Revenue cycle, transformation and technology services, explained in full.
Every service has its own page with what is included and what you receive.
Revenue cycle services
Billing, coding, denials, credentialing and audits: the operational work between a visit and a payment.
Credentialing & Provider Enrollment
Revelrex prepares, submits and follows up on payer enrollment and credentialing applications for each provider, monitors status until the effective date, and tracks revalidations so nothing lapses.
- One application per provider per payer or entity (for example Medicare, Medicaid, a commercial plan or a hosp…
- Application preparation, submission and confirmation of receipt.
- Scheduled follow-up until approval, denial or closure, with every contact logged.
Medical Coding
Certified coders review each encounter's documentation and assign ICD-10-CM, CPT and HCPCS codes with the right modifiers, run a quality review, and track completion so no encounter waits in a queue.
- Coding of professional encounters (office, telehealth, procedures, preventive visits) from documentation.
- Provider queries and re-coding after the provider responds.
- Monthly coding accuracy report from the quality review sample.
Medical Billing
Revelrex manages the billing lifecycle for your practice: charge review, claim preparation and submission, clearinghouse monitoring, rejection correction, payment workflow coordination and clear reporting, priced as a percentage of applicable collections.
- Professional claims for the providers, locations and payers listed in your service order.
- Daily claim submission and clearinghouse rejection handling.
- Payment posting and adjustment review.
Denial Management
An add-on to Medical Billing. Revelrex identifies and categorizes every denial, performs root-cause analysis, corrects and resubmits correctable claims, files appeals with supporting documentation, and reports recurring patterns with prevention steps for the practice.
- Denial capture and categorization for all claims in the billing scope.
- Corrections and resubmissions.
- First and second level appeals with supporting documentation.
RCM Audit & Revenue Leakage Analysis
A fixed-scope review of your revenue cycle: encounter-to-claim reconciliation, unbilled encounters, coding backlog, submission gaps, rejection and denial patterns, posting issues, AR observations and operational bottlenecks, delivered as a findings report with prioritized recommendations.
- Standard scope: one legal entity, up to five providers, the most recent 90 days of encounters and claims plus…
- Workflow interviews with billing, front desk and one provider.
- Findings report with quantified leakage estimates and prioritized recommendations.
Practice transformation
Programs that change how the practice works and how it is measured.
Closing Gaps in Care
Revelrex identifies and organizes open care-gap activities from payer gap reports and your EMR, coordinates the outreach and workflow with your team, tracks documentation and completion, and reports progress for the specified calendar year.
- Gap list build and maintenance for the measures and payers in scope.
- Outreach tracking and documentation checks.
- Monthly and year-end reporting.
PCMH
A full Transformation engagement that takes a practice from readiness assessment through workflow changes, evidence and submission. Third-party NCQA and Q-PASS fees are excluded.
- Readiness assessment, gap assessment, workflow redesign sessions, policy templates, evidence library, submiss…
- Annual reporting calendar and evidence habits set up after recognition.
Where does Revelrex work?
Revelrex serves healthcare organizations across the United States. Our work is delivered remotely inside your own systems, and our team is available on your practice's schedule.
What kinds of practices do you work with?
Independent physician practices, primary care and specialty groups, multi-provider and multi-location organizations, and practices that need credentialing, PCMH or website support without a full billing engagement.
Do you work inside our EMR and clearinghouse?
Yes. We ask each practice to create delegated user accounts for Revelrex staff in the EMR, practice management system and clearinghouse. You keep control of your systems and can revoke access at any time.
Ready to see what your practice is leaving on the table?
Request services online or book a call with a Revelrex specialist.