What RCMology Does

How we close the revenue gap

Flagship Solution

RCM Intelligence

The analytics solution that catches what your team can't see manually — before it becomes lost revenue.

Reconciliation & Charge Integrity

Catch missing charges, mismatched drug inventory, and coding errors before they go out the door.

Denials & A/R Management

Prioritize the accounts that matter, and never miss a follow-up or filing deadline again.

Payer & Payment Operations

See which payers are lagging, and which claims are still moving through paper.

Analytics & Reporting

Monthly trends on A/R days, denial rates, and collection performance — sliced by payer and provider.

Reconciliation & Charge Integrity

Stop losing revenue between the visit and the bill

Every appointment is checked against billed charges the same day. Drug administration is cross-checked against the inventory portal for missing or mismatched admin codes.

  • Daily charge reconciliation — every visit checked against every billed charge
  • Medication charge reconciliation vs. drug inventory, same-day
  • Charge entry lag alerts, before timely filing is at risk
  • Modifier usage and coding compliance review
  • False credit and wrong patient credit balance detection
$41,200
Unbilled charges caught this month
18
Drug/admin code mismatches
3
Locations under-booked next week
99.2%
Same-day charge match rate
Denials & A/R Management

Work the claims that are actually at risk

Denials are trended by month, payer, provider, and CPT within reason code — so you know exactly where the leak is, not just that one exists.

  • Denied claims unaddressed past a set number of days
  • First pass resolution rate — how many claims pay without rework
  • Denial appeal success rate by payer and reason code
  • Claims nearing filing or appeal deadlines — and those already past it
  • 80/20 A/R prioritization by dollar bucket
A/R by Balance — 80/20 ViewThis Week
A/R BalanceClaims% ClaimsTotal $% A/R
Over $5,000816%$32,00061%
$1,000–$5,0001530%$16,50031%
Under $1,0002754%$4,3008%
Total50100%$52,800100%

16% of claims hold 61% of the money — work these first.

Payer & Payment Operations

Know which payers are actually slowing you down

Payment trends are tracked by payer, by week, alongside how claims and payments actually move through your workflow.

  • Payment trend monitoring, flagged by payer
  • Prior authorization approval rate and turnaround by payer
  • Insurance eligibility verification before the visit, not after
  • Unposted ERA/EOB opportunity report — payments sitting idle
  • Paper vs. electronic claims and posting method tracking
Payer Payment LagWeekly
PayerAvg. daysTrend
Aetna18Stable
Cigna34Slowing
BCBS41Lagging
Analytics & Reporting

One financial summary, refreshed monthly

Charges, payments, GCR, liquidation rate, and per-visit and per-CPT economics — trended by month, payer, and provider, without a spreadsheet in sight.

  • Net collection rate — the single most important revenue cycle KPI
  • Cash collections waterfall, from gross charges to net cash
  • 45-day revenue liquidation — an early signal of cash flow trouble
  • A/R days and denial rate by month, payer, and provider
  • Cost-to-collect — what it actually costs you to collect a dollar
96.4%
Gross collection rate
31.2
Days in A/R
$212
Payment / visit
$584K
Charges, current month
Monthly Financial SummaryTrend
MonthChargesPaymentsAdjustmentsBalanceChg/VisitPay/VisitGCRNCR90+ A/RA/R Days
Jan$542,000$521,000$14,200$6,800$268$25896.1%94.8%$18,40032.1
Feb$560,000$541,000$13,900$5,100$271$26296.6%95.2%$16,90031.6
Mar$584,000$563,000$15,100$5,900$275$26596.4%95.0%$17,60031.2
Total$1,686,000$1,625,000$43,200$17,800$271$26296.4%95.0%$17,60031.6
Beyond the Solution

Extend it with the two things every revenue cycle also needs

Contract Variance

Payers don't always pay what they agreed to. We compare posted payments against your negotiated rates and flag the underpayments — often the highest-ROI catch in the entire revenue cycle.

Staff Augmentation

Need RCM capacity without the hiring cycle? Our team plugs into your workflows — reconciliation, follow-up, posting — backed by the same solution your team would use.

See what's slipping through your revenue cycle

A free assessment using your own data.

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