Revenue Cycle Management
End-to-end medical billing and revenue cycle services for independent practices. We handle every step from charge capture to final payment, so your team can focus on care.
What we do, and why it matters
Most independent practices lose 10 to 20 percent of collectible revenue to billing errors, missed follow-up, and slow denial resolution. Our RCM service is designed to recover that revenue and keep it recovered, month after month.
We are not a clearinghouse. We are not a software platform. We are a team of experienced billing professionals who work your accounts the way you would want them worked: thoroughly, promptly, and with a clear understanding of your specialty.
Because our fees are based on net collections, our success is directly tied to yours. We do not get paid unless you get paid.
How it works
A complete revenue cycle process, managed end to end. Here is what we do and in what order.
Practice Setup & Onboarding
We configure your practice management system, establish EDI and ERA enrollments with all payors, and build the workflows your team will use from day one. A clean setup prevents the downstream problems that plague most billing operations.
Charge Capture & Claim Submission
Every encounter is reviewed for payor reimbursement policy accuracy, modifier application, and completeness before submission. Our 98% clean claims rate means the vast majority of claims are paid on the first pass, without delays or rework.
Payment Posting & Reconciliation
We post all payments, contractual adjustments, and patient responsibility balances accurately and promptly. ERA automation handles the volume; our team reviews exceptions and ensures your books reflect reality.
Denial Management & AR Follow-Up
Denials are worked within 24 to 48 hours of receipt. We track denial patterns by payor and root cause, and we use that data to prevent recurrence. AR is segmented by age and payor, and every dollar is pursued systematically.
Patient Statements & Collections
Patient responsibility balances are billed clearly and promptly. We coordinate with patients to resolve balances and manage the collections agency referral process when needed. Patient satisfaction scores are tracked and reported to you monthly so you always know how your patients experience the billing process.
Reporting & Analytics
You receive regular reporting on collections, denial rates, AR aging, and payor performance. We benchmark your practice against industry standards and flag trends before they become problems.
What's included
Our RCM service is comprehensive. The following are included as standard, not add-ons.
Specialty expertise
Generic billing companies apply generic workflows. We know the procedure codes, modifier rules, and payor quirks specific to your specialty. That knowledge is the difference between a 75% and a 98% clean claims rate.
Frequently asked questions
Common questions about revenue cycle management and Uptick Health's approach.
Revenue cycle management is the process of tracking patient care from the initial appointment through final payment. It includes insurance verification, charge capture, claim submission, payment posting, denial management, and patient billing. Effective RCM ensures that practices are reimbursed accurately and promptly for the care they provide.
A clean claim is one that is accepted and processed by the payor on the first submission without any errors, missing information, or rejections. A 98% clean claims rate means that 98 out of every 100 claims we submit are paid without requiring rework. The national average is approximately 75 to 85 percent. A higher clean claims rate directly reduces your days in AR and improves cash flow.
Our RCM fees are percentage-based, calculated on net collections. This means we are only paid when you are paid, and our incentive is always aligned with maximizing your revenue. We do not charge flat monthly fees that are disconnected from performance.
We are fluent in ModMed (Modernizing Medicine), Athenahealth, and Epic, and have experience with several other platforms. Our team is trained on specialty-specific workflows within each system, including ModMed's dermatology and ophthalmology modules.
Most transitions are completed within 30 to 45 days, depending on the complexity of your payor mix and the state of your current billing setup. We manage the transition carefully to avoid any disruption to your cash flow, and we typically run parallel processes during the handoff period.
Yes. We provide MIPS consulting and reporting support as part of our RCM service. We track your quality measures throughout the year and ensure your data is submitted accurately and on time to avoid payment adjustments.
The core of our practice is dermatology, ophthalmology, and orthopaedics, with deep experience across pain management, neurosurgery, plastic surgery, OBGYN, pulmonology, sleep medicine, primary care, ENT, gastroenterology, and more. Our specialty-specific knowledge means we understand your procedure codes, your common denial patterns, and your payor landscape.
Ready to see what better billing looks like?
Most practices see measurable improvement in clean claims rate and days in AR within the first 90 days. Let's talk about what that could mean for your practice.
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