A medical billing company should do more than "send claims". The work that actually protects revenue happens around the claim: catching a missing referral before submission, fixing a clearinghouse rejection the day it arrives, noticing that a payer stopped paying a code, and telling the practice what it needs to change.
Revelrex runs that whole cycle for you and prices it as a percentage of what is collected. We are paid when you are paid, which keeps our attention where yours is.
Practices that benefit
- Independent practices replacing an in-house biller or a vendor that stopped communicating.
- Multi-provider and multi-location groups that need one consistent process across sites.
- New practices that want billing set up correctly from the first claim.
- Practices that want billing and denial management from the same team, under one rate.
What usually goes wrong
Claims that go out late or never
Encounters completed but never billed are the most expensive kind of leakage because nobody is looking for them.
Rejections that sit in the clearinghouse
A rejected claim is not a denied claim; it never reached the payer. Left unworked, it silently ages past timely filing.
Payments posted without review
Underpayments and incorrect adjustments are posted as "paid" and the balance is written off.
No visibility
The practice sees a deposit total but not what was billed, what is outstanding, or why AR is growing.
The actual work
Charge workflow
We reconcile completed encounters against charges so every visit becomes a claim. Missing charges are flagged back to the practice.
Claim preparation
Claims are scrubbed for payer rules, eligibility, authorization and referral requirements, modifiers and place of service before submission.
Claim submission
Electronic claims are submitted daily through your clearinghouse; paper claims where a payer requires them.
Clearinghouse monitoring
Acceptance reports and rejections are reviewed every business day. Rejections are corrected and resubmitted the same day whenever the correction is in our hands.
Payment workflow coordination
ERAs and paper EOBs are posted, adjustments are reviewed against the contract, and underpayments are queued for follow-up.
Billing status monitoring
Every claim has a status and an owner. Claims without a payer response inside the expected window are followed up.
Client communication
A named Revelrex contact, a support desk in your dashboard, and a monthly review of what changed and what the practice needs to do.
Reporting
Monthly charges, collections, adjustments, AR aging by payer, first-pass acceptance and the top reasons claims did not pay.
What is included
- Professional claims for the providers, locations and payers listed in your service order.
- Daily claim submission and clearinghouse rejection handling.
- Payment posting and adjustment review.
- Follow-up on unpaid claims within the billing scope.
- Monthly reporting and a monthly review meeting on request.
- Patient statement preparation through your existing statement process.
Not included
- Denial appeals and root-cause analysis (add Denial Management to include them).
- Coding of encounters (see Medical Coding).
- Clearinghouse, EMR, statement and card-processing fees.
- Legacy AR from before the start date of service unless included in the service order.
- Clearinghouse and EMR subscription fees, patient statement postage and payment processing fees are paid by the practice. Old accounts receivable taken over from a previous vendor can be included under a separate scope.
What your practice needs to provide
- The start date of service from which Revelrex is responsible for billing.
- Delegated access to the EMR, practice management system and clearinghouse.
- Payer contracts and fee schedules, or authorization for us to request them.
- Eligibility and demographic information captured at the front desk (we help you tighten this if needed).
- Timely responses to questions about charges, documentation and patient balances.
Step by step
- 1
Discovery
We review your payer mix, systems, current process and AR so the service order matches reality.
- 2
Agreement
Service order defines the billing percentage, what counts as applicable collections, the start date of service and the scope.
- 3
Onboarding
Access is set up, claim templates and payer rules are configured, and the first claims are reviewed together.
- 4
Daily operation
Charges reconciled, claims submitted, rejections corrected, payments posted, unpaid claims followed.
- 5
Monthly review
Report and review call: collections, AR, problems found, and the actions we need from the practice.
What you receive
Clean claims submitted daily and tracked to payment.
Same-day rejection correction log.
Monthly performance report with AR aging by payer and practice-action list.
Monthly invoice showing applicable collections and the calculated fee.
Add Billing to your Service Cart
A written proposal follows within two business days.
Frequently asked
What does a medical billing company actually handle?
Everything between a completed encounter and a posted payment: charge review, claim scrubbing, submission, clearinghouse rejections, payer follow-up, payment posting, adjustment review and reporting. Denial appeals are part of Denial Management.
How much does outsourced medical billing cost?
Revelrex charges a percentage of applicable collections, with a higher combined rate when Denial Management is included. The current standard rates and a calculator are on the pricing page, and your service order records your rate for the term of the agreement.
What counts as "applicable collections"?
Payments received on claims that Revelrex prepared, submitted or followed up on, from the start date of service onward, net of refunds. The exact definition is written into your service order so there is no ambiguity on the invoice.
When does Revelrex become responsible for our claims?
From the start date of service in your agreement. Encounters before that date belong to your previous process unless legacy AR is added to the scope.
What happens to our old AR?
You have three options: keep working it internally, let your previous vendor finish it, or add a legacy AR scope to your Revelrex service order. We help you decide based on the age and value of the balances.
How are rejections handled?
Clearinghouse rejections are reviewed every business day. If the fix is in our hands (a format issue, a modifier, a payer ID) it is corrected and resubmitted the same day. If the fix needs the practice (an eligibility problem, a missing referral) it appears on your action list with the deadline.
Can billing and denial management be combined?
Yes, and most practices choose to. The combined rate means denials are worked by the same team that submitted the claims, with root-cause reporting back to the practice.
Do you work inside our existing systems?
Yes. We work in your EMR, practice management system and clearinghouse through delegated user accounts. You keep your data and your systems.