U.S.-based inpatient billing experts ensuring accurate DRG coding, 98% clean claim rate, and full CMS compliance for hospitals & clinics nationwide.
Request a Free RCM AuditWe ensure timely submission of claims to insurance companies, following the latest coding guidelines to guarantee maximum reimbursement. Our team focuses on minimizing errors and optimizing the entire revenue cycle.
We prioritize strict adherence to insurance regulations, ensuring that every claim is accurate and compliant with insurance policies, which leads to fewer rejections and quicker processing times.
Our team stays up-to-date with the latest billing codes and healthcare regulations to ensure that claims are processed accurately and efficiently, avoiding costly mistakes and delays.
We provide full claims management services, from initial submission to follow-up and dispute resolution. Our team works diligently to ensure all claims are paid correctly and promptly.
By utilizing advanced analytics and reporting, we provide our clients with actionable insights into their revenue cycle performance, identifying opportunities to improve efficiency and maximize reimbursements.
We offer continuous support, ensuring clear communication with healthcare providers and insurers. Our team is readily available to answer questions and provide updates throughout the billing process.
Inpatient billing is among the most complex in healthcare. DRG mismatches, documentation gaps, and compliance errors lead to costly denials and delayed cash flow.
Incorrect principal diagnosis or missing comorbidities lead to DRG downgrades, causing 20–30% revenue loss per case.
Payer-specific edits, late submissions, or missing documentation cause 15–25% of inpatient claims to be denied or delayed.
Failure to comply with 2-midnight rule, observation vs. inpatient status, or medical necessity guidelines triggers audits and recoupments.
Charge capture gaps between clinical documentation and billing workflows result in under-coded or missed revenue opportunities.
A seamless, 5-step workflow designed for hospitals & clinics to maximize reimbursement and ensure compliance.
Capture complete clinical and demographic data at intake, including diagnosis, procedures, and insurance details.
Assign accurate ICD-10, CPT, and HCPCS codes; validate against clinical documentation to prevent under/over-coding.
Submit clean claims within 24–48 hours; monitor insurer responses and address edits in real time.
Post payments accurately, manage denials, resolve underpayments, and reconcile adjustments.
Deliver monthly KPIs: denial rates, net collection %, A/R aging, and actionable recommendations to improve performance.
Clean Claim Rate
Fewer Claim Denials
Faster Reimbursement
Based on 28 hospital clients served in 2024. Results may vary.
The average hospital loses 20–25% of inpatient revenue to preventable denials, coding errors, and compliance gaps.