Revenue & Billing
Revenue Cycle Management — From Eligibility to Paid
One accountable team across your whole cycle: coverage verified before service, claims out clean, denials worked by root cause, AR followed until it pays, and every deposit reconciled. Built for NEMT, home care, and small practices.
Quick Answer
Revenue cycle management (RCM) is the end-to-end handling of a healthcare or NEMT provider's revenue — eligibility and authorization before service, clean claim submission, denial and appeal work, accounts-receivable follow-up, and payment posting and reporting — run as one accountable workflow instead of disconnected tasks. It's built for NEMT companies, home care agencies, and small practices that lose revenue in the gaps between billing stages, such as the visit nobody verified or the denial nobody owned. SS Support Network runs all five stages inside the provider's own software, codes every denial by root cause, and staffs the work with dedicated, HIPAA-trained seats rather than taking a percentage of collections. The buyer outcome is fewer denials, less aged AR, and cash flow you can actually see in a weekly report.
The cycle, end to end
What are the stages of revenue cycle management?
Revenue leaks live in the gaps between stages — the visit nobody verified, the denial nobody owned. We close the gaps by running all five stages as one workflow.
1. Eligibility & authorization
- Coverage verified before every visit and trip
- Prior auths submitted and tracked to decision
- MCO plan changes caught on recurring patients
2. Clean claims out
- Claims scrubbed against payer-specific rules
- Broker trip claims with logs and signatures attached
- Every claim tracked against timely filing
3. Denials & appeals
- Denials worked the day they post
- Appeals filed with the documentation payers ask for
- Every denial coded by root cause
4. AR follow-up
- Aged claims worked oldest-first on a schedule
- Payer calls made and documented
- Dead balances flagged honestly, not chased forever
5. Posting & reporting
- ERAs posted, deposits matched to remits
- Short-pays flagged while disputable
- Weekly plain-English cycle report to you
Always: your systems
- We work inside your software and portals
- Your logins, your data, your visibility
- Leaving us later costs you nothing
How it works
How fast can you start?
- 1
Free revenue review
One call, plus your AR aging and denial reports. Within 1 business day you get a written map of where your cycle leaks and what fixing it costs.
- 2
We train on your setup
Your team of billers and verifiers learns your software, payers, and rules. Handoff points get documented in a playbook you approve.
- 3
Live in 5–10 business days
We start with the stage that is bleeding most — usually denials or verification — prove it, then take the rest of the cycle.
Proof, not promises
Back-office discipline that survived multi-state growth
For 2+ years we have run daily back-office operations for a growing East Coast NEMT provider — calls, trips, paperwork, and portal follow-up — while they expanded from one state to several. Growth multiplies paperwork; the cycle held because someone worked it every single day.
- Every stage worked daily inside the client's own systems
- Broker and payer relationships managed, not just billed
- 24/7/365 coverage — including holidays
- 2+ years retained, still running it today
Cost, honestly
How much does outsourced RCM cost?
Three inputs set the price: scope (one stage or all five), volume (claims and verifications per month), and payer mix (Medicaid MCOs and broker claims take more touches than commercial). What typical clients hand over first: eligibility checks and the denial queue — the two stages where a missed day costs real money. Staffing is dedicated seats, typically 35–70% below fully-loaded in-house cost per SS Support Network operations data, with no percentage-of-collections fees. If a single trained biller part-time would fix your cycle, the written review will say exactly that.
A revenue cycle is only as strong as its least-owned stage. Verification without denial work leaks; denial work without verification just reprocesses the same mistakes forever.
— SS Support Network revenue operations playbook
Common questions
RCM outsourcing, answered straight
Billing starts when a claim goes out. Revenue cycle management starts before the visit or trip: eligibility checked, authorization confirmed, claim scrubbed, denial worked, payment posted, and the root cause reported. Most denials are born before service — RCM is how you catch them there.
Yes. Most clients start with one stage — usually eligibility checks or the denial queue — and expand once the first weeks prove out. You choose the handoff points; we document them in a written playbook so your team and ours never work the same claim twice.
Yes — NEMT is our home turf. That means broker trip claims, Medicaid MCO rules, signature and trip-log documentation, and the rework loops brokers require. We run the same discipline for home care agencies and small practices, adjusted to their payers and systems.
By fixing causes, not symptoms: eligibility verified before service, authorizations confirmed and tracked, claims scrubbed against payer-specific rules, and every denial coded by root cause. When the report shows the same cause twice, we change the intake step that produced it.
Price follows scope: how many stages you hand over, monthly claim volume, and payer mix. Dedicated seats typically run 35–70% below the fully-loaded cost of equivalent in-house staff, per SS Support Network operations data. You get a written quote after the free revenue review.
You will see more, not less. Everything runs inside your own software, so your dashboards stay live, and you get a weekly report: claims out, denials by reason, AR aging movement, and cash posted. Nothing is hidden in our systems, because nothing lives there.
The free revenue review takes one call plus your AR aging and denial reports; you get a written plan within 1 business day. Training on your systems takes about a week, and most clients are live within 5–10 business days of saying yes.
Have a cycle question we didn't cover? Call +1 (657) 777-0006 — 24/7.
Related
Pieces of the cycle, on their own
Medical Billing Services
Claims, denials, AR follow-up, and reconciliation as a standalone service.
Learn more
Prior Authorization Services
Auth requests submitted, tracked, and chased to decision — with re-auth dates never missed.
Learn more
Healthcare Back-Office Support
The full admin stack for healthcare businesses — revenue, credentialing, and patient calls.
Healthcare overviewFree revenue review
See where your cycle leaks — in writing, in 1 business day
Tell us your volume and payer mix. You get a written revenue review: leak points by stage, the seats it takes to fix them, and real pricing. No sales pressure, no obligation.
Prefer to talk now? Call +1 (657) 777-0006 or WhatsApp us — 24/7.
