Revenue Cycle Perfected

End-to-End RCM Solutions Exclusively for Rounding Doctors

A/R Metrics that Matter

We Measure Over 100+ In-Process Metrics for Continuous Improvement

*Figures listed below are averages across 3200 hospital and facility physicians over the last 18 months.

95% Realization Rate at 45 Days

99.3% Net Collection Rate

99.4% Standard Clean Claim Rate

Only 3.1% A/R Over 120 Days

Only 2.7% Claim Denial Rate

98.6% First Pass Claim Yield

-51% Denial Write-Offs

+5.7% Net Patient Revenue

-25% Bad Debt Expenses

-15% Cost to Collect Expenses

-17.3% AR Days on Average

99.84% Audit “Survival”

blank
blank
blank
blank
blank

#1 Medical Claims Billing and Medical Claims Process for Hospitalists and Facility-Based Physicians

Free Revenue Process Analysis
Medical Claims Process
  • Over a 98% first pass acceptance (average is 70-90%)
  • Real time claim tracking and adjudication
  • AI-enhanced automations and quality control measures
  • 100% revenue cycle transparency at the micro and macro levels
  • Claims go out in an average of 10.2 minutes
  • New RCM specialist and billing hires are required to have a starting accuracy of 98% and don’t go live until they achieve 99%
  • 4500+ certified coders, billers, and RCM specialists on staff
  • Automated quality control checks and feedback loops for business intelligence and revenue growth opportunity analysis
  • 100% transparency, visibility, and data availability in real time
  • Full service coding automation with an average ROI of 7.1-14.3%
  • Coding efficiency measures and checks to protect against revenue loss from under coding and audit risks from over coding or inefficiencies
  • Provider benchmarking on a state, national, and specialty level for peer to peer analysis, provider productivity evaluations, and risk assessment.
  • Eliminate AR gaps and stuck points with revenue cycle perfected.
  • Machine learning provides data analyses for physician improvements
  • AI-Enhanced robust rules engine with hundreds of in-process tracking and evaluation options fully customizable to your practice and providers
  • KPI provider and practice analytics with predictive data intelligence
  • 99.9% uptime with multi layer recovery solutions and data protections
  • Real time claim tracking with multi stage evaluations for increasing accurate data including collection value estimates and timelines
  • Real time provider and practice revenue updates as claims process for reporting as well as compensation management formulas.
  • Denial and underpayment management
  • Credentialing and contracting services with high historical ROI returns
  • Claim review and scrubbing as well as appeals at all levels
  • 100% of appeals are processed within 5 business days and 96% are processed within 1 business day.
  • Real time comprehensive provider and practice reporting across standard and custom requirements to ensure your team has 100% data visibility
Medical Billing Software


What Do Key A/R Metrics Really Mean?

Benchmarking the revenue cycle management metrics of a clearinghouse is a very effective tool for evaluating the quality of the RCM service yet a clear understanding of the terms combined with qualifications of success criteria are essential for comparing one RCM company against another and making the best choice.

Clean Claim Rate Can Be Misleading

The term clean claim rate refers to a clearinghouse’s degree of consistent success in getting claims processed but nearly every clearinghouse worth it’s weight has a rate that exceeds 90% and the metric has been relatively outdated by increasingly complex payer rules.

The bottom line is that using clean claim rate as a reliable RCM benchmark for evaluating a revenue cycle service company is a flawed approach primarily because of its marginal impact on cash flow.

First Pass Claim Yield is a Top Metric

This represents the percentage of claims that are paid on their first submission, putting the emphasis on denial prevention by requiring a higher allocation of time and resources to the pre-claim submission process, limiting the number of incorrect claims which is turn reduces time spent working on denials while increasing cash flow.

The bottom line is that focusing on first pass yield creates more work on the front end yet driving measurably higher RCM efficiency.

KPI Evaluation: Net Collection Ratio

The net collection rate is the adjusted rate that measures the effectiveness in collecting reimbursement payouts.

The bottom line is that like first pass yield, the net collection rate is an indicator of the relative success or failure of the revenue cycle service by evaluating what percentage of everything owed is being collected.

Evaluating Your A/R Realization Rate

A high quality accounts receivable process is critical to a providers success and possibly the most critical KPI for evaluating the success of an RCM company. The magnitude of accounts definitely matters but the age of those accounts creates some of the most important RCM metrics for evaluative purposes.

The bottom line is that evaluating the percentages at more than 30, 60, 90, and 120 days gives crucial insight into where in the AR process the majority of claims are being paid and what degree of success is occurring at each stage for the more difficult .

► Patient Demographic
► Medical Coding Efficiency
► Charge Entry

► Payment Posting
► Accounts Receivable Optimization
► Denial Management

► A/R Follow Up
► Claims Submission & Processing
► QA/QC and Audits

blank

We Believe in Full Accessible Transparency

Your A/R and collections should be fully transparent, easily available,

We provide a full continuum of integrated revenue cycle services and products that supports various sized practices and a wide range of specialties.

The Claimocity medical billing and coding team typically sees a 9-26% increase in collections per visit.

Bringing Clarity to Medical Billing and Claims Processing

When you go with our PM solution or all in one software and services package you get an end to end claim tracker with unrivaled predictive medical billing data analysis technology built in, telling you what EVERY claim is worth (and when it will be paid) as soon you submit it.

At the point of care (or moment of capture), Claimocity uses proprietary AI-driven smart software to instantaneously analyze huge volumes of payment data against contract rates and historical insurance payment patterns to provide a predictive claim value timeline that is accurate to within 0.05%.

Claimocity Medical Claims Billing Service in Action

Point of Care

Our revolutionary smart software claim tracker gives you the first claim payment value and timetable at the point of care when the mobile charge is captured, providing you with an incredible and unprecedented look behind the insurance curtain of the billing cycle process so you can better understand your daily and monthly revenue.

The faster you get us the charge, which when you are using our accelerated mobile charge capture is as little as 9 seconds, our algorithm will analyze all the demographics and factors to provide a first level payment value and an estimated date. As we process the claim, this info will update to the level two estimates with incredible accuracy.

Payment Value

Not only does our AI-driven revolutionary claim tracker give you an immediate in-depth look at claim values rather than making you wait until a claim is paid to tell you how much it is worth, but our pattern analysis smart software offers point of care and point of charge insights that can assist with maximizing level coding and claim worth.

Knowing your claims payment value assists with tracking individual and practice level KPIs, financial goals, monthly revenue cycle optimization, and gives you a better understanding of what claims are likely to be denied, what insurance companies are unreliable, and any insights if available on how to adjust according to past data to maximize present value.

Benchmarking

Not only do you get the claim value and estimated payment date but the same statistical modeling that enables us to provide intensely accurate data within a few percentage points of variation also allows us to provide unheralded levels of benchmarking so you can see how your claim numbers and values stack up against your peers on multiple levels.

Now you can not only better evaluate your own data on a month over month (or year over year) comparison, but our benchmarking enables much greater levels of within-group comparisons and KPI goal-setting, as well as state and national levels comparisons that enable a much higher degree of measurable improvement and evaluation.

Save More Time Money Effort

Fast Free Chat

Leading Player in Providing AI-Enhanced Revenue Cycle Management Services

The Claimocity medical claims processing department is the US arm (for hospital and facility physicians) of our parent Global RCM group that has been providing technology enabled RCM services for 31+ years.

  • Proven experience partnering with complex health systems including integrations with 30+ practice management and EHR systems
  • In that span we are responsible for $1.5B+ in Revenue Improvement and handle 5M+ insurance calls per year
  • Over $200M+ in Cost Reductions have been delivered and 20M+ charts coded
  • We currently have active prospering clients in 49 states across 60+ specialties and just hit the anniversary of our first 20 year client
  • We provide RCM services for over 1700 practices and process 1.5B payments per year and have over a 99% retention rate over five years
blank

Charge Capture + RCM Services

Mobile medical billing software with end-to-end RCM services for practices with physicians who see patients in acute care, LTAC, IRF, SNF, or sub-acute step-down facilities.

blank

Practice Management + RCM Services

Practice management, charge capture, EHR (optional), and billing software with medical claims process RCM services for busy modern doctors in hospital and facility-based settings

blank

Stand Alone RCM Services

Full-service end-to-end medical claims billing RCM services with no software side inclusion for integration into your existing charge capture and practice software platforms.

Streamlined Medical Claims Process for Faster Reimbursements

The Claimocity end-to-end revenue solutions utilize a blend of AI-enhanced smart technology and robust RCM billing teams with decades of experience to achieve higher and faster reimbursements while maximizing your revenue cycle operations with award winning results.

Our software and services reduce administrative burdens and help automate and streamline claims management, payment processing, coding, contracting, credentialing, and compliance to ensure that the clinicians, front office, practice manager, and billing team are always on the same page.

blank
blank

Claimocity Smart Workflow

blank

Smart Custom Solutions

Long term success starts with the right initial processes. Our billing, coding, operations, intake, and software teams assist in the smart setup to proactively define the best platform combination for the client while identifying and resolving any root issues, completing a thorough A/R review, and designing a custom RCM solution platform to meet your specific specialty, practice size, and needs.

blank

Easy Implementation

Claimocity is designed to quickly and seamlessly integrate into any existing practice, system, or frameworks, supporting physicians, managers, and office staff in every critical role. The software is user friendly to streamline the workflow and focused on simplification and automation in order to improve time and revenue efficiency while making the software as intuitive and easy to use as possible.

blank

Time & Revenue Efficiency

Claimocity offers award-winning software options including native iOS and Android applications, mobile and desktop-based practice management suites, accelerated mobile charge capture, integrated EHR, contracting, credentialing, scheduling, and coding efficiency tools that reduce administrative burdens, streamline billing workflows, and save high-value time for staff and physicians.

blank

Award-Winning Expertise

Decades of highly specialized collective experience, cutting edge next gen AI-enhanced technology, implementable best practices, smart workflow processes, actionable insights, and the hands-on approach of our highly experienced team of coders, billers, support staff, techs, and medical specialists are just part of the reason that physicians, admin staff, practice managers, and owners love using Claimocity software.

blank

Data-Driven Decisions

KPIs, actionable analytics, and real-world data on both the provider and practice level enables a higher level of insight and data gathering for more effective decision making. Claimocity enables greater transparency in the billing and coding process while generating a stronger understanding of productivity and performance including compensation management tools and daily financial updates for physicians and practice managers.

blank

AI-Enhanced Advantages

From our proprietary rules engine and custom personalized patient and facility management filters to practice and provider-level AI-enhanced pattern analysis and machine learning systems, our technological advantage, super computing enhancements, big data processing infrastructure, and efficiency-driven statistical analyses create a deeper level of business intelligence for higher efficiency and productivity models.

Claimocity Hospitalist Reporting Features

Key Advantages

Award-winning benchmarks, metrics, and revenue efficiency processes driven by end-to-end technological and team-driven approaches that systematically outclass stand alone or in-house billing.

blank

Custom Solutions

Contract industry-leading revenue growth and claims processing services independently or use billing in conjunction with EHR/EMR, scheduling, and advanced practice management software.

blank

Financial Growth

From an initial A/R audit to triage live claims caught in process stuck points to AI-enhanced comprehensive billing services designed to maximize existing revenue streams and open up financial opportunities for growth.

“Our executive team approved participation in a voluntary two year time and revenue study in order to evaluate the quantitative and qualitative value compared to the numbers we were generating with the prior software in order to justify the switch. Within 24 months we had a 41.6% net revenue rate increase as well as an average of 38.8 hour savings per month per physician across our practice, which was a remarkable result.”

blankDr. Anas Kayal, Founder and CEO
Best Revenue Cycle Management Software
  • Accelerated Charge Capture
  • Modern PM App and Desktop Portal
  • Hybrid Custom Solutions
  • Seamlessly Integrated EHR/EMR
  • Full-Service Contracting & Credentialing
  • Patient and Facility Scheduling
  • Compensation Management
  • Advanced Reporting and Analytics
  • Comprehensive Patient Engagement
  • And so much more…

Claim Submission Process in Medical Billing

We Offer Streamlined Submissions Whether Paper, Fax, Electronic, Mobile Software, or Bulk Uploads

Talk to one of our specialists to get a very clearly delineated set of options based on your current standard operating procedures, desires, and implementation capabilities. If you are using either of our software packages with RCM services then you will be able to take advantage of the best technology in the industry for claim submissions and processing.

Claimocity Claim Cycle in Medical Billing Showcased

Unprecedented Claim Cycle Insights

One 15-minute pressure-free demo with one of our software specialists will set you on the path to better revenue understanding and maximization. We will show you the claim tracker and other features in action and answer any questions you may have.

What will you do with the extra time and money?

Schedule a Demo
blank

Specialty Focus

From practices with hospitalists and clinicians with encounters in acute care and step down facilities to office-based medical practices, we have solutions for every specialty.

blank

Revenue Efficiency

Even a 1-2% improvement in revenue efficiency can have a 10-20% impact on bottom line financial growth. By improving efficiency we maximize your financial potential.

blank

Custom Solutions

Cookie cutter software packages leave money on the table. Every practice and specialty requires a specific approach that we design to fit your needs and growth potential.

blank

Integrated Tech

Our full-service end-to-end RCM services are designed to work with any combination of mobile charge capture, scheduling, EMR/EHR, and practice management tools.

blank

Faster Growth

From a comprehensive initial A/R audit by our coding and billing team to our full RCM and PM processes, Claimocity drives consistent financial growth from month one.

blank

Over 40 Years of Industry Leading RCM

There is no “one size fits all” in medical billing.

Each organization has different needs from stand alone software to best in class end-to-end RCM solutions supported by award-winning billing cycle experts with decades of hands-on experience.

The First Step TRowards Better RCM

The first step is a simple 15 minute meeting with one of our specialists who will ask a few questions, answer any answers you have, and provide pricing for any services you are interested in.

It’s fast, pressure-free, and designed to provide the range of solutions that best align with your practice and provider needs, existing process, medical specialty, size, and current efficiency levels.

By the end of the brief conversation you will know how your current numbers compare to what you should be making.

blank