What are revenue cycle management services and what do they include?

RCM is the full set of administrative, clinical and financial processes a practice uses to submit claims, collect payments, manage denials and optimize reimbursement from scheduling through final payment posting. At Credexa this covers eligibility verification, prior authorization, charge capture, ICD-10/CPT coding review, claim scrubbing and electronic submission, ERA/EOB payment posting, denial management and appeals, A/R follow-up, patient statements, provider credentialing and monthly performance reporting, all handled by a dedicated team inside your existing EHR from 2.99% of collections.

How does outsourcing medical billing work without disrupting my practice?

A trained, dedicated team manages your claims, payments and denials remotely inside your existing EHR. The transition takes 7 to 10 days: we configure HIPAA-compliant role-based access, review your payer mix and denial history and start processing claims alongside your current workflow. Your staff does not change platforms, learn new software or take on extra tasks.

What types of billing errors does Credexa catch that in-house teams commonly miss?

Charge capture gaps, undercoded E/M visits, incorrect modifiers, expired prior authorizations submitted as active and denied claims sitting unworked past filing deadlines. These come from small teams handling high volume without built-in quality assurance, not from negligence. Our certified coders review every claim against payer rules and documentation, and every denial is categorized and corrected at the root.

What's included in Credexa's medical billing and credentialing services?

Everything under one team and one rate. Billing covers eligibility, coding review, claim submission, payment posting, denial management, A/R follow-up and reporting. Credentialing covers CAQH management, payer enrollment submission, weekly follow-up, recredentialing tracking and status updates from $99 per enrollment. Both run inside your existing EHR with no separate vendor.

How does Credexa handle claim denials and prevent them from recurring?

Three stages: immediate categorization by denial reason code (CO-16, CO-4, PR-1 and others), prioritized appeals with supporting clinical documentation and upstream root-cause correction. We track denial patterns by payer, provider and code, then fix the workflow or data entry habit that caused them, which is what separates real denial management from simple resubmission.

How quickly can my practice go live after the first call?

Most practices go live within 7 to 10 days. Onboarding includes EHR access setup, fee schedule review, payer mix analysis, denial history audit and team assignment. We process the first claims while your previous system is still active, so there is no gap in revenue, and your first performance report arrives within the first full billing cycle.

Is Credexa the right fit for a solo practice or only larger groups?

We work with solo practitioners, small groups and multi-provider practices across all 50 states. Solo practices often benefit most because they have the least redundancy; one missed charge or unworked denial has a bigger impact. Percentage-based pricing scales with your collections, so you never pay for capacity you don't use.

What makes Credexa different from other medical billing outsourcing companies?

We find and fix existing gaps in your billing before they compound. Instead of running your process the way your old team did, we audit your revenue cycle during onboarding, identify leaks in claims, denials, coding and A/R and build a corrected workflow: gap identification first, process correction second, ongoing management third.

Is Credexa affordable for small practices?

Yes. Pricing starts at 2.99% of collections with no setup fees, no long-term contracts and no per-claim charges; you pay only on what we collect. For a practice collecting $50,000 a month, that is $1,495 for eligibility, coding, claims, denials, A/R and reporting, versus about $3,000 at a 6% billing company.

How does Credexa pricing compare to hiring an in-house biller?

Typically 30% to 50% less once you count salary, benefits, payroll taxes, software and training. A US biller costs roughly $45,000 to $65,000 per year plus overhead. With Credexa you get a dedicated team and certified coders, remove hiring risk and coverage gaps and pay for results, not hours.

Is Credexa HIPAA compliant and how is patient data protected?

Yes, across every workflow. Access is role-based so each team member sees only what their function requires. We sign a Business Associate Agreement (BAA) before any patient data is accessed, use encrypted transmission, keep access logs and audit trails and leave you with full ownership of all patient records.

What kind of reporting does Credexa provide?

Weekly claim status updates and monthly full-cycle reviews covering collections by payer, denial rates by reason code, clean claim rate, days in A/R by aging bucket, posting accuracy and process recommendations. Reports arrive in your EHR dashboard or a shared document, and a real person who knows your account is always a call or email away.

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