Healthcare Logic supports FQHCs, critical access and community hospitals, radiology groups, medical centers, primary care clinics and physician organizations. Choose full-cycle RCM or targeted support for inpatient/outpatient coding, billing, denials, A/R, authorization and credentialing inside your existing systems.
Our revenue cycle team will follow up within one business day.
Finance and operations leaders need an RCM partner that protects patient data, works inside current systems, understands facility and professional coding, and makes payer issues visible before they become long-term A/R.
Outsourced medical billing and coding runs under a signed Business Associate Agreement, written HIPAA policies and role-based access limited to the minimum necessary PHI. Data stays on U.S.-hosted infrastructure; offshore teams work as access points, never as data stores.
Our revenue cycle teams work inside the EHR, practice management system and clearinghouse you already run, so charge entry, coding, claim submission and payer follow-up never become a separate billing silo.
Verify active coverage, benefits, coordination of benefits and payer-specific authorization requirements before service. Authorization status, medical-necessity dependencies and denial reasons are tracked so front-end exceptions can be corrected before they become avoidable claim failures.
Eligibility & benefits checksDenials are mapped to CARC/RARC and operational root cause, while aged A/R and payment variances are segmented by payer, dollar value, deadline and recovery path. The objective is to recover what is owed and stop the same failure from re-entering the cycle.
A/R & denial managementTell us where revenue is getting stuck, whether the pressure is coding capacity, denials, A/R, payer friction or a full-cycle gap. Our team will review the request and follow up within one business day.
We will review your organization and EHR context and follow up within one business day to schedule the assessment.
Eight connected revenue-cycle functions, delivered as one operating model or scoped independently: eligibility, prior authorization, credentialing, coding, billing, payment reconciliation, denial management and legacy A/R recovery.
Coverage and benefits verification, payer-specific authorization controls, CAQH maintenance and payer enrollment are connected upstream so avoidable denials and unbillable provider activity are caught before claims age.
Explore Patient Access
ICD-10-CM/PCS, DRG-focused inpatient coding, CPT, HCPCS, modifier review, documentation feedback and specialty-specific coding support aligned to the care setting and current code-set requirements.
Explore Medical Coding
Charge entry, claim edits, submission, payer follow-up, ERA/EOB posting and remittance reconciliation stay connected so a completed service can move cleanly from charge capture through posted payment.
Explore Medical Billing
Denials are prioritized by root cause, value and deadline while legacy A/R and payment variances are segmented by recoverability, payer and next action to recover cash without endlessly recycling work queues.
Explore Revenue Recovery
Revenue leakage can begin at registration, eligibility, authorization, enrollment, coding, charge capture, claim submission, payer adjudication, payment posting or follow-up. A strong RCM model connects those handoffs so the source is corrected, not just the downstream symptom.
One California healthcare organization engagement shows the operating model: correct the coding and workflow issue creating new leakage while a dedicated team works the aged backlog in parallel.
Chart review, specialty coding workflow correction, documentation alignment, direct payer follow-up and aged-receivable recovery — all inside the client's existing OCHIN Epic environment.
Documented integrated RCM engagement. Results are specific to this client and are not a guarantee of future performance.
200+ charts mapped against the OCHIN Epic workflow to locate charge-capture and documentation breakdowns.
Coding and specialty documentation workflows standardized so new revenue stopped leaking.
Bandwidth shifted to the 90-day-plus and legacy A/R backlog with direct payer follow-up while performance was monitored.
Denial rate, A/R movement and charge lag reported monthly so the gains did not quietly reverse.
How results were measured. Results shown reflect the documented engagement period and were calculated from client workflow, claim, denial, coding and A/R data available during the engagement. Results are specific to this organization and are not a guarantee of future performance.
Healthcare Logic supports provider organizations where payer complexity, coding specialization and staffing pressure can quickly turn into lost reimbursement. Workflows adapt to each care setting.
PPS, Medicaid managed care, wraparound, eligibility, coding, denials and A/R supported within health-center workflows.
Hospital billing, inpatient and outpatient coding, denials and A/R support for organizations operating with limited internal capacity.
Facility and professional work queues, coding coverage, payer follow-up and backlog recovery that extend the internal revenue cycle team.
Professional and technical billing, authorization, coding, modifiers, component splits, place-of-service rules and denial follow-up.
Front-end verification, coding, billing, payer follow-up, denials and credentialing for primary care and physician-led organizations.
Standardize billing and reporting while keeping specialty-specific coding, authorization and payer rules intact across locations.
Add accountable capacity inside your systems while giving finance and operations leaders clearer visibility into coding, payer performance and cash conversion.
Billing, coding, payer follow-up and reporting stay connected to your current operating environment instead of moving into a disconnected platform.
Add coding, billing, denials, legacy A/R or patient-access capacity where the bottleneck exists today, then expand only when the operational case supports it.
Inpatient, outpatient and professional coding workflows are aligned to the care setting, documentation, code set, modifiers and payer requirements.
Denials, underpayments and legacy A/R are grouped by payer, root cause, value and next action so recurring eligibility, authorization, coding or claim issues can be corrected upstream.
Track denial movement, current and legacy A/R, charge lag, coding turnaround and payment variance so finance leaders know what is delayed, why it is delayed and who owns the next action.
Your U.S. account team owns reporting and escalation while assigned production teams work defined queues through role-based access to approved U.S.-hosted systems.
How performed services disappear before they become clean billable claims, leaking revenue before collections even starts.
Read More
The documentation gaps that break reimbursement even when every other part of the claim is clean.
Read MoreHow payer requirements and authorization controls connect front-end workflow straight to downstream claim performance.
Read MoreQuestions CFOs, revenue cycle leaders and operations teams ask when evaluating outsourced RCM, medical billing and coding support.
Feedback from finance, billing and operations leaders at the organizations our revenue cycle teams support.
Working with your team has made a big difference for us. When we started, more than 30% of our A/R was over 90 days and two quarters later we were below 12%. But honestly the biggest difference for me is that now I know what is happening. I look at the denial report every week and I can see exactly where we need to focus.
I was honestly worried about switching billing support in the middle of the year because we already had enough going on. Your team took the time to understand how we were working before changing anything. You kept our clearinghouse in place and we didn't lose a collections cycle. Looking back, we made the right decision.
What I appreciated from the beginning was that your team actually understood RHC reimbursement and wrap-around payments. We had encounter-rate billing issues that had been missed before. It took a little time for everyone to get used to the new workflow, but once we got through that, the recovery work made the change worth it for us.
Working with your coding team has probably been the biggest improvement for us. We were seeing too much inconsistency before and it made forecasting difficult. Since working with you, the E/M downcoding issue has dropped off and our clean-claim rate is now above 96%. The revenue cycle feels much more predictable now.
Credentialing used to take up so much of my time every week. Since your team started handling it, I don't have to keep checking applications and following up with payers myself. Our new clinicians are also getting paneled in roughly half the time. You've taken a real burden off me and my staff.
One thing I really value is how easy your team is to work with. It doesn't feel like we are dealing with an outside billing company. When something changes with a payer, you let us know what happened and what we need to change on our side instead of us finding out after claims start denying.
The first review your team did was honestly an eye opener for us. You found about $40,000 in missed charges from one quarter that we didn't realize we were losing. Obviously that wasn't a number we wanted to see, but I'm glad we found it. More importantly, you helped us put a process in place so we aren't repeating the same problem.
What I like most is that I don't have to chase anyone for reports anymore. With our previous billing company I could wait a week or two just to get the numbers I was asking for. Now I can see what is happening and if I have a question I know what I am looking at. It has saved me a lot of time.
Before working with your team, denials were something we got to when someone had time. There wasn't really ownership. Now we know who is working each payer and what is still outstanding. We've also seen our overturn results improve quarter after quarter. The biggest thing for me is that there is finally a process.
Working with a CAH is different and that was one of my concerns when we were looking for support. Your team understood the Medicare and cost-reporting side without us having to explain everything from the beginning. You worked with our team through the audit and there were no surprises. For me, that consistency and communication is what matters.
Client feedback is shared with permission and anonymized by role and organization type where requested. Feedback may be lightly edited for length and clarity. Results are specific to each engagement and are not a guarantee of future performance.
