Skip to content
Book a Free Consultation

Revenue Cycle Management Services for US Practices

From eligibility checks to final payment, AAPC/CPC Certified Coders and Billers work your claims inside the EHR/PM system you already use. Hand us the whole cycle or only the parts you need help with.

  • HIPAA compliant
  • AAPC/CPC Certified Coders and Billers
  • Works inside your existing EHR/PM
Book a Free Consultation

Free consultation. No patient information needed for the first call.

Medical analytics dashboard on a desktop monitor and tablet, with a physician and a practice administrator talking in the background

Revenue Cycle Problems We Work on Every Day

They're common reasons practices start looking for an RCM partner.

  1. Billing specialist with a headset working at two monitors in a medical office, with shelves of files behind her
  2. 01

    High Claim Denial Rates

    Kodiak Solutions data, reported by HFMA, put the initial denial rate for hospitals and physicians at 11.65% in 2025 (January to November), up from 11.41% in 2024. Kodiak's data for the first half of 2026 show initial denial rates down from a year earlier, but every denial still has to be worked. One coding mismatch or missing authorization can turn a clean claim into a rejected one. We review claims before submission to catch these problems early.

  3. 02

    Slow Reimbursements and Aging Receivables

    When follow-up isn't consistent, claims sit in payer queues far longer than they should. The longer a balance sits unpaid, the harder it is to collect. Original Medicare claims are generally due within 1 calendar year of the date of service. Medicare Advantage, Medicaid and commercial plans set their own limits. We track claim status and follow up on claims that stall.

  4. 03

    Staffing Shortages

    When one biller leaves or is out sick, claims back up. Outsourcing gives you a full billing team without the hiring, training and turnover.

  5. 04

    Coding Inconsistencies

    Providers in the same practice often code the same service differently. We review coding across your team for consistency.

  6. 05

    Prior Authorization Delays

    Waiting on an authorization can hold up a whole treatment plan. Federal rules now require Medicare Advantage, Medicaid and CHIP plans to decide most prior authorization requests within 72 hours (urgent) or 7 calendar days (standard). We track what each plan requires, along with approvals, expiry dates and authorized limits, and flag issues to your team. Submission and payer follow-up are included when your agreement covers full authorization management.

  7. 06

    Changing Payer Requirements

    Payer policies change constantly, and what was billable last year may need different documentation this year. Starting with renewals scheduled on or after January 1, 2027, most Medicaid expansion adults will renew coverage every six months instead of once a year. For Medicaid applications made on or after January 1, 2027, retroactive coverage also gets shorter: one month before the application month for expansion adults, and two months for other applicants. That leaves less time to get a visit covered after the fact. We verify eligibility and benefits before scheduled visits. A coverage check isn't a guarantee that the payer will pay. We keep up with payer-specific rules.

  8. Free consultation. No patient information needed for the first call.

    Book a Free Consultation
Medicare physician payment, 2026 (last reviewed Oct 2026)

For 2026, CMS set two physician fee schedule conversion factors: $33.4009 for clinicians who aren't qualifying APM participants and $33.5675 for those who are, up from a single $32.3465 in 2025. CMS also finalized a -2.5% efficiency adjustment to the work RVUs of most non-time-based services, such as many procedures, imaging and tests. It doesn't apply to time-based services like E/M visits, care management and behavioral health, or to services on the Medicare telehealth list, maternity codes with an MMM global period, or other codes on CMS's updated list of exempt codes. We can review your 2026 fee schedule and payment variance reports against the new rates.

These figures apply to Original Medicare Part B payments under the physician fee schedule. Medicare Advantage and commercial rates follow them only where your contract is tied to Medicare. CMS has proposed 2027 changes, and final rates are expected by early November.

Full Revenue Cycle Services, Grouped by Stage

Most services below have their own page with the details.

Book a Free Consultation
Practice manager in a navy blazer and a physician reviewing a report on a tablet in a bright office

RCM That Scales with Your Practice

More providers means more patients, more specialties and more payer rules to keep straight. We run RCM for practices with several providers and locations, with reporting that keeps you informed.

  • Providers & locations

    One team across all your providers and sites.

  • Multi-specialty groups

    One team for groups with more than one specialty.

  • Complex payer rules

    Medicare, Medicaid and commercial payers, each with its own requirements.

  • By payer, provider, location and CPT

    So you can see where each dollar stands.

RCM Shaped Around Your Specialty

Each specialty comes with its own coding requirements, payer guidelines and documentation standards. We set up your revenue cycle around yours, whether you're a single-specialty group or a multi-provider practice.

All specialtiesBook a Free Consultation

What Makes Our RCM Work Differently

Here's what working with us looks like day to day.

  • Plain-Language Reporting

    You shouldn't need a billing background to understand your revenue cycle. Reporting by payer, provider, location and CPT, explained clearly.

  • Built Around Your Practice

    We don't force every client into the same template. Your specialty, patient volume and payer mix shape how we set up your billing.

  • You Own Your Data

    You decide who on our team has access, and the records stay with your practice. We sign a Business Associate Agreement (BAA) with every client before we access any patient information. Because we work inside your own system, your team can see the work there too.

Laptop and tablet showing practice dashboards on a wooden desk beside a stethoscope and notebook

What You Can Count On

  • Coding and billing by AAPC/CPC Certified Coders and Billers.
  • HIPAA compliant, with HIPAA-trained staff.
  • Multi-specialty billing, so a group with more than one specialty stays with one team.
  • Every client gets a dedicated point of contact for day-to-day questions.
  • We work in 50+ EHR and PM systems, including Epic, athenahealth, eClinicalWorks, NextGen, Tebra and AdvancedMD.
  • A real person to talk to: email info@medixcode.com.
Book a Free ConsultationAbout MedixCode

What Working with MedixCode Looks Like

We follow a set process, so you can see what stage your billing is in and what happens next.

How We Run Your Revenue Cycle

Each stage has a defined workflow, from claim scrubbing to structured follow-up, with clear reporting at the end of it.

  1. 01

    Discovery

    We review your current billing, payer mix and the problems you want fixed.

  2. 02

    Onboarding

    Our dedicated onboarding team sets up your account and reporting preferences. We agree the onboarding timeline with you after reviewing your systems and payers.

  3. 03

    Access Setup

    We work inside your existing EHR/PM system. No new software for your staff.

  4. 04

    Billing

    Claims are coded, scrubbed and submitted on a consistent schedule.

  5. 05

    Follow-Up

    Denials and aging balances are worked as they come in.

  6. 06

    Reporting

    Reports by payer, provider, location and CPT, so you can see where things stand. Practice Essentials includes a monthly performance report. Group Practice adds a weekly report and a monthly review call. Enterprise reports run on a schedule you choose.

Simple Pricing Based on Net Collections

You pay a percentage of what's actually collected for your practice. Net collections means the insurance and patient payments that actually land in your bank account. There's no fee on billed charges, adjustments or denied claims. Example: $40,000 in net collections × 3.8% = an estimated $1,520 fee for the month.

  • Practice Essentials

    For solo providers and small practices

    From3.8%

  • Group Practice

    For multi-provider groups

    From2.8%

  • Enterprise

    For hospitals and health systems

    Volume-basedCustom

  • $0 setup
  • $0 monthly minimum
  • No long-term contract. You can end the service with 30 days' notice. Your agreement says who finishes claims already submitted before your end date.

Starting rates shown, as a percentage of net collections. Your final rate is confirmed in writing.

Book a Free Consultation
See full pricing

  • Standard clearinghouse costs are included in your fee. Credentialing and payer enrollment are priced separately. Any third-party fees are shared upfront.

  • We don't write off a balance without your approval unless your agreement allows it.

Revenue Cycle Questions, Answered

What practices usually ask us before they hand over their billing.

Practice manager in a navy blazer and a physician reviewing a report on a tablet in a bright office

Didn't find your question?

Book a Free ConsultationContact us
More questions? See our FAQ
How much does RCM cost?

RCM is priced as a percentage of net collections. Solo and small practices start from 3.8%, groups from 2.8%, and hospitals and health systems get custom, volume-based pricing. We set your rate after a free consultation.

What is revenue cycle management?

It's the work of managing billing from eligibility verification through to payment.

What's the difference between medical billing and RCM?

Medical billing is getting claims out and paid. RCM covers the whole cycle. The AMA describes it in three phases, front end, mid cycle and back end, running from patient registration to payment collection. See medical billing

Why outsource revenue cycle management?

It takes billing work off your staff, gives you a full team of AAPC/CPC Certified Coders and Billers, and lets your practice stay focused on patient care.

Do we need to change our EHR?

No. Your practice keeps its current EHR/PM system, and our team logs in to it with access you control.

How do you protect patient data?

MedixCode is HIPAA compliant, and our staff are HIPAA-trained. Access to your EHR is granted and controlled by your practice. Read about our HIPAA compliance

What happens if a clearinghouse goes down?

We can reroute claims through another clearinghouse or send them through payer portals. Some payers need re-enrollment before electronic remittances (ERAs) can move to a new route, so until then we pull remittances from payer portals to keep posting going.

Billing specialist with a headset working at two monitors in a medical office, with shelves of files behind her

Let's Look at Your Revenue Cycle Together

Tell us about your practice. We'll look at where revenue may be leaking, stalling or sitting uncollected, and give you a written rate.

Book a Free Consultation

Prefer email? Send your revenue cycle questions to info@medixcode.com, or use our contact page.