Full-Cycle Revenue Cycle Management
Medical Billing
Services That
Get You Paid.
ProvidaRCM manages every step of your revenue cycle, from charge entry and claim submission to payment posting and denial recovery, so your practice collects more, faster, with less administrative burden.
- HIPAA Compliant
- AAPC Certified
- No Long-Term Contracts
- All 50 US States
Live Performance Dashboard
30%
Faster payments avg.
60%
Denial rate reduction
$10M+
Claims recovered
$140K
Avg. aged A/R recovered
500+
Providers Nationwide
Full-Cycle Billing From
Start to Payment
ProvidaRCM handles every step between a patient encounter and the final dollar deposited into your account. Nothing falls through the cracks. Nothing gets written off without a fight.
Setup
5–7 business days to full onboarding. We integrate with your existing EHR, no software changes required.
Contract
Month-to-month. No long-term contracts. No cancellation fees. We earn your business every month.
Coverage
All 50 US states. Medicare, Medicaid, all major commercial payers, and Medicare Advantage plans.
1
Patient Registration & Insurance Verification
We verify insurance coverage and benefits for every scheduled patient before their appointment, eliminating eligibility-related denials before they happen.
2
Charge Entry & Superbill Review
Every charge is reviewed and entered accurately. We catch documentation gaps, missing codes, and under-reported services before submission, not after a denial.
3
Claims Submission & Scrubbing
Clean claims are submitted electronically within 48 hours of service. Every claim is scrubbed against payer-specific edits before submission to eliminate preventable rejections.
4
Payment Posting & Reconciliation
All ERAs, EOBs, and patient payments are posted promptly and reconciled against expected reimbursement. Underpayments are flagged and challenged immediately.
5
Denial Management & Appeals
Every denied claim is captured, categorized, and worked within 24 hours. We file timely appeals with supporting documentation and track each one through final resolution.
6
A/R Follow-Up & Patient Collections
We aggressively follow up on every unpaid and underpaid claim. Patient balances are billed professionally, with payment plan options and online payment links to maximize collection.
7
Reporting & Performance Analytics
Monthly reports with clear KPIs, collections by payer, denial rates, A/R aging, and claim status, delivered to you and discussed with your dedicated billing manager.
From Onboarding to Optimized Revenue
A seamless transition that gets your billing running, typically within 5 to 7 business days with no disruption to your existing workflow.
1
2
3
4
5
Discovery Call
We learn your specialty, payer mix, current challenges, and billing software in a 30-minute consultation.
Billing Audit
We analyze your current claims, denial patterns, and A/R aging to identify every revenue gap and opportunity.
Onboarding
We integrate with your EHR, collect payer contracts, set up reporting access, and assign your dedicated team.
Billing Begins
Clean claims are submitted immediately. Denials are worked daily. You see results within the first billing cycle.
Optimize & Grow
Monthly reviews, performance reports, and ongoing coding optimization to continuously improve your revenue cycle.
What Makes Our Billing Different
Results that speak for themselves, and a team that goes beyond the basics to protect and grow your revenue cycle.
Specialty-Specific Billing Expertise
Every specialty has unique procedure codes, modifier requirements, documentation standards, and payer-specific coverage policies. Our billers are assigned based on specialty experience, not availability. Your cardiologist's claims are handled by someone who knows cardiology billing, not a generalist who looks it up.
99% First-Pass Claim Acceptance
The industry average is 95%. We consistently hit 99% by scrubbing every claim against payer-specific edits before submission.
Dedicated Account Manager
One person. One number. Direct access to a billing professional who knows your practice, not a call center ticket queue. Your account manager responds within one business day. Always.
100% HIPAA Compliant
Encrypted transmission, secure cloud storage, role-based access controls, and a signed Business Associate Agreement (BAA) before day one.
No Setup Fees. No Surprises.
We charge a percentage of monthly collections only. You pay nothing until we collect, which means our financial success is tied directly to yours.
Real-Time Reporting Dashboard
Live access to your claim status, collections, denial rates, A/R aging, and payer performance. Monthly reports reviewed with your billing manager so you always know exactly where you stand.
Faster Payment Turnaround
Clean claims and proactive follow-up help reduce reimbursement delays and keep your cash flow steady. We track unpaid claims daily, resolve payer issues quickly, and work to shorten your average payment cycle so revenue reaches your practice faster.
In-House Billing vs. ProvidaRCM
- $55,000–$75,000/yr biller salary + benefits, plus software costs
- Revenue drops when staff quits or takes leave, and turnover is high
- Generic coding knowledge, not specialty-trained for your procedures
- Industry average 85% first-pass rate, 15% of claims denied at the door
- Denied claims often not worked or written off due to time constraints
- No real-time reporting, you don't know your true collection rate
- Compliance risk if staff not AAPC or AHIMA certified
vs.
ProvidaRCM
- 2.49% only. Zero cost when you're not billing. Scales with your practice.
- Zero revenue disruption. Staff changes on our side never affect your cash flow.
- AAPC-certified billers assigned specifically based on your specialty.
- 99% first-pass rate. Above industry average, fewer denials from the start.
- Every denied claim is worked within 24 hours. Nothing is written off.
- Real-time dashboard. You know your collections, denials, and A/R aging.
- Full HIPAA compliance. BAA signed before we touch a single claim.
Billing for Your Specialty
What Our Clients Say
Real results from real healthcare providers across the United States.
Medical Billing FAQs
Everything you need to know about outsourcing your medical billing to ProvidaRCM. Don't see your question? Contact us directly.
Still have questions?
Our billing specialists are available to answer. We respond to all inquiries 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.
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.
Absolutely. ProvidaRCM is 100% HIPAA compliant. All patient data is transmitted through encrypted channels, stored on secure servers, and accessed only by authorized personnel. We sign a Business Associate Agreement (BAA) with every client before we begin work, required under HIPAA for all third-party billing relationships.
Every denied claim is captured, categorized by denial reason, and worked by our denial management team within 24 hours. 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, not just fixing the symptom, but eliminating the root cause.
Yes. ProvidaRCM handles billing for Medicare Part A and Part B, all 50 state Medicaid programs, Medicare Advantage plans, and managed Medicaid. We also manage Medicare EDI enrollment, ERA setup, and EFT registration for new providers.
Get Your Free
Billing Audit
We'll review your current billing workflow, analyze your claim data, identify revenue gaps, and deliver a clear picture of how much ProvidaRCM can recover for your practice, completely free.
What You'll Get in Your Free Audit
- Current Collection Rate Analysis: what you're actually collecting vs. what you should be
- Denial Pattern Review: the top 5 reasons you're losing revenue right now
- A/R Aging Assessment: how much money is sitting unpaid and why
- Revenue Recovery Estimate: a realistic projection of what we can recover
- Custom Proposal: pricing and timeline specific to your practice size and specialty
Explore Related Services
Medical Coding
AAPC-certified ICD-10, CPT & HCPCS coding for every specialty and procedure type.
Denial Management
Recover denied claims fast and eliminate the root causes of future denials.
A/R Management
Aggressive receivables follow-up that cuts your A/R days and accelerates cash flow.