ACCOUNTABLE REVENUE OPERATIONS

Outsourced Revenue Cycle Management Services for Medical Practices

A claim comes back denied for an eligibility gap that should have been caught at check-in. The billing vendor points to the front desk, the front desk points to the software, and nobody owns the fix. Meanwhile, the claim keeps aging.

Fragmented workflows fail for the same reason. Each vendor owns a task, nobody owns the outcome, and the handoffs between them are where revenue goes missing.

MedSole manages your revenue cycle as one operation, from eligibility through reporting, with one account team that answers for the whole cycle and one report tied to what you actually collected.

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See Where Your Revenue Is Leaking

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FULL-SERVICE RCM

Every Stage of Your Revenue Cycle,
Managed Under One Roof

When eligibility, coding, claims, and follow-up sit with separate vendors, a denial can sit between them for weeks while each waits for the other to move. MedSole manages every stage under one strategy, one account team, and one report tied to collected revenue.

Eligibility Verification

We confirm active coverage, copay, deductible, and authorization requirements before every visit. Registration and demographic errors get corrected at check-in, where a fix takes minutes instead of weeks of rework after a denial.

Learn More about Eligibility Verification

Prior Authorization

Authorization delays stall care and trigger denials your team never saw coming. We submit the requests, track payer follow-ups, and appeal refused authorizations, so your clinical staff stops sitting on hold and gets back to patients.

Learn More about Prior Authorization

Medical Coding & Charge Capture

Specialty-trained coders review CPT, ICD-10, and HCPCS codes against payer documentation rules. We reconcile your schedule against entered encounters daily, so billable services are captured and downcoding does not quietly erode revenue.

Claims Management

Every claim is scrubbed against payer-specific edits for bundling conflicts, modifier requirements, and place-of-service rules before it goes out. Claims are submitted daily and tracked through acceptance, so nothing sits waiting in a queue.

Learn More about Claims Management

Denial Management

We work every denial to root cause instead of simply refiling it. Denials are categorized by reason code, appealed with supporting documentation, and corrected upstream so the same denial stops showing up on next month's report.

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Accounts Receivable Management

Aged AR is revenue sitting in someone else's account. We work outstanding claims by age bucket, payer, and denial reason, prioritized by dollar value and timely filing deadline, so balances move toward resolution instead of aging out.

Learn More about Accounts Receivable Management

Payment Posting

We post ERA and EOB payments against your ledger, match them to billed charges, flag underpayments, and reconcile every discrepancy. You always know what was paid, what was shorted, and what is still owed on each account.

Learn More about Payment Posting

Reporting & Revenue Analytics

Reports tie back to collected revenue, not submitted claims. You see collections by payer, denial rate by category, days in AR by aging bucket, and net collection rate, with each problem traced to the stage that caused it.

Learn More about Reporting and Revenue Analytics

Separate vendors means separate teams who can each say the problem belongs to someone else. One RCM partner means one number to call and one team that already knows what happened at registration.

Need a single stage instead of the full cycle? Our medical billing services and provider credentialing services are also available on their own.

Want to see where your revenue cycle is leaking?

Get Your Free Revenue Cycle Audit

Our Process

From First Call to First Clean Claim: How We Run Your Revenue Cycle

Most RCM providers hand you a list of tasks. We run a connected system where each step depends on the one before it. Skip or weaken any step, and the next one pays the price.

Most practices complete the transition and begin live claim submissions within 7 to 10 business days. Here's how our revenue cycle management services work when we manage the whole process.

Step 1 · Days 1 to 7

Discovery and Setup

We review your current clean claim rate, denial patterns, AR aging, and payer mix before any work begins. The audit shows exactly where revenue is leaking and what recovery takes. Most practices find 5 to 8 areas of immediate improvement. We sign a BAA before we access anything.

Step 2 · Pre-Service

Eligibility and Authorization

Before every encounter, we verify patient coverage in real time: active plan, copay, deductible, and prior authorization requirements. Problems caught here never become denials downstream. This is the cheapest place in the entire revenue cycle to catch an error, and the most expensive place to miss one.

Step 3 · Claim Submission

Coding Review and Clean Claim Submission

We capture charges daily by reconciling your schedule against entered encounters. ICD-10, CPT, and HCPCS codes get reviewed against payer documentation rules before submission. Claims pass through payer-specific edit logic for bundling conflicts, modifier requirements, and place-of-service rules. The target is first-pass clean claim acceptance on every claim.

Step 4 · Post-Payment

Payment Posting and Denial Resolution

We post ERA and EOB payments and reconcile them on the day of receipt. Denied claims get categorized by denial reason code, appealed with supporting clinical documentation, and corrected at root cause. Refiling without fixing the upstream cause is why the same denials keep reappearing. We fix the cause.

Step 5 · Ongoing

A/R Follow-Up and Performance Reporting

We work aging claims daily, prioritized by dollar value and timely filing deadline. You receive regular performance reports showing collections by payer, denial rates by category, days in AR by aging bucket, and recommended adjustments. No black box. You get full visibility into every stage of your revenue cycle.

Ready to see what your practice is leaving on the table? Start with a free revenue cycle audit.

THE OPERATIONAL DIFFERENCE

Why Practices Choose MedSole for Outsourced Revenue Cycle Management

Reporting Tied to Collected Revenue, Not Submitted Claims

Most outsourced RCM providers report on what they sent out. We report on what came back. Your clean claim rate, denial rate, and net collection rate get measured against what you deposited, not what was billed. You stop watching a vendor and start reading a financial statement.

One Accountable Team for Every Stage

When registration, coding, claims, denials, and accounts receivable all run under one team, a problem at any stage gets traced to its source instead of passed between vendors. Nobody has to agree on whose fault it was before the work starts.

Escalation That Does Not Start From Zero

When a claim stalls, the person you reach already knows what happened at registration, what the payer said last week, and what was tried. You are not re-explaining your practice to a new ticket every time.

Your Accounts, Your Data, Your Assets

Your billing accounts, payer portals, and dashboards all stay in your practice name. We never hold data as leverage. If you ever move vendors or bring billing in-house, everything transfers cleanly. We sign a BAA before we touch any PHI, and we stay your business associate, not the owner.

BUILT FOR YOUR PRACTICE

Outsourced RCM for Solo Providers, Group Practices, and Hospital Systems

Solo providers, group practices, multispecialty clinics, and hospital systems each carry a distinct kind of billing risk. One person handling billing alone can fail in a single afternoon. A group without shared reporting loses coordination as it grows.

A multispecialty clinic loses track of which service line is working. A hospital system loses visibility across departments and locations without one consolidated view. MedSole RCM scopes its approach to the practice in front of it, not one template stretched across every size.

Solo Providers

A solo practice running one or two billers carries the highest revenue risk. When that biller leaves, billing stops. We give independent practices a complete revenue cycle team without adding internal staff, so you focus on patients.

Group Practices

Group practices need coordinated billing across multiple providers, tax IDs, and specialties. We run every provider under one strategy, with reporting by provider, specialty, and payer. Denial trends across the group get caught and fixed before they compound.

Multispecialty Clinics

Multispecialty clinics carry the most complex billing environment of any practice type. Every service line has its own coding rules, prior auth, and payer behavior. We staff billers by specialty, so each line gets coded and billed accurately.

Hospitals and Health Systems

Hospital-level RCM demands scale and coordination most vendors can't deliver. We handle facility billing, professional billing, and credentialing across every department, with a dedicated account team per location and consolidated revenue reporting at the system level each cycle.

Specialty Expertise

Specialty-Specific Revenue Cycle Management That Knows Your Payer Rules

Every specialty runs its revenue cycle differently. MedSole works to each one's documentation requirements, denial triggers, modifier rules, and payer-specific workflows, not a generic checklist. MedSole RCM covers over 75 specialties. Here are the revenue cycle challenges our team manages daily.

Don't see your specialty listed? We cover 75+ disciplines across all 50 states. Tell us yours, and we'll confirm the coverage and payer rules that apply to it.

PROVIDER FEEDBACK

What Providers Say About Working With MedSole

Feedback from providers who work with MedSole across credentialing, billing, and revenue cycle support, in their own words.

Isabella Saffioti

Occupational Therapist

Little Star Pediatric Therapy

"I cannot thank Medsole RCM for all they've done"

I cannot thank Medsole RCM for all they do for my practice. I was previously using a different billing company who was making several mistakes with my billing, I was not getting paid and it was a complete mess. I switched over to Medsole RCM at the end of August the week of my wedding and I am so happy I did. Medsole has been amazing. Andrew has been helping me with all of my billing and he even was able to get me a higher reimbursement rate with two insurance companies. I cannot wait to continue to grow my private practice with Medsole!

Svetlana McGrath

Nurse Practitioner, Pediatrics

Tongue To Toes Newborn and Family Clinic

"Very satisfied"

I am very satisfied with the services I have been receiving from Medsole for the last few years. This team has helped me to run my private medical practice very smoothly. I truly appreciate Jack and his help with the credentialing, Andrew and his help with billing and Alex with all the miscellaneous questions we have had. Thank you.

Twila Jones Mojica

Mental Health Counselor

Talk With Twila Ministries LLC

"Pleased with services"

I have found Medsole RCM LLC to be knowledgeable, professional, and courteous in regard to credentialing and billing. I found Stephen to be very patient as I had a loss in the family. Andrew communicates in real time and the turnaround for payments moves rather quickly. I highly recommend Medsole RCM for those in private practice.

Yzetta Martinez

Licensed Mental Health Counselor

House of the Sacred Journey INC

"Excellent Service and Responsiveness!"

I've been incredibly pleased with the professionalism and efficiency of Medsole RCM LLC. Their team responded quickly and thoroughly when it came to checking credentialing and addressing any discrepancies reported by patients regarding their insurance coverage. It's clear that they take their role seriously and are committed to making sure everything runs smoothly on the back end. Their attention to detail and prompt communication have made a noticeable difference in how confidently we can move forward with patient care. I truly appreciate the support!

Andrea Piazza

Licensed Mental Health Counselor

Dreavita Counseling Coaching and Consulting INC

"Medsole is a practice saver"

Medsole is an excellent and irreplaceable business partner. We keep coming back to them for more and more services because we trust their work that much. I would highly recommend them to anyone looking for a credentialing, billing or VMA vendor.

Cleavon Matthews

Counselor

Professional Practical Solutions Counseling LLC

"Revenue definitely increased"

Excellent services. Jack and the team made the credentialing experience pretty seamless. I also contracted with them to do monthly billing and my revenue definitely increased.

We Move Into the Software You Already Use

You don't switch platforms to work with us. We move inside your EHR and bill from the system your team already knows, so there's no migration, no retraining, and no gap in claim submission. We work across 50+ EHR and practice management systems, and if yours isn't listed, we'll integrate with it.

SUPPORT CENTER

Revenue Cycle Management: Questions Practices Ask Before Switching

Everything you need to know about our services, onboarding, reporting, and how we protect and grow your revenue cycle.

Still have questions?

Can't find the answer you're looking for? Our revenue cycle specialists will walk you through every detail.

Q1 What are revenue cycle management services and what do they include?

Revenue cycle management is the full process that captures, manages, and collects revenue from patient care, start to finish. It covers eligibility verification, coding, charge capture, claim submission, payment posting, denial management, AR follow-up, and patient billing. Outsourced revenue cycle management hands that entire process to a specialist team. With MedSole, it's one team, one account manager, and one report tied to what you collect.

Q2 How does outsourcing revenue cycle management work without disrupting my practice?

You keep your EHR and your workflow. We move inside the system you already use, so there's no platform switch and no gap in claim submission. We manage the revenue cycle behind the scenes while your front desk and providers keep working exactly as they do now. Onboarding runs in parallel with live billing, so nothing stops while we transition your account.

Q3 What types of billing errors does MedSole catch that in-house teams commonly miss?

Most missed revenue traces to a few repeat errors: eligibility not verified before the visit, expired authorizations, missing modifiers, mismatched patient data, and undercoded encounters. Each one gets caught at the point it happens, not after the denial. Our billers are trained by specialty, so they catch the coding and payer-rule gaps a generalist misses on your claims.

Q4 Do I need separate vendors for billing, coding, and credentialing?

Everything in the revenue cycle runs under one team: eligibility, prior authorization, coding, charge capture, claim submission, payment posting, denial management, AR follow-up, patient billing, and provider credentialing. You don't juggle separate vendors for separate stages. One account team owns the whole cycle, and one report shows how every stage performed against collected revenue.

Q5 How does MedSole handle claim denials and prevent them from recurring?

We work every denial to root cause instead of just refiling it. CO-16, CO-97, CO-50, and OA-18 each get specialty-specific appeals with supporting documentation. Then we fix the upstream cause so the same denial stops repeating. Refiling without fixing the cause is why denials keep coming back on most practices' reports.

Q6 How quickly can my practice go live with MedSole after the first call?

Most practices are fully onboarded and live within 7 to 10 business days. That includes EHR integration, account setup, and collecting credentialing documentation. Claims go out on day one of live operations. If you need payer enrollment or recredentialing, those run in parallel and complete within 30 to 90 days depending on the payer.

Q7 How does MedSole report revenue cycle performance?

Every report ties back to collected revenue, not submitted claims. You receive regular reports showing collections by payer, denial rates by category, days in AR by aging bucket, and recommended adjustments. Because one team runs every stage, the report shows which stage caused a problem, not just that one exists.

Q8 What is a clean claim rate, and what is MedSole's?

A clean claim rate is the percentage of claims that clear payer first-pass edits without a rejection. We maintain a 99% clean claim rate. The in-house benchmark runs 85 to 92%. A lower rate means more manual rework, longer days in AR, and higher administrative cost for every dollar you collect.

Q9 When should a practice outsource its revenue cycle management?

Four signals point to it: denial rate climbing above 5%, AR days stretching past 45, biller turnover disrupting cash flow, or adding providers faster than you can credential them. The free audit is the right first step. It shows exactly where your revenue leaks before you commit to anything.

Q10 What is the difference between medical billing and RCM?

Medical billing is the submission and follow-up of insurance claims. Revenue cycle management covers the full financial lifecycle of a visit, from registration and eligibility through coding, submission, payment posting, denial management, and patient collections. Billing is one stage of RCM. We cover every stage, so no revenue falls through the gaps between functions.

Q11 Do I keep ownership of my billing accounts and data?

Yes. Every account, portal, dashboard, and report stays in your practice name. We operate as your business associate, not the billing owner. We sign a BAA before we access any data, and you keep full access at all times. If you ever move vendors or bring billing in-house, everything transfers cleanly with no holdbacks.

Q12 Is outsourcing revenue cycle management worth it for a small practice?

Yes, and small practices often gain the most. A solo or small practice running one or two billers carries the highest risk: when that biller quits or takes leave, billing stops and cash flow stalls. Outsourcing gives you a full revenue cycle team whose coverage never depends on one person, with specialty-trained coders and reporting that most small practices cannot staff in-house. You get a 99% clean claim rate, faster payments, and fewer denials, all measured against what you actually collect.

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FREE REVENUE CYCLE AUDIT

Find Out How Much Revenue Your Practice Is Leaving on the Table

Our free revenue cycle audit reviews your clean claim rate, denial patterns, and AR aging to show you exactly where revenue leaks before it reaches your bottom line. This is the first step toward outsourced revenue cycle management with one accountable team. No cost. No commitment. We sign a BAA before we touch anything.