Four service lines. Take all of them, or take the one that's broken.
A denied claim costs you twice: once in the rework, and once in the 30 to 60 days it adds to your A/R. So the work goes in before submission, not after.
We bill Medicare Part A and B, Medicare Advantage, state Medicaid, managed care, and private pay. We sit in your triple-check, flag documentation gaps while they're still fixable, and reconcile every remittance against what we filed.
| Included | Cadence |
|---|---|
| Claim scrubbing & submission | Daily |
| Remittance reconciliation | Weekly |
| Triple-check participation | Monthly |
| Short-pay identification | Weekly |
| Payer enrolment maintenance | As needed |
| Rate & contract loading | As needed |
| Included | Cadence |
|---|---|
| Denial triage & assignment | Daily |
| Appeal drafting & submission | Within 5 days |
| Root-cause coding | Every denial |
| Timely-filing watchlist | Weekly |
| Payer trend reporting | Monthly |
| Escalation to payer reps | As needed |
Over half of revenue cycle leaders say denials are rising, and about half of providers still review claims by hand. That combination is why denials pile up in a folder somebody means to get to.
Every denial gets an owner, an appeal deadline, and a root cause. The root cause is the part most vendors skip — it's the difference between appealing the same denial forever and making it stop.
Denial trend figures: Experian State of Claims 2025 (n=250 revenue cycle leaders).
Medicaid pending is the most consistent driver of aged A/R in skilled nursing. A resident is admitted private pay, the application goes in, and unless somebody is tracking it, the conversion to Medicaid billing never happens cleanly.
With 63% of nursing facility residents on Medicaid, this is not an edge case — it's most of your book. We track every application from admission to determination, convert on approval, and keep a redetermination calendar so coverage doesn't quietly lapse.
Payer mix: KFF, July 2025.
| Included | Cadence |
|---|---|
| Application tracking | Weekly |
| Status calls to the state | Weekly |
| Private-pay conversion | On approval |
| Redetermination calendar | Monthly |
| Patient-liability calculation | Monthly |
| Family communication support | As needed |
| You receive | When |
|---|---|
| One-page A/R summary | 1st business day |
| Aging by payer & bucket | 1st business day |
| Benchmark scorecard | 1st business day |
| Accounts needing a decision | 1st business day |
| Denial root-cause summary | Monthly |
| Review call with your lead | Monthly |
Most billing reports are a data dump that tells an administrator nothing they can do anything about. Ours opens with the accounts that need a decision from you this month, and why.
Underneath that: aging by payer, your days in A/R, clean claim rate, and denial rate against published benchmarks — including the months we're behind on one of them.
Our fee is a percentage of collections, set per engagement based on payer mix, number of buildings, and the state of the book when we take it on. If we don't collect, we don't earn — which is the only fee structure that puts us on the same side of the table as you.
No setup fee. No long lock-in. 60 days' notice either way.
We'll tell you what's collectable, what's aging out, and what it's costing you. No fee, no obligation.