Revenue Cycle Management
Leaving money on the table isn't an option.
We manage the full revenue cycle — from front-end education and claims submission to denial management and payment posting — with transparency into every step so you always know where your revenue stands.
Front-End RCM Education
Preventing avoidable denials.
- HPA's RCM staff will provide practice staff with targeted training and real-time feedback on front-end denial prevention, including insurance verification, demographic accuracy, coordination of benefits (COB), missing tickets, and time-of-service (TOS) collections.
- HPA will deploy automated reporting tools to proactively identify front-end errors — such as missing charges, incomplete authorizations, and eligibility discrepancies — enabling staff to resolve issues before claims are rejected or payment is delayed.
- HPA will implement denial tracking and analytics to monitor avoidable denial rates by category, giving practice leadership the data needed to identify high-risk areas and drive continuous improvement.
Claims Submission
Submitting cleaner claims.
- HPA will transmit practice data from their system into HPA’s propriety EHR system
- Automated rule-based scrubber will be applied to capture possible denials
- HPA will correct the scrubber rejections and prepare for clearing house submissions
- Claims will be submitted from HPA’s system to the clearing house
Denial Management
Resolving denials faster.
- Dedicated denial specialists reviewing every denial by category
- Root-cause analysis & correction (coding, eligibility, medical necessity, bundling)
- Appeals prepared and submitted with supporting medical documentation
- Tracking of payer medical policy rules to prevent repeat denials
- Monthly denial trends & education back to the clinic
- Regular updates provided when payers change rules
Payment Posting
Keeping payments accurate.
- ERA/EOB posting with full adjustment mapping
- Variance analysis against contracted rates
- Underpayment identification (with reports to the practice or payer contracting team)
- Credit balance resolution
- Daily bank deposit reconciliation
RCM Analytics Reporting Packages Include
Tracking revenue clearly.
- Clean Claim Rate
- Denial Rate & Categories
- A/R Aging (total and by payer)
- Charge Lag
- Net Collection Rate
- Provider Productivity (RVUs, charges, collections)
- Payor Mix
- Benchmarking Comparisons
- Ad Hoc Custom Reporting and Dashboarding