End-to-End Claims
Management Services

Fast tracking your claims from submission to clearinghouse reconciliation with automated scrubbing to eliminate leakage

Our Process
99%
First-Pass Rate

Our daily scrubbing ensures claims are "Clean" before they ever hit the clearinghouse.

< 24h
Submission Speed

Claims are processed and submitted within 24 hours of encounter completion.

0%
Missed Deadlines

We strictly monitor payer-specific timely filing limits to protect your revenue.

Our Claim Management Expertise

More than just data entry—we provide active oversight for every single dollar.

Proactive Claim Scrubbing

Every claim undergoes a rigorous internal audit. We check for CCI edits, invalid modifiers, and demographic mismatches to prevent front-end rejections.

Electronic & Paper Submission

We utilize high-tier clearinghouses for instant electronic submission. For smaller payers, we handle manual paper claim submission with tracked documentation.

Secondary & Tertiary Billing

We don't stop at the primary payer. We automatically process secondary and tertiary claims with attached EOBs to ensure 100% reimbursement.

The ProRCM Strategic Workflow

Our systematic methodology ensures clinical data is accurately translated into revenue with zero leakage at every touchpoint.

Encounter Review

Daily audits of patient encounters to ensure clinical documentation substantiates every charge.

Clearinghouse Audit

Proactive monitoring of transmission reports to resolve "Rejected" claims before they become aging issues.

ERA/EOB Posting

High-precision payment and adjustment posting to ensure your A/R aging reports reflect real-time liquidity.

Trend Analysis

Monthly reporting on denial trends to identify and eliminate recurring errors at the point of care.

Reduce Your Denials by 30% This Month

Send us your most "difficult" claims, and we will show you the ProRCM difference at zero cost.