Revenue cycle management

Every stage of the revenue cycle, with one gate in the middle

We take claims and AR off your plate for dental and medical practices, from checking eligibility before the visit to reconciling the last dollar. In the middle sits the step most billing skips: every claim is tested before it leaves.

Before the visit

Most denials are decided before a claim exists. We catch them at the front of the cycle.

  • Insurance eligibility and benefits verification
  • Frequency limits and waiting periods checked against the planned treatment
  • Pre-authorizations and predeterminations where the payer requires them
  • Provider credentialing status confirmed with each payer, so no claim goes out for a provider the payer hasn't credentialed
AI-assistedDenial prevention

After the visit: capture and coding

A claim is only as good as the record behind it.

  • Clinical notes and patient demographics captured into your practice system
  • Patient encounter created
  • Procedures and diagnoses coded: CDT for dental, ICD-10 and CPT for medical
  • Every code backed by the chart. If a note is unclear, we ask before we bill.
Coding integrityNo upcoding or undercoding

The assay: tested before it leaves

This is the step that gives us our name. Before submission, every claim is checked against that payer's specific requirements and against the patterns behind past denials. If it fails, it doesn't go out. It gets fixed.

  • Payer-specific rules for the claim type and procedure
  • Codes checked against the documentation
  • Required attachments present: X-rays, perio charts, narratives
  • AI flags any claim that looks like one denied before, with the likely fix
  • Second-level review by a billing specialist before release
AI-assistedHuman reviewClean-claim gate

Submission

  • Clean claims submitted electronically with the right attachments, or on paper where a payer still requires it
  • Clearinghouse monitored for acceptance and rejections
  • Clearinghouse errors fixed and resubmitted promptly

Follow-up until paid

Claims don't get paid by waiting. Every claim has an owner and a next action date.

  • First payer follow-up within 15 days of submission
  • No response: followed up again within the next 15 days, and on each payer's timeline after that
  • Every unpaid claim reviewed the same day we learn it's unpaid
  • Timely-filing deadlines tracked, so nothing ages out
Nothing ignored

Denials and appeals

  • Root cause found for every denial, including a call to the payer where needed
  • Claims corrected and resubmitted, or appealed with the right documentation
  • Every finding becomes a new check at the assay, so the same denial doesn't happen twice
Feeds the AI

Payment posting and reconciliation

  • Payments confirmed against the remittance advice (ERA and EOB)
  • Paper checks matched to bank deposits by check number
  • Electronic payments reconciled to your account
  • Patient payments reconciled: copays, coinsurance and direct payments
  • Payments checked against your contracted rates, and overpayment refunds processed
No revenue left behind

AR recovery

  • Existing backlog sized by payer and aging bucket
  • Worked in priority order: highest value and closest to filing limits first
  • Progress reported against the baseline we agree with you at the start

Dental practices

General dentistry and specialties, including the claims that go wrong most often: attachments, frequency limits, and procedures that need a narrative. Where oral surgery or sleep appliances are billed to medical insurance, we handle the medical side too.

Medical practices

The same gate, applied to ICD-10 and CPT claims: eligibility, coding to the documentation, payer-specific edits and follow-up through to payment.

Built on proven procedures

Our billing team works from 20 years of experience with standardized procedures. Our technology makes those procedures sharper every week.

A clear line with your front desk

Before we start, we agree in writing what stays with your team and what moves to us. You can run side by side with us for a few weeks, or hand over cleanly from day one.

See where your claims are failing

Share your denial history (de-identified is fine to start) and we'll show you the patterns.

Book a discovery call