SERVICE · REVENUE CYCLE MANAGEMENT
Revenue Cycle Management services
Healthcare Revenue Cycle Management (RCM) is the day-to-day work that professionally turns clinical encounters into paying claims. Prime Health United is a HIPAA-compliant service provider working inside your existing RCM workflow with clear weekly and monthly reports — so you always know what went out, what got paid, and what needs attention.
WHY PHU
End claim denial drift and save revenue.
Long A/R, denials, and claim scrubber edits slow down cash flow and divert attention from patients. Prime Health United steps in as your trusted RCM outsource partner, keeping revenue moving and operations undisturbed.
- Route prior authorizations electronically, prefilled from charts — saving 14 minutes each and reducing cancellations.
- Prevent denials; if denied, correction or resubmission is completed within 48 hours.
- Reduce avoidable first-pass denials by fixing front-end errors and submitting clean claims with faster reimbursement.
- Capture visits with virtual scribes, cutting EHR time by 16% so providers regain patient-facing hours.
WHAT'S INCLUDED
Our RCM services, end to end.
Appointments / Scheduling
Schedule, reschedule, and confirm visits; verify eligibility in real time; send reminders and reduce missed appointments.
Credentialing
Fast-track payer enrollment, including Medicare and Medicaid, so providers can continue billing promptly.
Eligibility & Benefits Verification
Confirm coverage and benefits before appointments; verify insurance eligibility in real time to prevent denials.
Clean Claim Submission
Submit complete claims within 24 to 48 hours with optimized ICD-10/CPT coding; target 98% acceptance.
Payment Posting
Apply ERA/EOB, EFT payments, and adjustments accurately; reconcile remits and maintain clean ledgers across payers.
Automation (RPA)
Automate secondary claims and claim-status checks (EDI) to cut manual effort and speed acknowledgments.
A/R Aging / Follow-Up
Address aging claims and oversee each outstanding account within 15 days until it is resolved.
Denial Management & Appeals
Clear EDI rejections, correct underpayments, and initiate appeal actions within 28 hours where payable.
Patient Collections
Polite, policy-aligned outreach that explains balances clearly and supports timely, compliant resolution.
Reporting (weekly/monthly)
Concise financial snapshots with practice health analysis, trends, and next actions, delivered on your cadence.
WHO BENEFITS
Built for predictable cash flow.
Prime Health United RCM services are designed for practices seeking predictable cash flow and fewer roadblocks.
- Private Practices
- Specialty Clinics
- Telemedicine Providers
- Hospital-Affiliated Clinics
- Medical Centers
- Labs & Pharmacies
Benefits of PHU RCM
- Upstream & downstream coverage
- Upstream fixes reduce denials
- Practice health analysis
- Fast, low-friction start
- End-to-end ownership — one team
- HIPAA at the core
- Monthly reports
FAQs
RCM questions, answered.
Reach out for a discovery call and demo, sign a contract for HIPAA compliance, and your assistants go live. Integration is designed to be agile.
Yes. Our HIPAA-trained team adapts to your processes so your staff keeps working the way they like.
Yes. We handle complete prior authorization for medications, clinical procedures, DME, plus appeals and denials.
Yes. We handle fax management, records requests (referrals/legal), and form completion with HIPAA-compliant processing.
RCM services are available 24/7, so you can extend coverage after hours or during peaks without extra headcount.
Yes. We fast-track payer enrollment (including Medicare and Medicaid) so providers can bill promptly.
Revenue stuck in A/R? Outsource your RCM.
If claims bounce, front-desk gaps appear, authorizations are missing, and balances linger — our end-to-end RCM confirms eligibility before visits and submits clean ICD-10/CPT claims.