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HIPAA-CompliantEnterprise-GradeBuilt for NEMT Growth
Healthcare & NEMT

Revenue-Optimized NEMT Billing Designed to Maximize Reimbursements

Accelerate cash flow, reduce claim denials, and maintain broker-compliant revenue cycle management at scale.

97.1%
Clean Claim Rate
3.2%
Denial Rate
28 Days
Avg Days in AR
22%
Revenue Increase
The Challenge

Revenue Leaks You Cannot Afford

Billing errors and slow collections silently drain your revenue every month.

High Denial Rates

Industry average denial rate is 10-15%. Every denied claim costs $25-50 to rework.

Impact: Revenue loss per claim

Slow Collections

Aging AR over 90 days drops collection probability below 50%.

Impact: $$ uncollectable revenue

Coding Errors

Incorrect codes mean underpayment or denial. Missed modifiers leave money on the table.

Impact: Systematic underbilling

Payer Complexity

Medicaid, Medicare, brokers, commercial — each has different rules and requirements.

Impact: Compliance risk
Operational System

How Our System Works

A structured operational framework, not just a task list. Every workflow is engineered for consistency and scale.

Phase 01

Charge Capture

Trip and service data captured, validated, and prepared for coding with documentation review.

Phase 02

Code Assignment

ICD-10, CPT, HCPCS codes assigned by certified coders with modifier optimization.

Phase 03

Claim Submission

Clean claims submitted electronically with payer-specific edits and compliance checks.

Phase 04

Payment Posting

ERA/EOB processing, payment reconciliation, and variance identification.

Phase 05

Denial Management

Root cause analysis, appeal preparation, and resubmission for every denied claim.

Phase 06

AR Follow-Up

Systematic aging bucket management with escalation protocols for overdue balances.

Live Operations

Real-Time Dashboard

Every client gets a live operational view. Here is what your dashboard looks like.

SS Support — Revenue Analytics
LIVE
Monthly Collections
$842K
▲ +18.3% MoM
Denial Rate
3.2%
▲ -4.8 pts YoY
Clean Claim Rate
97.1%
▲ +3.2 pts
Days in AR
28
▲ -12 days
Performance Trend
On Track
Activity Feed
Claims Submitted Today347
Payments Posted$124,560
Appeals Won23 / 25
AR > 90 Days$18,200
Medicaid
Medicare
Commercial
Broker Billing
Capabilities

Features & Benefits

Every feature is designed to drive measurable operational improvement.

Revenue Maximization

Capture Every Dollar

Identify underbilling patterns and optimize coding for maximum reimbursement.

97%+ Clean Claims

First-Pass Accuracy

Rigorous quality checks ensure claims accepted on first submission.

Faster Collections

Accelerated Cash Flow

Aggressive follow-up and systematic AR management cut collection times dramatically.

Transparent Analytics

Full Financial Visibility

Weekly and monthly reports on collections, denials, aging, and revenue trends.

Multi-Payer Expertise

Every Payer Covered

Medicaid, Medicare, commercial insurance, brokers, and private pay.

Denial Prevention

Proactive, Not Reactive

Pattern analysis identifies denial causes before they become systematic problems.

HIPAA Compliant

PHI Protected

Encrypted billing systems with certified billing professionals.

Revenue Growth

15-25% Increase

Clients see measurable revenue growth within the first 90 days.

What You Receive

Deliverables & Infrastructure

A complete operational infrastructure, not just warm bodies.

Dedicated Team

Named agents assigned exclusively to your account with full onboarding.

Standard Operating Procedures

Custom SOPs developed for your workflows and updated quarterly.

Weekly Performance Reports

Detailed KPI tracking with trend analysis and recommendations.

Quality Monitoring

Daily QA reviews with scoring and continuous improvement plans.

Escalation Management

Tiered escalation protocols with defined response times.

Compliance Coordination

Ongoing training and audit support for regulatory requirements.

Integrations

Platforms & Tools We Support

Seamless integration with your existing technology stack.

Epic
Cerner
athenahealth
eClinicalWorks
Trizetto
Availity
Waystar
AdvancedMD
Security & Compliance

Operational Controls

Enterprise-grade security practices embedded in every workflow.

HIPAA Data Handling

All patient and trip data processed under strict HIPAA protocols with encrypted transmission and storage.

Access Management

Role-based access controls with multi-factor authentication and audit logging on all systems.

Quality Assurance

Daily QA reviews, weekly performance audits, and monthly compliance reporting.

Operational Controls

Documented SOPs, supervisor oversight, real-time monitoring, and incident escalation protocols.

FAQ

Common Questions

Most clients are fully operational within 5-10 business days. We handle recruiting, training, system setup, and parallel testing before full transition.
We offer flexible pricing based on volume, team size, and service complexity. Contact us for a custom quote tailored to your needs.
Yes. Every client receives named, dedicated team members who are trained specifically for your account. No shared agent pools.
Daily QA audits, weekly performance reports, recorded interactions, supervisor oversight, and continuous training programs.
Absolutely. Scale your team size based on seasonal demand, growth, or operational changes with no long-term commitments required.