Frequently asked questions
Straight answers to what practices ask before working with a revenue cycle partner. Don't see your question? Ask it on a discovery call.
Working with RCMHUB360
How does switching from our current billing company work?
We plan the transition with you: system access, open claims and who works which balances during the handoff. Existing AR can be included as a defined clean-up project or left with your current vendor to finish, so ownership is never unclear.
Do we need to change our EHR or practice management system?
No. We work in the systems you already use where user access can be provisioned for our team. If a system cannot support an outside billing team, we'll tell you during the assessment.
What exactly is included in the contract?
The proposal lists every service in scope, what is excluded, what we need from your team and how results are reported. You choose which services to include — full-cycle billing or specific functions such as credentialing or AR.
Who does the coding?
Coding is done by people on our team, from your providers' documentation. We query the provider when documentation is unclear and never code what isn't documented. We'll introduce the team assigned to your account during the consultation.
How do you handle HIPAA?
RCM work involves protected health information, so we discuss a business associate agreement (BAA) as part of contracting and work through access you control. This website itself never asks for PHI. A website alone isn't proof of compliance; ask us about our safeguards on the call.
Will you talk to our patients?
Only if you choose the patient billing helpdesk service. Conversations are limited to billing questions; anything clinical is routed back to your practice.
How much does it cost?
Pricing is custom and depends on specialty, claim volume, payer mix and scope. Common models include a percentage of collections, a per-claim fee or a flat monthly fee. We'll explain which fits your practice and put it in writing — no surprises.
Can you guarantee higher collections?
No — and you should be cautious of anyone who does. What we commit to is a defined process, transparent reporting and accountability for the work in scope. Results depend on your payers, documentation and starting point.
End-to-end medical billing
Do we have to change our EHR or practice management system?
No. We work inside the system you already use where user access can be provisioned for our team. If your system cannot support an outside billing team, we will tell you during the assessment.
Who owns the claims and data?
You do. Claims are filed under your practice's NPI and tax ID, and your data stays in your systems. Our access is provisioned by you and can be removed by you.
What happens to claims that were already outstanding before we start?
Existing AR can be included as a defined clean-up project, or left with your current team. We scope it separately so ownership is clear from day one.
How is pricing set?
Pricing is custom and depends on specialty, monthly claim volume, payer mix and which services you include. We explain the pricing models we offer during the consultation and put the scope in writing.
Medical coding and coding quality
Are your coders certified?
We will share the credentials of the team assigned to your account during the consultation. We do not list certifications on this website until they are verified for each team member.
Will you change what our providers selected?
If documentation supports a different code, we explain why and confirm with the provider before the claim is submitted. Final documentation is always the provider's.
Can you only do a coding review, without billing?
Yes. A standalone coding review can be scoped as a project. It is a good way to see how we work before deciding on full-service billing.
Credentialing, payer enrollment and contracting
Can you guarantee we will get in-network with a payer?
No one can. Payers decide whether to contract with a provider, and some panels are closed in certain areas. What we control is a complete, accurate application and consistent follow-up.
How long does enrollment take?
It varies by payer, state and application type, and payers change their processing times. We share realistic ranges for your payer list during the assessment and track actual time to decision for you.
Do you only do credentialing?
Credentialing is one part of our revenue cycle service. Many practices start with it while opening or adding providers, then move billing to us so enrollment and claims are managed together.
How do we send provider documents securely?
Through a secure file-sharing method agreed during onboarding. Please do not upload licenses, Social Security numbers or other personal documents through any form on this website.
EDI, EFT and ERA setup
Which clearinghouses do you work with?
We confirm compatibility with your existing clearinghouse during the assessment. If you do not have one, we help you evaluate options; we do not receive referral fees from clearinghouses.
Why do we still get paper checks?
Usually because EFT enrollment was never completed for that payer, or it was tied to an old bank account or tax ID. The inventory step shows exactly which payers are affected.
Accounts receivable management
Can you take over a backlog from our previous biller?
Yes. We scope legacy AR as a separate clean-up project with its own report, so it is clear which balances are recoverable, which need patient billing and which are past recovery.
Do you write off balances?
Only under an adjustment policy you approve in writing. Every recommended write-off is listed with its reason.
Denial prevention and appeals
What is a good denial rate?
It depends on specialty, payer mix and how denials are counted. Rather than quote a benchmark, we measure your baseline in the first month and report the trend against it.
Do you use templates for appeals?
We maintain payer- and reason-specific appeal structures, but every appeal is completed and checked by a person against the actual claim and documentation.
Eligibility, benefits and prior authorization
If you verify eligibility, will the claim definitely be paid?
No. Verification reflects what the payer reports at that moment. Payers make final decisions when the claim is processed, and coverage can change. Verification significantly reduces avoidable surprises; it does not remove payer discretion.
How far ahead do you verify?
We agree a lead time with you — commonly a few business days before the visit, with same-day checks for new patients where your schedule allows.
Payment posting and reconciliation
Do you need access to our bank account?
No. We work from deposit reports your team provides. We do not need, and will not ask for, banking credentials.
Patient billing helpdesk
Will patients know they are talking to an outside company?
That is your choice, agreed in writing. We follow your disclosure preference and applicable rules.
Practice launch and onboarding
How early should we start?
As early as possible — enrollment is usually the longest step. We will give you a realistic sequence for your payer list during the assessment.
Talk through your revenue cycle with a specialist
Tell us where payments are getting stuck. In 20 to 30 minutes we'll show you what we'd check first, and tell you plainly if we can help.
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