Revenue & Care OperationsRCM
Carevory Health supports the work behind accurate billing and organized revenue operations. Engage a full-cycle team or address a specific backlog, with responsibilities and reporting matched to your practice.
Best for: Practice owners, administrators, RCM directors and finance leaders.
What we support
Engage the full scope or pick the functions you need. Each item below can be included, excluded or phased in your proposal.
- 01
Appointment scheduling, confirmations, rescheduling and front-desk workflow support.
- 02
Eligibility and benefit verification, deductible/copay review and payer requirement checks.
- 03
Prior authorization, pre-certification and referral tracking, including payer follow-up.
- 04
Charge entry, documentation completeness checks and coding support within the agreed review model.
- 05
Claim preparation, submission, status tracking, corrections and resubmissions.
- 06
Denial analysis, appeals, reconsiderations and root-cause reporting.
- 07
Payment and adjustment posting, underpayment review and A/R recovery follow-up.
- 08
Patient statements, balance inquiries and payment coordination through approved systems.
- 09
Provider enrollment, credentialing follow-up, payer participation and contracting coordination.
- 10
Operational reporting, account auditing, exception tracking and management review.
How we work
We assess your systems and backlog, agree work queues and sign-off responsibilities, transition access, and begin a controlled rollout. Regular reviews surface unresolved claims and process issues.
Agree queues & sign-off
Transition access
Controlled rollout
Regular reviews
What you receive
Deliverables, not promises.
- Transition plan
- Responsibility matrix
- Documented work queues
- Exception log
- Service-specific performance reporting
What we measure
Defined before baselined.
Every metric gets an agreed definition, denominator and reporting period before we compare performance.
- First-pass acceptance
- Denial rate
- Days in A/R
- Aging mix
- Turnaround
- Appeal outcomes
Often chosen by
Organizations that usually start with Medical Billing & RCM.
FAQ
The questions practices raise most often about Medical Billing & RCM.
Yes. Eligibility, prior authorization, denials or A/R can be scoped separately. Coding and claim sign-off responsibilities are documented; payment and reimbursement are not guaranteed.
Yes. An engagement can address one workflow, a defined project or an ongoing delivery function. Additional services can be scoped as your requirements evolve.
Pricing depends on scope, volume, staffing, coverage, complexity and third-party costs. We provide a proposal that separates implementation, recurring services and optional work.
Yes. Carevory is HIPAA compliant. We sign a Business Associate Agreement before anyone on our team accesses protected health information, work only inside the systems you authorize, and cover subcontractor arrangements too.
Clinical judgement, triage and prescribing remain with your licensed staff. Scope, coverage and responsibilities are agreed in writing before launch.
Start with one workflow
Tell us what is slowing your organization down or what you want to build. We will help define a focused starting point.
Business inquiries only. Please don't include patient information.