Medical RCM & Billing
Custom quote
Charge lag, rejections, and unworked denials.
Medical Billing
Medical Billing Support Built Around Your Specialty
Medical billing is a chain of hand-offs, and revenue leaks wherever ownership is unclear.
The problem
Charges wait for days, clearinghouse rejections pile up unread, and nobody can say with confidence why A/R is growing.
How we help
Claims, clearinghouse follow-up, denial queues, and reconciliation for physician practices.
Best for: Primary care, Behavioral health, Dermatology, Orthopedics, Urgent care, Outpatient and ambulatory practices.
Scope
What is included
Coding and billing hand-off design
A documented path from provider documentation to coded charge to claim, clarifying who codes, who reviews, and who submits.
Eligibility checks
Coverage verification before visits to reduce eligibility-related denials, recorded where your front office will see it.
Clean claim preparation
Claim edits for demographics, payer IDs, required fields, and authorization references before submission.
Clearinghouse follow-up
Daily review of acceptance and rejection reports on agreed working days, with corrections made and resubmitted.
Denial work queues
Denials sorted by reason and value, worked in priority order, with appeals prepared for clinical or practice review where needed.
Payment reconciliation
ERA posting, deposit matching, and flags for payments that differ from expected amounts.
Patient account follow-up
Statement support and balance follow-up where authorized, using policies and scripts you approve.
KPI reporting
Charge lag, first-pass acceptance, denial reasons, and A/R by payer and age, delivered on your agreed cadence.
Not included
- Representing coding credentials or U.S. licensure that have not been confirmed for your assigned team
- Clinical documentation or medical necessity decisions
- Guaranteed reimbursement levels
- Payer contract negotiation unless separately scoped
How it works
Step by step
- 01
Specialty discovery
We study your visit types, payer mix, systems, and current workflow.
- 02
Onboarding assessment
A read-only review of open claims, denials, and aging, with your approval.
- 03
Responsibility split
We agree which steps Zincat owns and which remain in-house, in writing.
- 04
Access and agreements
Services agreement and BAA as applicable; least-privilege user setup.
- 05
Operate
Daily queues with documented escalation rules.
- 06
Monthly review
Trends, root causes, and process adjustments.
What you keep control over
- Coding policy and final code selection
- Clinical documentation
- Payer contracts and fee schedules
- Patient financial policy
- System ownership and user access
Compliance note
Where our work requires access to protected health information, it begins only after a signed services agreement and, as applicable, a business associate agreement (BAA). We use the minimum necessary access in client-owned systems. Our group security practices are ISO/IEC 27001-focused; that framework supports, but does not by itself establish, HIPAA compliance, which remains a shared responsibility defined by your agreements and safeguards.
More detail
Open any topic below.
Background and common problems
Medical billing is a chain of hand-offs, and revenue leaks wherever ownership is unclear. We operate the links you assign, with specialty-specific discovery first and qualified staffing defined in your contract.
Primary care, behavioral health, dermatology, and orthopedics do not bill the same way. Visit types, modifiers, authorization rules, and payer mix vary enough that a generic billing process creates its own denials. That is why every engagement begins with specialty-specific discovery: how a visit is documented, who codes it, how charges reach the claim, and where the work currently stalls.
Zincat then takes ownership of the defined steps, such as eligibility, claim preparation, clearinghouse management, denial work queues, and payment reconciliation, while coding decisions and clinical documentation stay with appropriately qualified people. The exact scope and the qualifications of assigned staff are set in your contract, not assumed on a website.
- Charge lag between date of service and claim submission
- Clearinghouse rejections that sit unresolved
- Denials worked only when someone has spare time
- Underpayments never compared with expected reimbursement
- Patient balances aging without follow-up
- Monthly close that never quite reconciles
Sample reporting
An example of the kind of summary you would receive. Figures are demo data, not results.
DEMO DATA · NOT A CLIENT REPORT
- Median charge lag
- 3.1 days
- First-pass acceptance
- 91%
- Open denials
- 64
- A/R over 90 days
- 22%
- Escalations awaiting practice
- 4
Is outside support the right choice?
| Option | Works well when | Watch for |
|---|---|---|
| Keep fully in-house | Volume is steady, staff are trained, and reports are reviewed regularly. | Single points of failure when someone leaves or is out. |
| Targeted outside support | One queue (verification, A/R, credentialing) keeps falling behind. | Clear hand-offs so nothing falls between teams. |
| Broader outsourced RCM | Multiple stages are stretched and leadership wants one accountable partner. | Requires assessment, BAA, and well-defined metrics first. |
What to have ready
- Recent A/R aging and denial reports (no patient details in email)
- List of PMS/EHR, clearinghouse, and payer portals used
- Approximate monthly claim or appointment volume
- Who on your team will approve access and escalations
Related packages
Ways to engage
Prior Authorization Desk
Custom monthly quote
Authorization backlog and expired approvals.
Prices are illustrative starting points pending management approval and are confirmed only in a written proposal.
FAQ
Medical Billing questions
Often paired with
Related reading
Do you provide certified medical coders?
Coding scope is defined per engagement. We will tell you exactly who performs coding-related tasks and what qualifications have been confirmed for them. We do not advertise credentials that have not been verified for your assigned team.
Which specialties do you support?
Primary care, behavioral health, dermatology, orthopedics, urgent care, and other outpatient practices are typical. Every specialty requires discovery first, because modifiers, authorization rules, and visit types change the work significantly.
Can you work in our EHR and clearinghouse?
Usually, yes, as long as secure named accounts can be provisioned and our team is trained on your configuration. We confirm this during assessment rather than assuming compatibility.
Will you contact our patients about balances?
Only where authorized in writing, using scripts and financial policies you approve. Patient-facing work is optional and is always identified clearly in the scope.
How is this different from full revenue cycle management?
Medical billing focuses on charges, claims, and payments. Full RCM extends upstream to scheduling, eligibility, and authorization, and downstream to analytics. See our article on medical billing versus RCM for a detailed comparison.
How quickly can you start?
Start dates depend on agreements, access provisioning, and training on your systems. We will give you a realistic onboarding plan after assessment rather than a generic promise.
Next step
Talk through your medical billing workflow.
Tell us how things run today. We will point out where we see friction and be honest about whether we can help.