Missed Charges Across Departments
Services documented in the record but never charged. We reconcile department activity against submitted claims so nothing is silently lost.
Hospital Revenue Cycle Management
Hospital Revenue Cycle Management Across Every Department
ClainetRCM manages hospital revenue cycle end to end, from registration and charge capture through denial appeals and payment posting. Certified coders, department-level reporting, and a dedicated team assigned to your account.
Engagement at a glance
- Claim submission
- 24 to 48 hours
- Onboarding
- 7 to 14 business days
- Starting rate
- 2.29% of collections
- Coverage
- All 50 states
- Compliance
- HIPAA, BAA signed
01 / Overview
Why Hospitals Need a Specialist RCM Partner
Hospital revenue cycle is not one process, it is dozens running in parallel across departments, each with its own payers, documentation standards, and failure modes. Losses rarely announce themselves. They accumulate quietly in unbilled encounters, unworked denials, and contracts nobody has audited in years.
Certified coders review inpatient and outpatient claims against payer policy and internal documentation before they leave the hospital
AAPC certified coding team
02 / Where revenue leaks
Hospitals and Health Systems Billing Challenges We Solve
Hospitals face revenue cycle obstacles that generic billing companies consistently underestimate. We know them, and we work them systematically.
Unworked Denials
Denials that age past the appeal window become permanent write-offs. We work them on a documented schedule with tracked outcomes.
Contractual Underpayments
Payers paying below the contracted rate is common and rarely caught. We compare every remittance against the contract and pursue the difference.
Registration and Eligibility Errors
Front-end demographic and coverage errors drive a large share of downstream denials. We surface the patterns and help fix them at the source.
Aging Accounts Receivable
Large balances sitting past ninety days tie up working capital. We prioritize by recoverability rather than working the queue top to bottom.
Compliance and Audit Exposure
Coding that will not survive external review creates repayment risk. Our audits find it before an auditor does.
Billing Staff Turnover
Losing experienced billing staff can stall cash flow for months. Our team absorbs that risk so collections continue uninterrupted.
Under-Documented Acuity
Documentation that understates patient complexity reduces reimbursement legitimately owed. We identify the gaps and the query opportunities.
03 / What we run for you
Complete RCM Solutions for Hospitals and Health Systems
From charge capture to final payment posting, ClainetRCM manages every step of the revenue cycle so your teams stay focused on patient care.
Inpatient and Outpatient Complexity
Multi-Payer Contract Management
Government and commercial contracts each carry distinct fee schedules and appeal timelines. Underpayments go unnoticed unless someone compares remittances against the contracted rate.
Cross-Department Coordination
Charges originate in the emergency department, surgery, imaging, laboratory, and the floors. Any department without a reconciliation step is a source of permanent revenue loss.
Executive Level Reporting
Leadership needs revenue performance broken out by department and payer, not one aggregate number that hides where the problems actually sit.
Inpatient grouping and outpatient billing follow entirely different rules. A partner has to handle both accurately, and reconcile the professional and facility sides of the same encounter.
04 / The difference
What Changes When ClainetRCM Runs It
A plain comparison of how each part of the revenue cycle is typically handled without a specialist partner, and what we commit to instead.
| Area | Without a specialist partner | With ClainetRCM |
|---|---|---|
| Claim submission | Batched whenever staff have capacity | Within 24 to 48 hours, every working day |
| Denial follow-up | Worked when somebody finds the time | A documented schedule, prioritized by recoverability |
| Coding review | Assumed correct until an audit says otherwise | AAPC certified review before the claim is submitted |
| Credentialing | Handled reactively, lapses found after payment stops | Tracked calendar, renewals started ahead of every deadline |
| Contract rates | Assumed to match the agreed fee schedule | Remittances compared to contract, variances pursued |
| Reporting | One collections figure at month end | Detail by provider, payer, and denial reason |
| Cost | Fixed salaries and benefits regardless of collections | From 2.29% of collections, no setup fee, no contract |
05 / Onboarding
Live in Five Steps
Onboarding is fast and structured. Most hospitals and health systems go live within one to two weeks with no interruption to daily operations.
- 1
Free Consultation
We review your revenue cycle and identify where money is being lost, at zero cost.
- 2
Custom Onboarding
We integrate with your EHR and practice management system and configure your workflows.
- 3
Team Assignment
A dedicated billing team with direct experience in your setting is assigned.
- 4
Claims Submission
Clean, policy-compliant claims submitted within 48 hours with real-time tracking.
- 5
Revenue Growth
Collections climb with transparent monthly reporting you can act on.
What We Commit To on Every Claim
24-48hFrom charge capture to claim submission, every working day
7-14Business days to onboard your organization end to end
14 daysBetween full accounts receivable reviews, every cycle
2.29%Starting rate on collections. No setup fee, no contract
06 / Coverage
Hospital Settings We Support
From critical access facilities to multi-hospital systems, ClainetRCM scales to your volume and reports at the level your leadership needs.
Community and Critical Access Hospitals
Smaller facilities that need enterprise-grade revenue cycle capability without building a large internal billing department.
Health Systems and Multi-Site Networks
Multi-facility systems needing consistent coding standards, consolidated reporting, and coordinated payer contract management.
Academic and Specialty Hospitals
Teaching hospitals and specialty facilities with complex documentation requirements, resident supervision rules, and high acuity caseloads.
07 / Explore
Services and Specialties for Hospitals and Health Systems
The services and specialty programs hospitals most often engage us for.
08 / Questions
Frequently Asked Questions
Yes, and reconciling the two is where a lot of hospital revenue is recovered. A single encounter frequently generates a facility claim and one or more professional claims, and when those are managed separately without reconciliation, one side is routinely dropped or duplicated. We track both and match them against the encounter record.
We work denials on a documented schedule, prioritized by recoverability and by how close each one is to its appeal deadline, rather than working a queue from the top. We also categorize root causes and report them back, because the same registration or coding issue usually drives a large share of the volume and fixing it upstream is worth more than appealing each instance.
Yes. Our revenue cycle audit compares actual remittances against contracted rates to identify systematic underpayments. Payers paying below contract is common and almost never detected without a line-level comparison, because the claim shows as paid. Finding it gives you the evidence to recover the difference and to renegotiate.
Monthly reporting broken out by department and payer, covering collections, denial rates and reasons, AR aging by bucket, and clean claim rate. One aggregate number hides where the problems are, so the reporting is built to show which department and which payer is driving the variance.
ClainetRCM integrates with the systems hospitals and health systems already run, including Epic, Cerner, Meditech, Allscripts, Athenahealth, and eClinicalWorks. We adapt to your existing technology rather than asking you to migrate, so onboarding does not disrupt clinical or front-office operations.
Pricing starts at 2.29% of monthly collections, so we are only paid when you are paid. There are no setup fees, no long-term contracts, and no hidden charges. Book a free consultation for a quote based on your volume, payer mix, and service lines.
Ready to Strengthen Your Revenue Cycle?
Talk to a hospital revenue cycle specialist about your denial backlog, your contract underpayments, and your AR aging.
09 / Free consultation
Let's Strengthen Your Hospital Revenue Cycle
No obligation. Our specialists will review your current setup and identify exactly where you are losing revenue.
Why Consult With ClainetRCM?
In a single free session, our RCM experts will uncover hidden billing gaps and give you a clear roadmap to increase collections starting immediately.
- Free Revenue Audit We review your billing performance and identify gaps at zero cost to you.
- Dedicated Billing Expert You will speak directly with a specialist who understands your setting.
- 100% Confidential All information shared is protected by HIPAA and never shared with third parties.
- Fast Onboarding Organizations go live within 7 to 14 business days of signing on.
- No Long-Term Contracts Pricing starts at 2.29% of collections. No setup fee, no lock-in.
Request Your Free Consultation
Free revenue audit
Find out what your practice is losing to denials.
Send us 90 days of remittance data and we will show you, line by line, which claims were underpaid, denied, or never worked, and what it would take to recover them. No cost, no obligation, and you keep the report either way.
No setup fee. No long-term contract. Pricing from 2.29% of monthly collections.