ProvidaRCM delivers end-to-end medical billing and RCM, services that help healthcare providers across the USA get paid faster, reduce claim denials, and focus on what matters most, patient care.
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Industry avg. is 95%
Across all 50 states
Specialty-specific billing
Within 90 days of launch
Credentials, portals, and quirks learned plan by plan, so new clients do not pay for our training.
Payer names and marks are the trademarks of their respective owners.
Hand us one function or the whole cycle. Every service runs with the same ownership model: a named team, a defined result, and a report you can check.
Our core practice. Charge capture through payment posting, run by a team that owns the result each month. Clean claims out daily, payments reconciled against contracted allowables, shortfalls flagged the day they land.
Explore billingAAPC-certified coders working ICD-10, CPT, and HCPCS against your specialty's payer policies, not a generic codebook.
Explore codingEvery denial categorized by root cause, appealed on deadline to the last available level, and corrected at the source.
Explore denial managementAuthorization requests submitted and followed through before the visit, so procedures stop bouncing back unpaid.
Explore prior authReal-time benefit and coordination-of-benefits checks before the patient arrives, catching coverage issues while they are still fixable.
Explore verificationPayer enrollment, revalidation, and CAQH upkeep run against a calendar, so participation lapses never interrupt your revenue.
Explore credentialingAging receivables worked by recovery date and dollar value. On average $140K in aged A/R recovered per engagement.
Explore A/R recoveryClear, timely patient billing and collections that recover balances without costing you goodwill or reviews.
Explore patient statementsOON claims, payer negotiation, and Independent Dispute Resolution filings handled by specialists who track every deadline.
Explore OON billingNeed documentation turnaround too? Medical transcription is available for practices that want it bundled in.
The eight leaks below account for most of what a free assessment finds. Each one has a measurable fix.
Billing headcount, software, and turnover cost more than a percentage of collections ever will.
Open billing seats mean claims sit. Our bench absorbs the volume the day we start.
Appeal windows close quietly. We track every deadline and appeal to the last available level.
Procedures performed without auth rarely get paid. Requests go out before the visit, tracked to approval.
Downcoding and missed modifiers shrink allowed amounts. Certified coders audit against the documentation.
An expired enrollment can zero out weeks of claims. We run the revalidation calendar for you.
Payers pay under the contract and count on you not noticing. We check every remit against the allowable.
Claims past 90 days decay fast. We work aging by recovery date, averaging $140K recovered per engagement.
Forty disciplines in production. Coders and billers work inside the coding rules and payer behavior of one field rather than in a general queue.
Session limits, telehealth modifiers, and parity rules handled by coders who bill behavioral health daily.
Explore billingCath lab coding, diagnostic bundles, and global periods reconciled to the contracted allowable.
Explore billingSurgical globals, DME, and fracture care coded to the operative note the first time.
Explore billingAT modifiers, visit caps, and Medicare documentation rules applied to every adjustment claim.
Explore billingScreening-to-diagnostic conversions, ASC facility claims, and anesthesia splits handled cleanly.
Explore billingInterventional fluoroscopy guidance, drug-screen limits, and NCCI bundling edits applied before submission.
Explore billingChemo administration sequences, J-code units, and buy-and-bill reconciled against acquisition cost.
Explore billingGlobal maternity packages, payer plan transfers mid-pregnancy, and split visits billed accurately.
Explore billingYour specialty is not listed? We likely already bill it.
Browse all 40 specialtiesWe optimize every invoicing phase, armed with clinical knowledge and a commitment to first-class claims processing. Cloud tech validates insurance eligibility instantly and files claims electronically to quicken payments.
Faster payments avg.
Denial rate reduction
A/R days avg. for clients
Avg. aged A/R recovered
Billing company that does
Medical Claims Right
Managing billing in-house comes with real costs, staff salaries, training, software, and revenue loss from errors. ProvidaRCM eliminates those burdens while delivering measurable results.
A seamless onboarding process that gets your billing optimized in days, not months.
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We collect your payer contracts, review your workflow, and integrate with your existing EHR/PM system.
We submit clean claims immediately, following up relentlessly until every dollar is collected.
Denied claims are identified, appealed, and resolved. Root causes are fixed to stop repeat denials.
Monthly performance reports with clear KPIs and direct access to your billing manager anytime.
A seamless onboarding process that gets your billing optimized in days, not months.
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We collect your payer contracts, review your workflow, and integrate with your existing EHR/PM system.
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We submit clean claims immediately, following up relentlessly until every dollar is collected.
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Denied claims are identified, appealed, and resolved. Root causes are fixed to stop repeat denials.
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Monthly performance reports with clear KPIs and direct access to your billing manager anytime.
As a trusted medical billing company in the USA, we are not a faceless billing factory. We operate as a true partner that understands your specialty, knows your payer contracts, and takes full accountability for your revenue cycle.
State Medicaid programs, regional payer rules, and local filing quirks, learned state by state.
Every state has its own Medicaid portal, timely-filing window, and regional payer behavior. We publish a page for every state. Browse billing services by state
Every state handles Medicaid and CHIP differently. We stay current on the specific filing limits and coding requirements for all 50 state agencies.
From Blue Cross Blue Shield regional affiliates to local HMOs, we understand the unique adjudication rules that vary by geography.
If your organization operates across state lines or offers telehealth services nationwide, we provide a single point of contact to manage your entire fragmented revenue stream.
ProvidaRCM integrates seamlessly with all major EHR and practice management platforms. No switching software, we work inside the system you already use.
ProvidaRCM operates to the highest standards of compliance, certification, and data security, so your practice is always protected.
Real results from real healthcare providers across the United States.
Stay ahead of payer policy changes, coding updates, and revenue cycle best practices with insights from the ProvidaRCM team.
Most owners are handed forty pages and read one. Here is the one-page alternative: five numbers covering the money, the backlog and the leakage, the definitions to freeze first, and the meeting that turns each line into an owner and a date.
A system change is a data migration with a revenue cycle attached. Here is the inventory to take before anything moves, the enrolments each payer requires, and the daily checks that show a transition going wrong before the cash does.
The front desk decides whether a practice collects. These are the five conversations that carry a patient balance to payment, written as language a staff member can use, with the record each one has to leave behind.
Everything you need to know about working with ProvidaRCM. Can't find your answer? Contact us directly and we'll respond within one business day.
ProvidaRCM charges a percentage of your monthly collections 2.49% There are no setup fees, no hidden charges, and no long-term contracts. You only pay when we collect, meaning our success is directly tied to yours. Contact us for a free custom quote based on your practice.
Most practices are fully onboarded and billing within 5 to 7 business days. Our team integrates with your existing EHR and practice management software, collects your payer contracts and credentialing documents, and begins submitting clean claims immediately. There is no long downtime or transition gap, we make the switch seamless.
No, in fact the opposite happens. ProvidaRCM achieves a 99% first-pass claim acceptance rate, which is significantly above the industry average of 95%. Our certified billers catch errors before submission, verify eligibility upfront, and apply the correct codes for your specialty, resulting in fewer denials and faster payments from day one.
Absolutely. ProvidaRCM is 100% HIPAA compliant. All patient data is transmitted through encrypted channels, stored on secure servers, and accessed only by authorized personnel through role-based access controls. We sign a Business Associate Agreement (BAA) with every client before we begin work, which is required under HIPAA for all third-party billing relationships.
Getting started is simple. Click the Free Consultation button, fill out the short form, and a ProvidaRCM billing specialist will contact you within one business day. We’ll review your current billing workflow, identify revenue gaps, and put together a custom proposal for your practice, completely free with no obligation.
Yes. ProvidaRCM handles billing for Medicare Part A and Part B, all state Medicaid programs, Medicare Advantage plans, and managed Medicaid. We also manage Medicare EDI enrollment, ERA setup, and EFT registration for new providers so you can start receiving Medicare payments as quickly as possible.
Every denied claim is captured, categorized by denial reason, and worked by our denial management team. We file timely appeals with supporting documentation, follow up with payers until resolution, and report recovered revenue to you monthly. We also analyze denial patterns and implement preventive fixes so the same denials stop recurring, not just fixing the symptom but eliminating the root cause.
Yes. We work with all major EHR and practice management platforms including Kareo, AdvancedMD, athenahealth, eClinicalWorks, DrChrono, Epic, Cerner, Practice Fusion, and many more. We integrate directly into your existing workflow, there is no need to switch software or retrain your staff on a new system.
ProvidaRCM operates on a month-to-month basis with no long-term contracts required. We believe our results should be the reason you stay, not a contract. Most clients stay because they see consistent improvement in collections, denial rates, and A/R days, not because they’re locked in.
ProvidaRCM provides medical billing and coding services for 40+ specialties including Internal Medicine, Cardiology, Orthopedics, Neurology, Psychiatry, Gastroenterology, Oncology, Radiology, Physical Therapy, Podiatry, Dermatology, OB/GYN, Pain Management, and Emergency Medicine. Each specialty is assigned a dedicated biller trained specifically in that field’s coding rules, documentation requirements, and payer contracts.
The same standard runs through every service, specialty, and state page we publish. Start with whichever one answers what you need next.
Every discipline we run in production, each with its own coding rules, payer notes and denial patterns.
See the specialty library Coverage 50State Medicaid portals, timely-filing windows and regional payer behaviour, documented state by state.
Open the state index Insights 30Payer rules, coding details and the changes that decide what a claim pays.
Read the blog ServicesCharge capture through payment posting, owned end to end by a named team.
Explore billing ServicesAAPC-certified coders working inside your specialty's payer policies.
Explore coding ServicesEvery denial categorised by root cause and appealed to the last level.
Explore denials ServicesRequests filed and tracked before the visit, so procedures stop bouncing back.
Explore prior auth