Medical Billing & Coding
Revenue cycle management for medical and dental practices. From eligibility verification through claims submission to denial management and AR follow-up.
What This Is
Revenue cycle management covers everything that happens between a patient walking through your door and payment hitting your bank account. That includes verifying insurance before the visit, getting prior authorizations when needed, submitting clean claims, posting payments, working denials, and following up on unpaid balances.
Most practices try to handle this internally with front desk staff or a billing person who wears multiple hats. The result is usually a growing pile of denied claims, aging receivables that never get worked, and revenue that quietly disappears because nobody has time to chase it down.
Front End Work
Front End Work
Patient eligibility and benefits verification before appointments. Prior authorization requests for procedures that require them. Making sure insurance information is correct and coverage is confirmed before services are rendered. Catching problems before they become denied claims.
Back End Work
Back End Work
Claims submission with proper coding. Payment posting as remittances come in. Denial management and appeals when claims get rejected. AR follow-up on unpaid balances. Regular reporting on practice performance and collection rates.
Why This Matters
Many medical and dental practices that close within the first few years don’t fail because they lack patients. They fail because they can’t collect on the work they’ve already done. Insurance claims get denied. Denials sit in a pile. Receivables age past the filing deadline and become uncollectable.
The gap between what you bill and what you collect is where practices lose money. A 10% denial rate might not sound catastrophic until you realize that’s 10% of your revenue disappearing if those denials never get worked. Most in-house billing staff don’t have the bandwidth to properly appeal every rejection.
The Denial Problem
The Denial Problem
Every denied claim represents revenue you earned but won’t receive unless someone follows up. Initial denials are often resolvable with additional documentation or corrected coding. But that requires time, knowledge of payer requirements, and persistence that overwhelmed staff simply don’t have.
The Aging Problem
The Aging Problem
Insurance companies have filing deadlines. If a claim isn’t submitted or a denial isn’t appealed within the window, that money is gone permanently. When billing falls behind, claims age out and revenue becomes uncollectable. The clinical work was done perfectly. It just never got paid for.
What Changes
Claims go out clean the first time because verification happens before the appointment and coding is done by specialists. Denials get worked promptly instead of sitting in a pile. AR gets followed up on a schedule instead of when someone remembers to look at it.
You get visibility into your practice finances that most providers don’t have. Regular reporting shows collection rates, denial patterns, aging buckets, and payer performance. You can see where money is getting stuck and make informed decisions about your operations.
Faster Collections
Faster Collections
Clean claims get paid faster. Proper follow-up on denials recovers revenue that would otherwise be lost. Consistent AR management keeps aging balances from slipping past filing deadlines. The gap between what you bill and what you collect shrinks over time.
Practice Analytics
Practice Analytics
Monthly reporting on the metrics that matter. Collection rate, denial rate, days in AR, aging buckets by payer. You see which payers are slow to pay and which procedures get denied most often. Data that helps you make better decisions about your practice instead of guessing.
Metro Detroit's Small Business Bookkeeper
The Next Step:
A Short Conversation
Tell us about your business and your current bookkeeping situation. We'll listen, answer your questions, and give you a clear quote.
