The revenue cycle, step by step

Revenue cycle management works when each stage feeds cleanly into the next. Here’s exactly how a claim moves through our process, from pre-authorization to final reporting.

A billing professional reviewing financial reports at her desk
A doctor and patient reviewing paperwork together
  1. 01

    Patient Pre-Authorization

    We request and track pre-authorizations for office appointments, procedures, and medications whenever a payer requires one, so a scheduled procedure doesn’t get delayed or denied for lack of approval.

    Before the visit
  2. 02

    Eligibility & Benefits Verification

    Essential insurance benefit information is documented in your EHR ahead of the appointment, so your front desk can collect the accurate patient-responsible amount at check-in.

    Before the visit
  3. 03

    Charge Entry & Medical Coding

    Encounters are coded using CPT, ICD-10, and HCPCS, and charges are entered into your EHR or billing system with the modifiers and detail needed to support a clean claim.

    Point of care
  4. 04

    Claims Submission

    We generate bulk electronic claims in accordance with your payers and clearinghouses, submitting accurately and promptly to ensure compliant, timely reimbursement.

    Post-visit
  5. 05

    Rejection Review & Correction

    Claims rejected by the clearinghouse or payer (for a formatting error, mismatched eligibility data, or a missing field) are corrected and resubmitted quickly, before the delay risks a timely filing deadline.

    Post-submission
  6. 06

    Payment Posting

    Payments, patient-responsible amounts, and write-off figures are recorded precisely, so your accounts accurately reflect the correct balances.

    Post-adjudication
  7. 07

    Denial Management

    Denials are investigated, root causes corrected, and appeals filed with the documentation each payer requires, rather than written off.

    As needed
  8. 08

    AR Follow-Up

    Outstanding claims are thoroughly investigated, inaccuracies corrected, appeals initiated, and missing payments tracked down, with detailed reporting on the types of denials found.

    Ongoing
  9. 09

    Reporting

    Revenue reports give you precise, customizable, and timely insight into your financial performance: the same visibility we use internally to manage your account.

    Continuous
A clinician reviewing a patient report with a pen in hand
Why the Sequence Matters

Every stage protects the ones after it

A mistake caught at eligibility verification never has the chance to become a denial. A denial caught quickly never has the chance to become uncollectible AR. Working the cycle in order is what keeps revenue from leaking at the seams.

See where your current process breaks down

We’ll map your existing workflow against this process and show you where revenue is being lost.

Schedule a Consultation