More Than Billing
Billing, Credentialing, and Revenue Cycle Services
From credentialing and payer contracting through claim submission, denial management, and revenue cycle consulting, we provide the full infrastructure specialty practices, surgery centers, and multi-entity groups need to get paid.
Our Services
Everything Your Revenue Cycle Needs
Credentialing and Enrollment
We manage the full credentialing and enrollment process for new and existing providers. From initial applications through CAQH, NPI registration, PECOS enrollment, and payer-specific requirements, we handle the paperwork and follow up with payers until your providers are fully credentialed and billable. Delays in credentialing mean delays in revenue, and we work proactively to prevent that.
Payer Contracting and Network Activation
Getting credentialed is only the first step. We help your practice secure contracts with insurance payers and activate network participation so you can begin seeing patients and billing for services. We review fee schedules, negotiate where possible, and ensure your contracts support sustainable revenue from day one.
New Practice and Provider Setup
Starting a new practice involves more than clinical decisions. We help with the full administrative build-out, including credentialing for new providers, contracting with insurance payers, billing system setup and workflow design, and multi-entity or specialty practice configuration. Whether you are opening a single location or expanding into multiple entities, we build the revenue infrastructure your practice needs to get paid from day one.
Contracts and Agreements Consulting
We review existing billing agreements, consult on new practice contracts, and help structure revenue cycle consulting agreements that align with your practice goals. Every engagement is customized based on client needs, and we work with you to define the right scope of services for your situation. Whether you need a full-service partnership or targeted support in a specific area, we tailor the agreement to fit.
Medical Claim Coding
Every dollar starts with a code. If it is wrong or imprecise, the claim gets denied or underpaid and most practices never know why. Our coders assign ICD, CPT, and HCPCS codes to the standard, specialty by specialty.
Charge Entry
A clean claim starts before the claim is even built. Patient demographics, insurance details, and service data all have to be entered correctly, or the claim goes out with a flaw baked in. We verify before we submit.
Claim Submission
Claims go out electronically to all major payers, with paper submission where required. Before they go, every claim gets scrubbed for errors. Timely filing windows are tracked. Nothing ages out.
Payment Posting
Every payment that comes in gets posted with full detail, allowed amounts, patient responsibility, adjustments, and denials. That level of documentation is how you catch underpayments before they become a pattern.
Denial and Appeals Management
Every denial gets a root cause review. We find the reason code, fix the problem, and send it back, either as a corrected claim or a formal appeal. We track each one through to resolution. Nothing gets written off because it was inconvenient to fight.
Patient Billing
After insurance pays, patients get a clear statement for whatever is left. We also field billing questions so your front desk does not have to. Clear communication reduces disputes and gets balances paid faster.
Accounts Receivable (AR) Follow-Up
Aging claims do not fix themselves. We work insurance AR and patient balances systematically, following up before things go stale. Practices that do not track this lose thousands a year to claims that simply expired.
End-of-Month Reporting and Analytics
At the end of every month, you get a report showing what came in, what was denied, how your AR is aging, and how the practice is performing financially. No black box. You see the full picture.
Compliance Auditing
A payer audit is not something you want to be caught unprepared for. We review your claims, coding, and documentation against HIPAA requirements and AAPC standards on an ongoing basis. Catching compliance gaps early prevents the kind of problems that cost real money.
Free Billing Audit
Michelle reviews your current billing setup at no charge. She will look at your denial rate, your AR aging, your collections against expected reimbursement, and your coding accuracy. If your team is solid, she will tell you. If there are gaps, she will show you where the money is going.
Services provided by ClearClaim RCM vary based on the scope of the written agreement. Not all services listed on this website are included in every contract. The exact scope of services, deliverables, and fees are defined in the executed agreement between ClearClaim RCM and the client.
How It Works
Getting Started is Simple
Free Billing Audit
Michelle reviews your denial rate, AR aging, and coding accuracy at no cost. No pitch. Honest feedback, whether or not you decide to work with us.
Practice Onboarding
We connect to your practice management system, establish the workflows, and get everything running before your first claim goes out.
Ongoing Revenue Cycle Management
Claims go out clean. Denials get challenged. Reports land in your inbox every month. You stay focused on patients.
No Obligation
Start With a Free Audit
Michelle Recek reviews your denial rate, AR aging, and coding accuracy at no cost. Book a consultation or reach out directly.