner reads your last 90 days of denials, AR aging, and payer mix, and walks you through a written 4-page gap report. No sales theater, no obligation.