End-to-End Revenue Cycle Management - From Coding to Final Payment
At CodeEMR, we
provide complete revenue cycle management (RCM) that helps healthcare providers
streamline billing, lower claim denials, and increase reimbursements.Â
Why Providers Partner with CodeEMR
Imagine this: A busy clinic sees many patients each day. However, the billing staff feels overwhelmed with claim rejections, delayed payments, and increasing administrative tasks. This causes revenue delays, a drop in productivity, and challenges for the clinic to keep up.
Reduce Claim Denials
Minimizes claim denials using improved workflows and expert oversight
Scalable Solutions
Grows with your needs, offering solutions for hospitals, specialty practices, and clinics
Compliance & Security
Maintains security and compliance by meeting HIPAA standards and protecting data privacy
Our End-to-End Revenue Cycle Management Services
|
Step 1 Eligibility Verification |
Step 2 Charge Capture |
Step 3 Medical Coding |
Step 4 Claim Submission |
Step 5 Denial Management |
Step 6 AR Follow-Up |
|---|---|---|---|---|---|
| Confirm insurance & patient eligibility before service | Document every service rendered, coded and billable | Accurate ICD-10, CPT & HCPCS code assignment | Clean claims submitted on time to all payers | Identify, appeal & recover denied or underpaid claims | Track aging AR, resolve balances, deliver reporting |
See Where Your Revenue Cycle Is Leaking
Recommended Table: Before CodeEMR vs. After CodeEMR
| Metric | Before CodeEMR | After CodeEMR |
|---|---|---|
| Claim Denial Rate | 12–18% | < 5% |
| Days in AR | 45–60 days | < 30 days |
| Clean Claim Rate | 75–82% | > 95% |
| Admin Hours (billing) | 20–30 hrs/week | < 5 hrs/week |
| Revenue Leakage | Untracked | Identified & recovered |
Case Study
Excelsior Orthopaedics was experiencing high claim denials and 52 average days in AR before partnering with CodeEMR. Within 90 days of outsourcing their revenue cycle management, denial rates dropped to under 4% and AR days fell to 28 — recovering over $180,000 in previously lost revenue. → Read the full case study:https://www.codeemr.com/case-studies/medical-coding-case-study-for-excelsior-orthopaedics/
Excelsior Orthopaedics: From 14% Denial Rate to Under 4% in 90 Days
Frequently Asked Questions (FAQs) About Medical Billing Services
Medical billing is the process of submitting healthcare claims to insurance payers, following up on unpaid claims, posting payments, and managing patient balances. CodeEMR supports healthcare organizations by ensuring billing workflows align with accurate documentation and compliant coding practices.
Medical coding translates clinical documentation into standardized codes, while medical billing focuses on claim submission, payment posting, denial follow-ups, and reimbursement management. CodeEMR integrates coding accuracy with billing workflows to support clean claim submission.
Common causes include incomplete documentation, eligibility issues, incorrect coding, missing modifiers, and payer-specific rules. CodeEMR reduces billing errors by aligning billing processes closely with compliant coding and payer guidelines.
Accurate documentation supports medical necessity and proper code selection, which directly affects claim acceptance and reimbursement. CodeEMR’s billing teams work from provider documentation to ensure claims are defensible and compliant.
Yes. CodeEMR follows HIPAA-aligned security and confidentiality protocols to protect patient information throughout the billing lifecycle.
Healthcare organizations can outsource:
- Charge entry
- Claim submission
- Payment posting
- Denial and rejection follow-ups
- Patient billing support
Denied claims are reviewed to identify root causes, corrected based on documentation and payer rules, and resubmitted when appropriate. This structured approach helps reduce repeat denials over time.
Yes. CodeEMR’s billing services are designed to scale based on patient volume, payer mix, and organizational growth without requiring additional in-house staff.
No. CodeEMR can function as a full-service billing partner or as an extension of existing billing teams, depending on organizational needs.
- Physician practices
- Multi-specialty clinics
- FQHCs and community health centers
- Telehealth providers
- Growing healthcare organizations
CodeEMR's pricing is based on a percentage of collections - typically ranging from 3% to 8% depending on specialty, volume, and payer mix. There are no upfront setup fees. Because our clients see a measurable increase in collections and reduction in claim denials, the service consistently pays for itself. Contact us for a custom quote based on your practice's specific needs.
Most practices see a measurable reduction in claim denials within 30-45 days of onboarding. Full AR stabilization and clean claim rate improvement typically occurs within 60-90 days. CodeEMR provides weekly performance reports so you can track progress from day one.
Yes. CodeEMR can operate as a full-service billing partner or as an extension of your in-house team. Many clients use CodeEMR for specific functions - such as denial management, AR follow-up, or coding oversight - while retaining internal billing staff for patient-facing interactions. We integrate with your existing EMR and workflows without disruption.