Revenue cycle management
Revenue cycle management services
Revenue cycle management (RCM) is the full process a practice uses to get paid for patient care: checking insurance, recording and coding each visit, sending claims, posting payments, working denials and collecting patient balances. We run every step for you, inside your EHR, and report the results each month.
- Claims out within 24 hours of receiving charges
- Denials worked within 5 business days
- Monthly reports on collections, denials and A/R
What is RCM
What is revenue cycle management?
Revenue cycle management is everything that happens between scheduling a patient and collecting the last dollar for that visit.
The revenue cycle starts when a patient books an appointment and ends when the insurance payment and the patient’s share are both collected and posted. Every step depends on the one before it. A missed eligibility check becomes a denial. A wrong code becomes an underpayment. A denial no one works becomes a write-off.
Medical billing is part of RCM. Billing usually means creating and sending claims. RCM also covers the front end (insurance and authorizations), the follow-up (denials and A/R) and the reporting that tells you whether the whole cycle is healthy.
The stages
The three stages of the revenue cycle
The revenue cycle is usually split into front-end, mid-cycle and back-end work. Problems that show up at the back end often start at the front.
| Stage | What happens | What goes wrong if it is skipped |
|---|---|---|
| Front end | Scheduling and registration, insurance eligibility and benefits checks, prior authorizations, patient cost estimates | Coverage denials, missing authorizations, surprised patients |
| Mid-cycle | Documentation review, charge capture, charge entry, coding, claim scrubbing | Coding errors, missing modifiers, missed charges, rejections |
| Back end | Claim submission, payment posting, denial management, A/R follow-up, patient billing, reporting | Unworked denials, aging A/R, underpayments, unpaid patient balances |
What we manage
What we manage for your practice
We take on the full cycle or the parts you want to hand off. Most practices hand off everything after the visit.
Your front desk keeps scheduling and checking patients in. We handle the rest of the cycle in your systems, and we tell you right away when something needs your team, such as a missing note, an expired authorization or a provider who is not yet enrolled with a payer.
- Insurance eligibility and benefits checks before visits
- Prior authorization tracking for payers and services that need it
- Charge entry and coding review
- Claim submission the same day or within 24 hours of receiving charges
- Payment posting and ERA reconciliation
- Denial correction, resubmission and appeals within 5 business days
- A/R follow-up on unpaid and underpaid claims
- Patient statements and balance tracking
- Provider credentialing and CAQH upkeep so claims are paid in-network
- Monthly reporting, and a real person who replies within 1 hour during business hours
We work inside SimplePractice, TherapyNotes, Tebra (Kareo), AdvancedMD, Valant, Osmind, athenahealth, DrChrono, eClinicalWorks, Office Ally and other systems.
Reporting
The numbers we report every month
You should be able to see how your revenue cycle is doing without asking. Every month you get a report on the measures that matter.
| Measure | What it shows | Our company-wide average |
|---|---|---|
| Clean claim rate | Share of claims accepted and processed without errors the first time | 98% |
| Days in A/R | How long, on average, it takes to get paid | 21 days |
| Denial rate and trend | How many claims are denied, and why | 38% reduction |
| Recovery rate | Share of denied or aged claims we recover | 89% |
| Collections | Payments posted by payer, provider and month | Reported for your practice |
| A/R aging | Unpaid balances by age bucket and payer | Reported for your practice |
Averages are company-wide across active clients, not a guarantee for any single practice.
Pricing
RCM pricing that fits your practice
Full RCM is 2.5% of collections, or a flat monthly fee. We credential 5 commercial payers free when you sign up for billing. No long-term contract required.
Common questions
What is revenue cycle management in healthcare?
Revenue cycle management is the process of getting paid for patient care, from checking insurance before the visit to collecting the final balance after it. It covers eligibility, coding, claims, payment posting, denials, A/R and patient billing.
What is the difference between medical billing and RCM?
Medical billing is one part of RCM: creating, sending and following up on claims. RCM is the whole cycle, including front-end insurance checks and authorizations, denial prevention, A/R recovery, patient billing and reporting.
Should a small practice outsource RCM?
Often, yes. A small practice rarely has enough work to keep a full-time biller, coder and A/R specialist busy, but it still needs all three skills. Outsourcing gives you the full team for a percentage of collections or a flat fee.
How much do RCM services cost?
Our RCM service is 2.5% of collections. We also offer a flat monthly fee and dedicated staff by custom quote.
How do you measure whether RCM is working?
We report clean claim rate, days in A/R, denial rate, recovery rate, collections and A/R aging every month. Our company-wide averages are a 98% clean claim rate and 21 days in A/R.
Do you only work with mental health practices?
No. Our core focus is psychiatry, PMHNP and behavioral health practices, but we manage the revenue cycle for practices in all specialties nationwide.
How long does it take to switch RCM companies?
Most of the work is getting access to your EHR, clearinghouse and payer portals, and signing a BAA. We then review your open A/R so nothing from the old setup is lost during the change.
Guides from our team
Learn more before you decide
Charge Entry in Medical Billing: Complete 2026 Guide with Examples
What charge entry in medical billing is, the full 7-step process with real CPT and ICD examples, the 12 most common errors, and how to fix each one fast.
Read the guide →Claim Denial Codes Explained: What CO-16, CO-50, CO-197, PR-1 and Others Mean and How to Fix Them
What common denial codes mean (CO-16, CO-18, CO-50, CO-97, CO-197, PR-1 and more) and how to fix each, for mental health and medical practices.
Read the guide →Accounts Receivable Management in Medical Billing: How to Reduce Days in A/R
Learn how accounts receivable management reduces days in A/R, recovers aged claims, and keeps your medical practice’s revenue cycle healthy.
Read the guide →Find out what your claims are leaving on the table
Tell us about your practice. We will review 90 days of claims and show you what is recoverable, at no cost.
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