+1 (339) 365-2443 info@clainetrcm.com Boston, MA, USA

Revenue Cycle Management Excellence

Maximize Your Healthcare Practice Revenue

ClainetRCM delivers comprehensive revenue cycle management solutions designed to optimize your healthcare practice's financial performance. From patient registration to final payment collection, we streamline every step of your revenue cycle.

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Patient
Registration
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Insurance
Verification
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Coding &
Billing
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Payment
Collection
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Claims
Management
Click to understand Claims Management
RCM
Excellence
Our comprehensive RCM approach

Why Choose ClainetRCM for Revenue Cycle Management?

Our comprehensive RCM solutions are designed to address the unique challenges faced by healthcare providers in today's complex billing environment.

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Increase Revenue Collection

Our proven RCM strategies can increase your practice revenue by up to 15%. We optimize every step of the revenue cycle to ensure maximum reimbursement and minimize revenue leakage.

Reduce Days in A/R

Accelerate your cash flow with our efficient claims processing and follow-up procedures. We typically reduce days in accounts receivable by 25-30% within the first six months.

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Improve Clean Claims Rate

Our quality assurance processes and experienced coding team help achieve clean claims rates of over 95%, reducing denials and rework while speeding up payment cycles.

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Comprehensive Reporting

Access detailed analytics and reporting that provide insights into your practice's financial performance, helping you make informed decisions for growth and optimization.

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Compliance Assurance

Stay compliant with ever-changing healthcare regulations including HIPAA, ICD-10, CPT updates, and payer-specific requirements with our expert compliance monitoring.

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Dedicated Support Team

Work with a dedicated team of RCM professionals who understand your practice's unique needs and provide personalized support throughout the entire revenue cycle process.

Our Comprehensive RCM Process

We manage every aspect of your revenue cycle with precision and expertise, ensuring optimal financial outcomes for your healthcare practice.

1

Patient Registration & Demographics

We ensure accurate patient information collection, including demographics, insurance details, and authorization requirements. Our team verifies patient identity and eligibility to prevent downstream issues.

2

Insurance Verification & Authorization

Real-time insurance verification and prior authorization management ensure coverage validation before services are rendered, reducing claim denials and patient responsibility issues.

3

Medical Coding & Charge Entry

Our certified coders ensure accurate ICD-10, CPT, and HCPCS coding for all procedures and diagnoses. Proper coding maximizes reimbursement while maintaining compliance with coding guidelines.

4

Claims Submission & Processing

Electronic claims submission with real-time validation and error checking. We monitor claim status and handle any required corrections or appeals promptly to ensure timely payment.

5

Payment Posting & Reconciliation

Accurate posting of all payments, adjustments, and patient responsibilities. Our team reconciles payments against expected amounts and identifies any discrepancies for resolution.

6

Denial Management & Appeals

Proactive denial management with root cause analysis and systematic appeals process. We work aggressively to overturn denials and recover lost revenue for your practice.

7

Patient Collections & Follow-up

Professional patient billing and collection services that maintain positive patient relationships while ensuring optimal collection rates for patient responsibility amounts.

Comprehensive RCM Service Portfolio

From front-end patient services to back-end collections, we provide end-to-end revenue cycle management solutions tailored to your practice's specific needs.

Patient Access Services

  • Patient registration and scheduling
  • Insurance verification and eligibility
  • Prior authorization management
  • Financial counseling and estimates
  • Point of service collections

Medical Coding & Billing

  • ICD-10, CPT, and HCPCS coding
  • Charge entry and validation
  • Claims preparation and submission
  • Coding compliance audits
  • Provider education and training

Claims Management

  • Electronic claims submission
  • Claims status monitoring
  • Rejection and denial analysis
  • Claims correction and resubmission
  • Appeals and dispute resolution

Payment Processing

  • ERA processing and posting
  • Payment reconciliation
  • Contractual adjustments
  • Refund processing
  • Underpayment identification

Accounts Receivable Management

  • A/R aging analysis and follow-up
  • Insurance follow-up and appeals
  • Patient statement generation
  • Collection agency coordination
  • Bad debt management

Analytics & Reporting

  • Financial performance dashboards
  • KPI tracking and benchmarking
  • Custom reporting solutions
  • Trend analysis and insights
  • Revenue optimization recommendations

Ready to Optimize Your Revenue Cycle?

Join hundreds of healthcare providers who trust ClainetRCM to maximize their revenue and streamline their billing processes. Let us help you achieve your financial goals.

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