Medical Billing & Coding

Medical Billing and Coding at SYS RCM 247 is designed to ensure that every service provided by a healthcare practice is accurately translated into compliant medical codes and submitted correctly to payers. Our experienced billing and coding professionals work closely with clinical documentation to assign appropriate CPT, ICD-10, and HCPCS codes in accordance with payer-specific guidelines. By focusing on accuracy and compliance at the coding stage, we significantly reduce claim rejections, audits, and payment delays. Our billing team manages the complete claim lifecycle—from charge entry to submission and follow-up—ensuring timely reimbursements and improved revenue integrity for our clients.

Revenue Cycle Management (RCM)

Revenue Cycle Management at SYS RCM 247 covers the entire financial journey of a patient encounter, beginning from appointment scheduling and eligibility verification through final payment reconciliation. Our RCM approach integrates front-end, mid-cycle, and back-end processes to eliminate revenue leakage and enhance cash flow. We analyse payer behaviour, identify workflow gaps, and implement corrective measures to optimize collections. By continuously monitoring performance metrics and denial trends, we help healthcare providers achieve financial stability while maintaining compliance with CMS and commercial payer regulations.

Charge Capture & Payment Posting

Charge Capture and Payment Posting is a critical function that ensures no revenue is lost due to missed or incorrectly recorded services. SYS RCM 247 carefully reviews clinical documentation to capture all billable services performed during patient encounters. Once payments are received from insurance companies or patients, our payment posting specialists accurately apply payments, adjustments, contractual write-offs, and patient responsibility amounts to the correct accounts. This detailed and transparent posting process allows providers to clearly track revenue, identify underpayments, and maintain accurate financial records. Proper charge capture and posting form the foundation for reliable reporting and effective accounts receivable follow-up.

Accounts Receivable (AR) Management

Accounts Receivable Management at SYS RCM 247 focuses on recovering outstanding and underpaid claims in a timely and systematic manner. Our AR specialists actively monitor claim aging, payer response timelines, and reimbursement patterns to ensure consistent follow-up on unpaid balances. We communicate directly with insurance carriers to resolve claim issues, correct errors, and submit appeals when necessary. Through structured AR workflows and performance tracking, we help reduce days in AR, improve collection rates, and recover revenue that might otherwise be written off.

Eligibility & Benefits Verification

Eligibility and Benefits Verification is a proactive service that helps prevent avoidable denials before claims are submitted. SYS RCM 247 verifies patient insurance coverage, policy status, benefit limitations, and authorization requirements prior to service delivery. By confirming coverage details upfront, we help providers avoid claim denials related to inactive policies, non-covered services, or incorrect payer information. This process also improves patient communication regarding financial responsibility, resulting in fewer billing disputes and improved patient satisfaction.

Provider Credentialing & Enrolment

Provider Credentialing and Enrolment services ensure that healthcare providers are properly registered and approved with Medicare, Medicaid, and commercial insurance carriers. SYS RCM 247 manages the complete credentialing lifecycle, including initial enrolment, re-credentialing, and payer updates. Our team tracks application status, resolves payer inquiries, and maintains accurate provider records to prevent claim denials caused by enrolment issues. Proper credentialing allows providers to bill payers without interruption and receive reimbursement without unnecessary delays.

Denial Management

Denial Management at SYS RCM 247 goes beyond correcting individual denied claims by identifying root causes and preventing recurring issues. Our denial specialists analyse payer denial codes, review documentation, and implement corrective actions to address errors related to coding, eligibility, authorization, or medical necessity. We prepare and submit timely appeals with appropriate supporting documentation and track appeal outcomes. By combining proactive denial prevention strategies with effective appeals management, we help clients improve first-pass claim acceptance rates and protect long-term revenue.

Compliance & Quality Assurance

Compliance and Quality Assurance are embedded into every service offered by SYS RCM 247. We follow strict HIPAA guidelines, payer policies, and CMS regulations to safeguard patient information and ensure ethical billing practices. Our internal quality checks, audits, and performance reviews help maintain high accuracy standards while minimizing compliance risks. By prioritizing data security and regulatory adherence, we provide clients with confidence that their billing operations are managed responsibly and professionally.

Client Reporting & Transparency

SYS RCM 247 believes that transparency is essential to a successful billing partnership. We provide clear and detailed reports that give clients visibility into claim status, payments received, outstanding balances, denial trends, and overall financial performance. Our reporting approach allows providers to make informed decisions, track progress, and measure the effectiveness of billing operations. Through consistent communication and data-driven insights, we ensure our clients always understand where their revenue stands.