RCM Resources to Empower You

1. Verify insurance eligibility and benefits before every visit

2. Confirm prior authorizations for services that require them

3. Capture accurate patient demographics and insurance at registration

4. Code accurately with current CPT/HCPCS/ICD-10 and correct modifiers

5. Ensure documentation supports every code billed

6. Scrub claims for errors before submission

7. Submit claims promptly to stay within timely-filing limits

8. Post payments and reconcile against ERAs/EOBs

9. Track and work every denial by reason and payer

10. Monitor clean claim rate, days in A/R, denial rate, and net collection rate

1. Eligibility and benefits verified at the visit

2. Prior authorization obtained and documented where required

3. Patient and insurance data validated at registration

4. Codes and modifiers accurate and current

5. Documentation supports medical necessity and the level billed

6. Coordination of benefits confirmed for patients with more than one plan

7. Claim scrubbed for errors before submission

8. Claim filed within the payer’s timely-filing window

9. Denials tracked by reason and appealed promptly

10. Recurring denial causes fixed at the source, not just reworked