Service
Revenue Cycle Management (RCM) Services
Revenue cycle management services that connect eligibility, coding, claim submission, denial management, AR follow-up, payment posting, and reporting into a single accountable workflow.
Overview
What revenue cycle management covers.
Revenue cycle management (RCM) is the end-to-end process of capturing, billing, and collecting payment for healthcare services — from scheduling and eligibility through claims, denials, payment posting, and patient collections. LRx Healthcare operates that cycle for medical practices, clinics, labs, behavioral health providers, and pharmacies as a single accountable workflow: eligibility verification and authorization, charge capture and coding review, claim submission, denial management, A/R follow-up, payment posting, and monthly KPI reporting.
The value of running these steps together is that each one informs the others. A denial is traced back to the intake question, authorization check, or coding pattern that caused it; a payment posted below contract becomes an underpayment dispute instead of a closed claim; and the monthly KPIs show whether each fix worked. Medical billing — taking claims from charge entry to payment — is the core of it; RCM adds the front end, the back end, and the reporting that ties them together. For multi-location clinics, the same workflow runs at every site, with site-level reporting.
RCM can replace your billing operation in full or in part. Many clients begin with denial recovery or A/R cleanup and expand to the full cycle once trust is established; our guide to in-house vs. outsourced medical billing explains the hybrid model. Most engagements start with a free billing audit, and onboarding for full revenue cycle work typically takes 2–4 weeks.
Scope: RCM here is a managed service delivered by our team inside your existing practice management and EHR systems — no system switch, and you keep access to your own data. Your providers remain responsible for clinical documentation; we bill from what is documented.
What you get
What’s included.
- Eligibility verification and authorization workflows
- Charge capture and coding review
- Claim submission and payer follow-up
- Denial management and AR recovery
- Payment posting and reconciliation
- KPI dashboards and monthly performance reviews
Outcomes
What better looks like.
- Predictable revenue performance
- Cleaner first-pass claim rates
- Lower AR days outstanding
- Clear, board-ready reporting
How it works
How an RCM engagement runs.
- 1
Diagnostic review
Most engagements start with a free billing audit of denials, A/R aging, payer mix, and workflow gaps, so the scope is based on your data rather than assumptions.
- 2
Scope & agreement
Services in scope, reporting, named points of contact, documented SLAs, and escalation paths are agreed, and a Business Associate Agreement is signed before any PHI is exchanged.
- 3
Access & workflow mapping
User access is set up for your practice management system, clearinghouse, and payer portals, and we map how work moves today before changing anything.
- 4
A/R handover
Your current A/R aging is taken over at onboarding, so claims already in flight are worked by priority rather than lost in the transition.
- 5
Front-end operations
Eligibility, benefits, and authorization requirements are confirmed before visits, and charges are reviewed for coding accuracy before claims go out.
- 6
Back-end operations
Claims are submitted and tracked, payments are posted line by line, denials are corrected or appealed, and unpaid claims are followed up with documented payer contact.
- 7
Prevention loop
Recurring denial reasons and payment variances are traced to the step that caused them — intake, authorization, coding, or claim data — and fixed at the source.
- 8
Monthly KPI review
A monthly report and review covers clean claim rate, denial categories, A/R aging, net collections, and payer-level trends, with open issues and anything we need from your team.
What onboarding needs from you
- User access to your practice management system, EHR, clearinghouse, and payer portals
- A current A/R aging report and recent denial or remittance history
- Your fee schedule and any payer contracts you want reimbursement checked against
- Provider NPIs, tax ID, and current payer enrollment details
- A practice contact for documentation questions and approvals
- A signed Business Associate Agreement before any PHI is exchanged
What your monthly KPI review covers
- Charges, payments, and adjustments for the month
- Clean claim rate, denial categories, and top denial reasons by payer
- A/R aging by bucket and by payer
- Net collections and payer-level trends
- Root causes addressed and the workflow change made for each
- Open issues and anything we need from your team
Related services
Often paired with this service.
Most providers see the biggest gains when these workflows are operated together.
Revenue Cycle Management guides
Free guides on this topic.
Practical, answer-first guides from the LRx Healthcare revenue cycle team.
How to Read an AR Aging Report (and Find Where Revenue Leaks)
How to read a medical AR aging report: what each aging bucket means, how to calculate days in AR and net collection rate, and how to prioritize AR follow-up.
Read the guideInsurance Eligibility Verification Checklist for Front-Desk Teams
Front-desk insurance eligibility verification checklist: when to verify, what to confirm, coordination of benefits rules, and Medicare and Medicaid tips.
Read the guideProvider Credentialing for Small Practices: CAQH, Payer Enrollment, and Revalidation
How provider credentialing and payer enrollment work: documents needed, CAQH ProView, Medicare PECOS, typical timelines, and revalidation schedules.
Read the guideRevenue Cycle Management FAQ
Common questions about this service.
Quick, direct answers to the questions providers ask most about LRx Healthcare.
Let's get started
Ready to upgrade your revenue cycle management workflow?
Request a free consultation or billing audit and we’ll walk you through where this service fits in your revenue cycle.