Revenue Cycle Management Services That Transform Your Practice Finances
From the moment a patient schedules an appointment to the day the final payment is posted, OrinSols manages every step of your revenue cycle eliminating leaks, accelerating cash flow, and maximizing every dollar your practice earns.
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98% First-Pass Claim Acceptance
AR Days Reduced by 30–40%
$50M+ Revenue Managed
500+ Providers Served
What Is Revenue Cycle Management and Why Does It Matter?
Revenue cycle management commonly called RCM is the complete financial process that healthcare organizations use to track patient care from initial appointment scheduling through final payment collection. It encompasses every administrative and clinical function that contributes to capturing, managing, and collecting patient service revenue.
Done well, RCM is the financial engine of a healthy practice. Done poorly or left to an understaffed or undertrained billing team it becomes the single biggest drain on your practice’s profitability.
The numbers are stark. The average US medical practice has an AR days figure of 45–55 days, a denial rate of 5–10%, and a net collection rate that is 8–15% below what it should be. That gap between what practices earn and what they actually collect represents hundreds of billions of dollars in lost revenue across the US healthcare system every single year.
OrinSols exists to close that gap for every practice we serve. Our end-to-end RCM platform combines certified billing professionals, specialty-specific coding expertise, data-driven denial management, and transparent performance reporting to deliver results that in-house billing teams and generic billing companies simply cannot match.
The Complete OrinSols RCM Cycle
Stage 1: Patient Scheduling & Registration
The revenue cycle begins before the patient ever walks through your door. Errors made at the scheduling and registration stage wrong insurance information, missing authorization requirements, incorrect demographic data cause more downstream claim denials than any other single factor. Our RCM team works with your front desk to implement rigorous patient registration protocols. We verify that every required field is captured accurately at the point of scheduling including the patient's legal name, date of birth, insurance ID, group number, and referring provider information so the claim has everything it needs to be paid on the first submission.
Stage 2: Insurance Eligibility Verification
Before every appointment, we verify the patient's active insurance coverage, benefit details, co-pay and deductible amounts, out-of-pocket maximums, and any authorization or referral requirements for the scheduled services. Real-time eligibility verification is one of the highest-ROI steps in the entire revenue cycle. A single missed eligibility check can result in a denied claim, a delayed payment, and a patient billing dispute that damages your reputation. We verify every patient, every visit, every time with no exceptions.
Stage 3: Prior Authorization Management
Prior authorization requirements have exploded in recent years. Commercial payers now require authorization for an increasingly wide range of procedures, imaging studies, specialist visits, and prescription medications and denials for missing or incorrect authorizations are among the most common and most preventable in medical billing. OrinSols manages the entire prior authorization process on your behalf. We identify which services require authorization for each specific payer, submit authorization requests with complete supporting clinical documentation, track approval status in real time, and alert your clinical team before procedures are performed without required approvals.
Stage 4: Charge Capture & Entry
After every patient encounter, your billable services must be captured completely and accurately before a claim can be created. Missed charges at this stage represent pure revenue loss services were provided, documented, and never billed. Our charge capture process cross-references clinical documentation, operative reports, and superbills to ensure every billable service, supply, and procedure is identified and entered. We use specialty-specific charge capture checklists developed over years of experience to catch the missed charges that generic billing teams consistently overlook.
Stage 5: Medical Coding (CPT, ICD-10, HCPCS)
Accurate medical coding is the technical heart of revenue cycle management. Every service must be translated into the correct combination of CPT procedure codes, ICD-10-CM diagnosis codes, and HCPCS supply codes with the right modifiers, the right sequencing, and the right linkage between diagnosis and procedure. Our certified professional coders hold active CPC and CCS credentials and have specialty-specific training in the coding rules that govern your particular service lines. We code for maximum legitimate reimbursement not the minimum that keeps you out of trouble, and not the maximum that creates compliance risk. Precise, defensible coding that earns every dollar your documentation supports.
Stage 6: Claim Scrubbing & Quality Review
Before any claim leaves our system, it passes through a multi-layer quality review process. Our proprietary claim scrubbing workflow checks for demographic errors, coding errors, modifier issues, bundling violations, payer-specific formatting requirements, and National Correct Coding Initiative (NCCI) edit conflicts. Claims that fail scrubbing are corrected before submission not after rejection. This single step is responsible for the majority of our 98% first-pass acceptance rate, and it is the step that most in-house billing teams and budget billing companies skip.
Stage 7: Electronic Claim Submission
Clean claims are transmitted electronically to payers through our EDI-enabled clearinghouse integrations within 24 hours of service. We submit to Medicare, Medicaid, and all major commercial payers electronically with real-time submission confirmation and immediate notification of any technical rejections. Electronic submission dramatically accelerates payment timelines compared to paper-based processes. Most electronically submitted clean claims are adjudicated within 14–21 days for commercial payers and 14 days for Medicare.
Stage 8: Payment Posting & ERA Reconciliation
When payments arrive whether by electronic funds transfer, check, or patient payment they are posted accurately against each claim in your system within 24 hours. Electronic Remittance Advice (ERA) files are reconciled automatically, and any discrepancies between the payment received and the amount expected under your contracted fee schedule are flagged immediately for follow-up. Accurate payment posting is not just bookkeeping it is the foundation of effective AR management. You cannot chase what you have not accurately recorded.
Stage 9: Denial Management & Appeals
Despite our best efforts at prevention, some claims will be denied. When they are, our denial management team springs into action immediately. Every denial is categorized, analyzed, and assigned to a specialist with expertise in that specific denial type and payer. We distinguish between denials that require a simple correction and resubmission and those that require a formal appeal with supporting clinical documentation, medical records, or physician letters of medical necessity. Both are pursued with equal urgency. We track every denied claim through the entire appeals process until it is either paid or exhausted through all available appeal levels.
Stage 10: Accounts Receivable Follow-Up
Unpaid claims are followed up at 14, 30, 60, and 90-day intervals with escalating levels of urgency. Our AR specialists contact payer representatives directly, track claim status through payer portals, and escalate unresponsive payers through formal dispute channels. We maintain payer-specific follow-up protocols because every payer has different requirements, timelines, and escalation paths. What works for UnitedHealthcare does not work for Medicaid. Our team knows the difference and acts accordingly.
Stage 11: Patient Billing & Collections
The patient responsibility portion of every claim co-pays, deductibles, co-insurance, and self-pay balances is billed clearly and professionally after insurance adjudication. We generate itemized patient statements, offer flexible payment arrangements, and handle patient billing inquiries with care and professionalism. Patient collections are handled compliantly under FDCPA guidelines and state-specific billing regulations. We never use aggressive collection tactics that damage your patient relationships but we are persistent and systematic about recovering every legitimate patient balance.
Stage 12: Reporting, Analytics & Continuous Improvement
Every month you receive a comprehensive RCM performance report covering your key financial metrics collections by payer and provider, denial rate by category, AR aging by bucket, first-pass acceptance rate, net collection rate, and revenue trend analysis. But we do not just report the numbers we interpret them. Our team identifies trends, flags emerging problems, and recommends specific workflow improvements to continuously optimize your revenue cycle performance month over month.
Key RCM Metrics We Improve for Your Practice
AR Days The average number of days between service delivery and payment. Industry average is 45–55 days. OrinSols clients typically achieve 28–35 days within the first 90 days of engagement.
First-Pass Claim Acceptance Rate: The percentage of claims paid on the first submission without correction or appeal. Industry average is 85–88%. OrinSols consistently achieves 97–98% for established clients.
Net Collection Rate: The percentage of collectible revenue actually collected after contractual adjustments. Industry average is 92–95%. OrinSols clients typically achieve 96–99%.
Denial Rate: The percentage of claims denied on first submission. Industry average is 5–10%. OrinSols clients typically achieve 2–3%.
Clean Claim Rate: The percentage of claims submitted without errors. OrinSols target is 99%+ for all clients.
Days in AR Over 90: The percentage of AR that has been outstanding for more than 90 days. This is a critical indicator of billing team effectiveness. OrinSols maintains this metric below 10% for all active clients.
RCM Services by Practice Type
RCM for Solo Physicians
A solo physician practice has no margin for billing inefficiency. Every denied claim, every missed charge, every day of unnecessary AR delay directly impacts your personal income. OrinSols provides solo practitioners with the same level of RCM expertise that large hospital groups pay enormous internal billing departments to deliver at a fraction of the cost, with no hiring, no training, and no management overhead.
RCM for Small & Mid-Size Group Practices
Group practices introduce complexity that amplifies billing errors multiple providers, multiple locations, multiple tax IDs, and varying documentation styles across physicians. Our RCM system standardizes your billing workflows across all providers while accommodating the individual coding patterns and documentation habits of each physician in your group.
RCM for Large Practices & Hospital Systems
High-volume billing operations require enterprise-grade RCM infrastructure. OrinSols brings sophisticated workflow management, real-time performance dashboards, dedicated specialty teams, and senior account management to large practices and hospital outpatient departments that need scalable, reliable RCM performance at volume.
RCM for Telehealth Providers
Telehealth billing involves a constantly evolving set of rules place of service codes, audio-only billing requirements, cross-state licensure considerations, and payer-specific telehealth coverage policies that change frequently. Our telehealth RCM specialists stay current on every update and manage the unique billing requirements of virtual care delivery so your telehealth revenue is captured completely and compliantly.
RCM for Ambulatory Surgery Centers
ASC billing involves facility fee coding, implant billing, supply cost recovery, and complex coordination between surgeon, anesthesia, and facility claims. Our ASC RCM team has deep experience in the specific billing requirements of ambulatory surgery environments including HOPD vs. ASC rate differentials and outpatient surgical coding under the ASC payment system.
RCM for Behavioral Health Providers
Mental health billing presents unique challenges parity compliance, session-based billing, measurement-based care documentation requirements, and restrictive payer policies around behavioral health services. Our behavioral health RCM specialists understand these nuances and ensure your practice captures every billable session compliantly and completely.
Specialties We Serve
Our RCM specialists have deep expertise in the specific billing rules, coding requirements, and payer policies governing every major medical specialty:
Dentistry
Dental procedures, preventive care, and insurance claim handling with precision coding support.
OB/GYN
Maternity, prenatal, and gynecological procedure billing with global package expertise.
Neurology
EEG, EMG, and neurological testing billing with accurate CPT coding and documentation support.
Orthopedics
Surgical, fracture care, and therapy billing with correct modifier usage and global period handling.
Psychiatry
Mental health billing, telehealth claims, and behavioral health documentation compliance.
Primary Care
Routine visits, chronic care management, and preventive service billing solutions.
Endocrinology
Diabetes, thyroid disorders, and hormone therapy billing with accurate diagnosis linking.
Pain Management
Injection therapies, nerve blocks, and chronic pain treatment billing services.
Infectious Disease
Complex infection treatment billing with inpatient and outpatient coding accuracy.
ASolo physician practices · Small and mid-size group practices · Large multi-location practices · Hospital outpatient departments · Ambulatory surgery centers · Behavioral health organizations · Home health agencies · Skilled nursing facilities
Payers We Manage
Medicare · Medicaid (all state programs) · Medicare Advantage Plans · Blue Cross Blue Shield (all regional plans) · Aetna · UnitedHealthcare · Cigna · Humana · Tricare · Workers' Compensation · No-Fault & Auto Insurance · All commercial and regional payers nationwide
Technology & Systems We Work With
OrinSols integrates with your existing EHR and practice management system no disruptive software migration required: Epic · athenahealth · eClinicalWorks · Kareo · AdvancedMD · DrChrono · Meditech · Allscripts · NextGen · Practice Fusion · Greenway Health · ModMed · Cerner · CureMD · ChartLogic · And more
The True Cost of Poor Revenue Cycle Management
Most practice administrators think of poor RCM in terms of denied claims. The real cost is much larger and far less visible.
Consider a primary care group with three physicians each seeing 20 patients per day. At an average reimbursement of $150 per visit that is $9,000 in daily billings or approximately $2.2 million annually. A net collection rate of 92% which many practices consider acceptable means $176,000 per year in uncollected revenue. Close that gap to 97% and the same practice recovers an additional $110,000 annually without seeing a single additional patient.
Now add the cost of in-house billing staff typically $45,000–$65,000 per biller annually, plus benefits, training, software, and management time. Add the cost of turnover the average medical biller stays in a position for less than two years, and every transition creates gaps in AR follow-up and denial management. Add the opportunity cost of physician time spent reviewing billing disputes instead of seeing patients.
The total cost of underperforming in-house RCM in a three-physician practice is typically $200,000–$400,000 per year when all factors are accounted for.
OrinSols eliminates most of that cost and recovers most of that lost revenue for a percentage-of-collections fee that pays for itself many times over.
OrinSols RCM vs. In-House Billing
Hiring in-house: $45,000–$65,000 per biller annually plus benefits. OrinSols: percentage of collections only, no fixed overhead.
Staff turnover: Average medical biller tenure under 2 years. OrinSols: dedicated team with no turnover impact on your AR.
Coding expertise: General billing staff with limited specialty knowledge. OrinSols: certified coders with specialty-specific credentials.
Technology: Practice-purchased PM software and clearinghouse fees. OrinSols: enterprise clearinghouse and billing technology included.
Denial management: Claims often worked individually without pattern analysis. OrinSols: systematic denial categorization and root cause resolution.
Reporting: Basic collections reports from your PM system. OrinSols: comprehensive monthly KPI reports with trend analysis and strategic recommendations.
Scalability: Hiring and training required for volume increases. OrinSols: scales immediately with your practice growth.
Compliance: Dependent on individual staff knowledge and training. OrinSols: CPC and CCS certified team with ongoing education requirements.
How Much Does OrinSols RCM Cost?
OrinSols operates exclusively on a percentage-of-collections pricing model typically between 3% and 8% depending on your specialty, patient volume, payer mix, and the specific RCM services included in your engagement.
You pay nothing unless we collect. No setup fees. No monthly minimums. No charges for denied claims we cannot recover. Our pricing model aligns our financial interest completely with yours the more we collect for your practice, the more we earn.
For practices transitioning from in-house billing, the cost savings on salaries, benefits, and software alone typically exceed our fee in the first year before accounting for the additional revenue we recover through better coding, fewer denials, and more aggressive AR follow-up.
Request a custom quote based on your practice specifics.
Getting Started With OrinSols RCM
Transitioning your revenue cycle to OrinSols is designed to be completely seamless. Here is exactly what the process looks like:
Week 1 Discovery & Assessment. We conduct a thorough review of your current billing performance, payer mix, EHR setup, and outstanding AR. We identify the highest-priority opportunities for immediate revenue improvement.
Week 2 Credentialing Verification & System Access. We verify your provider credentialing status with all relevant payers, set up secure system access, and configure our billing workflows to your practice's specific requirements.
Week 3 Parallel Operations. We run our billing processes in parallel with your existing system to validate accuracy and ensure zero claim submission gaps during the transition.
Week 4 Full Transition & Go-Live. By the end of week four, OrinSols is fully managing your revenue cycle. Your team experiences no disruption. Your patients experience no change. Your cash flow continues without interruption.
Ongoing Monthly Reviews & Continuous Optimization. Your dedicated account manager meets with you monthly to review performance metrics, discuss any issues, and identify opportunities to further improve your financial results.
Frequently Asked Questions About Revenue Cycle Management
How quickly will I see improvement in my collections after switching to OrinSols?
Most practices see measurable improvement in their denial rate and first-pass acceptance rate within the first 30 days. Significant improvement in AR days and net collections typically occurs within 60–90 days as our team resolves outstanding denials, works through aging AR, and optimizes coding patterns.
Will OrinSols work with my current EHR system?
Yes. We integrate with virtually all major EHR and practice management systems including Epic, athenahealth, eClinicalWorks, Kareo, AdvancedMD, and many others. In most cases no software changes are required on your end.
What happens to my existing AR when I switch to OrinSols?
We take full responsibility for your existing AR from day one. Our team conducts an AR aging analysis, prioritizes outstanding claims by recovery potential, and systematically works through your backlog while simultaneously managing current billing operations.
How do I know OrinSols is actually performing well for my practice?
Complete transparency is a core part of our service. You receive monthly performance reports covering every key RCM metric, and you have real-time access to your billing data at any time. Your dedicated account manager reviews these metrics with you personally each month and is directly accountable to your financial results.
Do you handle workers' compensation and no-fault billing?
Yes. Workers’ compensation and no-fault auto insurance billing involve separate rules, forms, and fee schedules from standard health insurance. Our specialists manage these payer types with the specific expertise they require.
Can OrinSols help if my practice is already under a payer audit?
Yes. Our team can assist with payer audit responses, documentation preparation, and appeals. We can also conduct an internal billing audit to help you understand the scope of any potential findings before responding to the payer.
Is there a minimum practice size or volume to work with OrinSols?
No. We serve solo practitioners, small group practices, large groups, and hospital-based facilities. Our service model scales to any volume, and our percentage-of-collections pricing means the cost is always proportionate to your practice size.
What specialties does OrinSols have RCM experience in?
We have certified coders and billing specialists with expertise across all major medical specialties including cardiology, dermatology, orthopedics, psychiatry, nephrology, endocrinology, internal medicine, family practice, physical therapy, pain management, gastroenterology, neurology, oncology, OB/GYN, podiatry, ophthalmology, and more.
What makes OrinSols different from other RCM companies?
Three things distinguish us consistently. First, our certified coding team every coder holds active CPC or CCS credentials with specialty-specific experience, not just general billing knowledge. Second, our transparency you see everything, every month, with no black box billing operations. Third, our accountability your dedicated account manager is personally responsible for your financial results, not a call center representative reading from a script.
Book An Appointment
Ready to Transform Your Revenue Cycle? Get a Free RCM Assessment
A free RCM assessment from OrinSols takes less than 48 hours and gives you a clear, honest picture of where your revenue cycle stands and exactly how much improvement is possible. We review your current denial rate, AR days, net collection rate, and coding patterns, then present you with specific findings and a projected financial impact of working with OrinSols. No sales pressure. No obligation. Just honest data about your practice’s financial performance and what it could look like with the right RCM partner.
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- 117 S Lexington St, Ste 100 Harrisonville, MO 64701
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Locations We Serve
OrinSols provides revenue cycle management services to healthcare providers across the United States including: RCM Services in California · RCM Services in Texas · RCM Services in Florida · RCM Services in New York · RCM Services in New Jersey And remotely to practices in all 50 states from our headquarters at 117 S Lexington St, Ste 100, Harrisonville, MO 64701.