How to choose an RCM partner
Eight questions that separate a partner who protects your revenue from one who simply processes it. Ask them of any vendor, including us.
How are you paid?
Percentage-of-collections pricing grows with your revenue, not with the work done, and it makes every dollar you recover cost you more.
Who approves what goes to the payer?
Your practice carries the risk on every claim. You should decide what is sent and what is written off.
Do you catch problems before submission, or after a denial?
A denial costs time, cash flow and staff hours to rework. Prevention is cheaper than recovery.
Will we understand every flag?
A code or a status your team can’t act on just moves the work around.
Do we have to change our EHR or practice management system?
Switching systems disrupts scheduling, documentation and billing for months.
What happens to underpayments?
Short payments are easy to miss and rarely chased. Over a year they add up.
When is patient data protected, and how?
Data handling should be settled before any patient information moves.
What are the contract terms?
Long terms and automatic renewals lock you in before you have seen results.
Three ways to run your revenue cycle
| Percentage-based billing service | Software your staff runs | Claira Health | |
|---|---|---|---|
| Pricing | A percentage of collections | Subscription, plus your staff’s time | A flat fee, agreed up front |
| Who does the work | Their staff | Your staff | AI agents, with your team approving |
| When problems are caught | Varies by service | Depends on your staff | Before the claim is sent |
| Who makes the decisions | Often the service | Your team | Your team, every time |
| What you can see | A monthly report | Your own reports | Every flag, explained in plain English |
| Changing your systems | Sometimes required | Usually required | Not required |
General categories, not named vendors. Ask any vendor you’re considering to confirm their own terms.
Bring one recent denial. We'll show you the rule behind it.
Your specialty, your payers, your claim. No slides.
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