Services We Offer
At iRise RCM Solutions, we offer end-to-end Revenue Cycle Management (RCM) services to help healthcare providers optimize revenue, reduce claim denials, and improve operational efficiency. Our AI-driven solutions and industry expertise ensure faster reimbursements, compliance, and financial stability for your practice.
Industries We Serve
🏥 Hospitals & Health Systems
🏥 Ambulatory Surgery Centers (ASCs)
🏥 Private Practices & Clinics
🏥 Specialty Healthcare Providers (Radiology, Cardiology, Oncology, etc.)
How can we help you?
Medical Coding & Billing
Our expert coders ensure accurate and compliant medical coding, reducing claim rejections and maximizing reimbursements.
✅ Medical Coding: ICD-10, CPT, HCPCS coding with specialty expertise.
✅ Medical Billing: Charge entry, claim submission, and superbill processing.
✅ Audit & Compliance: Ensuring payer and regulatory compliance.
Accounts Receivable (AR) Management
Recover lost revenue and reduce outstanding claims with our proactive AR follow-up and denial management strategies.
✅ Aging AR Follow-ups: Aggressive follow-up on pending claims.
✅ Denial Management: Identifying root causes and reworking denied claims.
✅ Insurance & Patient Collections: Ensuring timely revenue recovery.
Payment Posting & Reconciliation
Accurate payment processing to ensure error-free revenue reconciliation and prevent financial discrepancies.
✅ ERA & EOB Processing: Posting payments with 99% accuracy.
✅ Underpayment & Overpayment Review: Identifying discrepancies in payments.
✅ Revenue Reconciliation: Ensuring accurate financial records.
Provider Credentialing & Enrollment
We handle the complex process of credentialing healthcare providers with payers to ensure seamless operations.
✅ Provider Enrollment & Contracting: Negotiation and verification with insurers.
✅ Re-credentialing & Compliance Updates: Keeping provider information up to date.
✅ NPI & CAQH Registration Assistance: Hassle-free documentation management.
Patient Eligibility & Benefit Verification
Prevent claim denials by ensuring accurate eligibility checks before service delivery.
✅ Insurance Eligibility Verification: Confirming active patient coverage.
✅ Pre-authorization Assistance: Securing approvals to avoid payment delays.
✅ Copay & Deductible Analysis: Informing patients of their financial responsibility.
AI-Driven RCM Solutions
Harness the power of Artificial Intelligence & Machine Learning to improve revenue cycle efficiency.
✅ Automated Claim Processing: AI-driven accuracy for faster claim approvals.
✅ Predictive Denial Analytics: Identifying and preventing claim denials.
✅ Smart AR Recovery: AI-based follow-ups for quicker collections.
