- info@rcmexperts.us
- 2701 taft blvd wichita falls TX 78208
- Medical Billing Full Time Employee Charges - $11/hour
As of April 2025, six major claims administrators in New York, Texas, and California have changed clearinghouses. Submitting to outdated channels can lead to denials and delays. We stay ahead of these changes so your claims always go to the right place.
Our system automatically updates your routes—like rerouting Tristar to Data Dimensions after the Jopari switch. With direct clearinghouse connections and real-time formatting updates, we prevent lost claims and reduce rejections before they happen.
Stay ahead of payer changes.
Equipped to escalate claims and enforce your rights under regional statutes.
We manage the entire billing cycle, from credentialing through appeals, so you stay focused on patient care.
Here’s what that looks like:
We don’t let delayed or underpaid claims slip through the cracks. At day 15, we automatically launch appeals to fast-track aging claims and push for resolution. Our recovery methods are customized to each state’s specific billing rules.
By day 30, we send legal demand notices using the appropriate state laws to pressure payers into action. If payment still isn’t received, we file secure liens by day 45—at no extra cost—ensuring you protect your rights and recover every dollar owed.
Key Billing Metric | Industry Average | RCM Experts |
First-Pass Acceptance Rate | 68% | 94% |
Denial Recovery Success | 12% of denied claims | 41% |
Average Time to Payment (TX/NJ) | 47 days | 22 days |
Advanced handling of DWC billing rules and modifier logic for prompt, compliant payments.
We stay synced with the latest DWC form updates, PR-2 timelines, and secondary review protocols.
Our process adapts to fast-changing payer behaviors, ensuring high recovery without legal tangles.
Expert coding aligned to Florida-specific statutes and timely filing rules prevents unnecessary disputes.
We apply strategies like isolating implant pass-throughs under §306(f.1)(5) to maximize surgical reimbursements.
→ Proactively include PR-2 documentation to prevent claim delays
→ Code drug screenings correctly to avoid bundling flags
→ Leverage unique CPT/DWC pairings for California-specific approvals
→ Manage utilization review efficiently to shorten turnaround time
→ Separate and document surgical hardware (implants) for full pass-through payments, especially in PA & NJ
→ Align billing with state-mandated reimbursement schedules to reduce appeal cycles
AI-Powered Revenue Audits: Detects errors and underpayments most systems miss—down to modifier misuse and duplicate bundling.
Dedicated Billing Experts: Every client works with a named team member, not a rotating support desk.
Clarity Through Reporting: Our monthly insights dashboard compares your revenue trends to industry benchmarks, giving you real-time visibility into performance.
On average, we uncover over $15,000 in missed revenue per 100 denied claims. If we don’t find that for your practice, we’ll write the check ourselves. That’s how confident we are.
RCM Experts: Smarter Billing. Faster Payments. More Revenue.
