Resources / Guides

Fix the revenue cycle, step by step.

Practical playbooks for the parts of US healthcare billing that leak money — written to be used, not filed away.

Featured guide

First-pass clean claims are the single biggest lever in the revenue cycle — every claim reworked adds cost and delays payment. Run this before anything goes out the door.

Run it on your claims
  1. 01Verify active eligibility and benefits (270/271) before the visit.
  2. 02Confirm the prior authorization on file matches the service performed.
  3. 03Code to the highest specificity — laterality and the 7th character where required.
  4. 04Make sure the diagnosis supports medical necessity for the CPT/HCPCS billed.
  5. 05Apply the correct modifiers for the scenario.
  6. 06Use the right form and place-of-service code (837P vs 837I; POS).
  7. 07Confirm provider NPI and taxonomy are correct.
  8. 08Run payer-specific edits/scrubbing, then submit within the timely-filing window.

The guide library.

One playbook per leak. Pick the stage that's costing you the most.

Denials

Cut first-pass denials

Root-cause your top denial reasons with CARC/RARC and fix them upstream, where prevention is cheaper than appeal.

Talk this through→
A/R

Bring down days in A/R

Worklist discipline and a follow-up cadence that keeps aging claims from quietly becoming write-offs.

Talk this through→
Access

Eligibility, done right

Move coverage checks to real-time 270/271 at the front desk so nothing bills into a dead policy.

Talk this through→
Access

Prior auth without the delays

Secure authorizations before care and make sure what's on file matches what's performed.

Talk this through→
Denials

The denial appeals playbook

Read the remark codes, assemble the documentation, and appeal before the deadline closes the window.

Talk this through→
Coding

Coding for specificity

Laterality, the 7th-character extension, and diagnosis-to-procedure medical necessity — the specificity payers reward.

Talk this through→
Posting

Payment posting & underpayment recovery

Reconcile the 835/ERA line by line so partial denials and underpayments don't slip past.

Talk this through→
Strategy

Choosing an RCM partner

The questions to ask, the red flags to watch for, and how to keep visibility instead of buying a black box.

Talk this through→

Guides are the map. We'll walk it with you, on your claims.