Our Healthcare RCM & BPO Services
Engineered to accelerate collections, eliminate administrative bottlenecks, and protect your medical practice against payer denials.
End-to-End Revenue Cycle Management (RCM)
“Synchronized financial lifecycle from patient registration to final bank deposit.”
Our full-spectrum RCM service relieves your practice of all back-office administrative burdens. We connect directly to your PM/EHR system to manage patient intake, verify insurance benefits, scrub claims, post electronic payments, resolve denials, and accelerate cash flow.
Key Deliverables & Workflow:
Medical Billing & Claims Processing
“Fast, accurate claim filing with zero backlogs and meticulous deposit reconciliation.”
Flawless charge capture and rapid electronic filing ensure that your practice captures every dollar earned without administrative lag. Our certified billing analysts verify provider fee schedules, enter charges with precision, and reconcile every remittance down to the penny.
Key Deliverables & Workflow:
Certified Medical Coding & Auditing
“Certified AAPC/AHIMA coders ensuring maximum compliance and zero downcoding.”
Accurate medical coding is the bedrock of clean claims. Our coders hold CPC, COC, CIC, and CCS certifications with deep sub-specialty acumen across cardiology, orthopedics, surgery, radiology, pediatrics, and emergency medicine. Every code is audited internally before submission.
Key Deliverables & Workflow:
Denial Management & Strategic Appeals
“We don't accept wrongful write-offs. Aggressive clinical appeals that recover trapped revenue.”
Up to 65% of denied healthcare claims are never resubmitted, creating massive revenue leakage. Our specialized denial recovery unit reviews every rejection code (CARC/RARC), crafts evidence-backed clinical appeal packages, and escalates delayed claims through payer peer reviews.
Key Deliverables & Workflow:
Accounts Receivable (AR) & Aging Recovery
“Targeted liquidation of aging claims in 30, 60, 90, and 120+ day buckets.”
Unresolved accounts receivable strangle practice cash flow. Our dedicated AR callers pursue delayed, underpaid, and stalled claims with commercial payers, Medicare, and Medicaid, ensuring that your average days in AR drop well below the 30-day benchmark.
Key Deliverables & Workflow:
Provider Credentialing & Payer Enrollment
“Accelerated provider onboarding with Medicare, Medicaid, and commercial health plans.”
Slow credentialing delays patient care and prevents providers from billing for months. Praveera manages the entire CAQH profile creation, primary source verification, payer application submission, and re-attestation process from start to finish.
Key Deliverables & Workflow:
Why Healthcare Organizations Choose Praveera
| Feature & Benchmark | Praveera Healthcare | In-House Staffing | Generic Offshore BPO |
|---|---|---|---|
| Clean Claim Submission Rate | 98.8%+ (Guaranteed) | 85% - 90% | 88% - 92% |
| 24/7 Continuous Delivery Cycle | Included (Overnight processing) | Standard 9-5 only | Limited timezone overlap |
| Certified Coding Acumen (AAPC/AHIMA) | Dual-tier certified reviews | High turnover & costly | Entry-level non-certified |
| Aged AR Follow-up (90+ Days) | Aggressive clinical appeals | Often neglected due to time | Generic automated calls |
| Overhead & Staffing Costs | Up to 40% cost reduction | High salary, benefits & tax | Moderate savings, poor quality |
Ready to Upgrade Your Practice Performance?
Submit your inquiry below or reach us directly at info@praveerahealth.com