MEDICOSE RCM Our Services

Our Services

Comprehensive Revenue Cycle Management Solutions

Ready to Optimize Your Revenue Cycle?

We handle the complete lifecycle of your medical billing, credentialing, and RCM workflows to ensure maximum financial growth for your practice.

Explore our services below ↓


Core Workflows

MEDICAL BILLING

RCM & A/R


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Coding, claim submission, payment posting & A/R recovery.

Accurate medical coding, timely claim submission, daily payment posting, persistent aging balance recovery, and systematic insurance follow-ups to accelerate cash flow.

DENIAL MANAGEMENT


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Denial analysis, appeals & recovery.

Root-cause denial categorization combined with aggressive multi-level appeals to overturn rejected claims quickly.

VOB & ELIGIBILITY


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Verification of Benefits & eligibility.

Real-time coverage verification and pre-authorization tracking before patient encounters to eliminate front-end denials.

APPOINTMENT SETTING


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Appointment scheduling & outreach.

Dedicated patient intake outreach and streamlined appointment scheduling to optimize practice daily capacity.

OON NEGOTIATIONS


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Out-of-network rate negotiation.

Strategic negotiation of out-of-network reimbursement rates directly with commercial payers for maximum settlement.

END-TO-END SUPPORT


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From front-end operations to back-end RCM.

Full-time availability and dedicated end-to-end RCM support for healthcare providers—managing intake, coding, claims, posting, and auditing around the clock.


Payer Contracting

CREDENTIALING SERVICES

PROVIDER ENROLLMENT


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Initial group & individual provider setup.

Complete end-to-end setup for new practices and individual providers, handling application submissions, NPI registration, and CAQH profile maintenance.

MEDICARE & MEDICAID


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Government payer enrollment & EDI setups.

Expert navigation of PECOS and state Medicaid portals to secure quick Medicare/Medicaid group linkings, EFT setups, and billing clearance.

COMMERCIAL ENROLLMENT


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Private insurance contracting & paneing.

Direct contract acquisition and credentialing with major commercial payers (Aetna, BCBS, Cigna, Humana, UnitedHealthcare) for in-network status.

RE-CREDENTIALING


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Re-validation, re-enrollment & attestation.

Proactive tracking of re-validation deadlines, quarterly CAQH attestations, and timely re-enrollment submissions to prevent gap in billing privileges.


Direct Sync

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