Provider Credentialing
Primary source verification, hospital privileging, and license and DEA expiration monitoring — so no provider is quietly dropped from a payer panel mid-contract.
What we do
Thirteen services, arranged the way money actually moves.
A claim passes through four stages before it becomes revenue, and it can stall at any one of them. Find the stage where yours is stalling.
STAGE 01
Get enrolled
Nothing can be billed until the provider is active with the payer.
Credentialing, Revalidation & CAQH
We manage payer enrollment, CAQH attestations, and Medicare revalidation deadlines end to end, tracking every follow-up so approvals land before reimbursement lapses.
STAGE 02
Before the visit
Most denials are caused here, days before a claim is written.
Practice Management
Scheduling, real-time eligibility checks, prior authorization tracking, and patient balance follow-up — so your front desk spends less time waiting on payer phone lines.
Electronic Health Records
We work inside the system you already use — Epic, athenahealth, eClinicalWorks, Kareo — pulling charges straight from provider notes so nothing is rekeyed or billed twice.
STAGE 03
Charge to claim
The encounter becomes a coded, scrubbed, transmitted claim.
Medical Coding
Coders assign CPT, ICD-10-CM and HCPCS Level II directly from documentation, apply modifiers correctly, and flag gaps in the note before a payer rejects the claim.
Medical Billing
Daily claim submission, payment posting, and patient statements handled under HIPAA-compliant process. You get monthly performance reports with no hidden fees or unexplained gaps.
Quality Billing Services
Every claim is scrubbed against current payer edits before submission. The result is a higher first-pass rate, transparent reporting, and fewer write-offs from preventable errors.
Fusion EDI
Secure X12 transactions — 837 claims, 835 remittances, 270/271 eligibility — exchanged through encrypted clearinghouse connections with same-day submission confirmation.
STAGE 04
Claim to cash
Where most practices quietly write off money they are owed.
Specialized in Rejected Claims
Every denial gets a root-cause review. We correct the coding, gather payer-required documentation, and file appeals inside the deadline to recover revenue already earned.
Denial Management
We track denial patterns by payer and CARC code, then fix the upstream cause — eligibility, authorization or documentation — so the same rejection stops repeating.
ALL STAGES
Across the cycle
Three services that don't sit at one stage — they run underneath all four.
Hospital RCM
Full-cycle support for facilities: eligibility verification, charge capture, coding audits, AR follow-up and denial management under one team. Finance receives clear reporting at every stage, so no dollar goes untracked between admission and remittance.
Analytics and Reporting
Monthly dashboards covering days in AR, clean claim rate, net collection rate and denials by payer — with the underlying data available so you can verify every figure.
Specialty Coverage
Cardiology, orthopedics, behavioral health, DME and more. Each specialty carries its own modifiers and payer rules, so billers are assigned by specialty rather than rotated.