Turn denials, aging AR, and billing chaos into predictable cash flow.

Revenue Cycle Management (RCM) is the entire financial process behind every patient visit—verifying eligibility, securing authorizations, coding and submitting claims, posting payments, appealing denials, and reporting. Strong RCM makes sure the care you deliver is actually paid, in full and on time.

Medical billing is the core of the revenue cycle: preparing accurate claims, submitting them to insurance payers, and following up until they're paid. It covers coding review, clean-claim submission, payment posting, patient statements, and working rejections and denials.

Medical billing is one part of RCM. Billing focuses on creating and collecting on claims; revenue cycle management is the broader system around it—eligibility, denial prevention, payment posting, AR follow-up, and reporting. ClaimCore starts with full-service medical billing today and scales into broader RCM services as you grow.

Behavioral and mental health practices, substance-use and IOP/PHP programs, FQHCs and CCBHCs, group practices, community-based and nonprofit organizations, and home- and outpatient-care providers. If your claims involve complex payers and authorizations, it's our specialty.

Yes—behavioral and mental health is our core focus. We handle time-based therapy codes, IOP/PHP, and SUD treatment, plus the authorization-heavy payers that make behavioral health billing uniquely difficult.

Yes. Medicaid and managed-care billing is a primary specialty. We work within state-specific rules, MCO enrollment requirements, and the documentation standards Medicaid demands to keep clean claims moving and denials down.

We're Texas-first but serve providers nationwide—including New York, California, Florida, Georgia, New Jersey, Arizona, Utah, and every other state plus DC. Because Medicaid and payer rules vary by state, we bill to each payer's specific requirements.

No. We work inside your existing EHR, practice management, and clearinghouse—no rip-and-replace. Our reporting sits on top, so you gain visibility without changing the tools your team already uses.

Yes. We can complement an in-house biller—taking on denial management, AR cleanup, or overflow—or fully manage the revenue cycle. Many providers start with a focused project alongside their current team before expanding our role.

Engagements are scoped to your volume, payer mix, and services—project-based for audits and AR cleanups, or an ongoing model for full-service RCM. We outline pricing transparently on the discovery call: no hidden fees and no surprise write-offs.

Most engagements begin within a few weeks. Timing depends on access to your systems, your existing payer setup, and scope. You'll get a clear onboarding plan with each step and milestone up front.

It is a limited review of summary-level AR, denial, claim volume, and collection data to identify visible leakage and determine whether a deeper paid audit or cleanup engagement makes sense. It is not a full claim-level audit.

No. A full audit requires a paid engagement. The free snapshot is capped to summary-level review and is designed to determine whether there is enough opportunity to justify deeper work.

We may review summary-level AR aging, denial summaries, claim volume, payer mix, monthly collections, and top billing pain points. We do not review thousands of individual claims for free.

High-volume providers receive an executive-level snapshot only. Claim-level review, large-volume denial analysis, or detailed AR investigation requires a paid Revenue Recovery Audit.

It helps both sides determine whether there is a real billing opportunity before committing to a paid engagement. It is a qualification tool, not free recovery work.

Yes. We verify benefits, coverage, and patient responsibility before the visit, so claims go out clean the first time and front-desk surprises disappear.

Yes. We trace every denial to its root cause, file structured appeals, and fix the upstream coding or eligibility issue so the same denial doesn't keep recurring.

The paid Revenue Recovery Audit is a deeper, claim-level review—AR, denials, payer patterns, unpaid claims, claim samples, remittance issues, and billing-workflow problems—with a clear plan to recover what's collectible. It typically follows a free Revenue Leak Snapshot once we've confirmed the opportunity is worth pursuing.

We operate with HIPAA-conscious workflows: role-based and least-privilege access, encrypted handling of PHI, a secure intake process, and a signed BAA before any PHI access. Protecting patient information is built into how we work, not added on afterward.

Yes. A Business Associate Agreement (BAA) is signed as part of every engagement before any PHI is shared.

It's a short, no-pressure conversation about your providers, payers, systems, and biggest revenue-cycle pain points. We come prepared, answer your questions, and outline a focused plan with transparent pricing. There's no obligation.