Healthcare Revenue Cycle Management Built on Daily Billing Work
SMCG runs medical billing operations for physician practices and healthcare organizations in all 50 states. Claims are submitted on a regular production schedule based on the practice's billing activity. Denials get worked rather than written off, and receivables get followed until they pay or are determined uncollectible. Payment posting and patient statements stay current, so the practice sees where its money stands every week.
Practices comparing revenue cycle management companies are usually choosing among three moves. Hire another biller, buy more software, or hand the operation to a firm that does this work all day. We are the third move. You see collection rates, denial patterns, and A/R aging in plain monthly reporting, and we answer for the work behind every number.
The engagement covers claims submission, denial management, A/R follow-up, payment posting, and patient statements. Organizations that want payer enrollment handled in the same relationship pair this with provider credentialing, and groups working through wider operating problems bring in practice operations alongside the billing team.
Physician RCM: Solo Practices Through Multi-Specialty Groups
A solo physician sends a few hundred claims a month and cannot carry a single stalled payer. A twelve-provider group sends thousands and cannot carry a billing operation that only keys charges. RCM for physician practices has to hold up at both ends, which is why the work is staffed by function rather than by headcount.
Solo physicians weighing their revenue cycle management options usually want one number first, the percentage of billed dollars that becomes banked dollars. Groups want that number by provider, by location, and by payer. Both get it from the same operation.
Claims submission
Charges leave inside the payer's timely filing window, run through that payer's own edits before they go. Rejections get corrected within 24 to 48 business hours.
Denial management
Every denial gets a category, a fix, and a resubmission path. Denial trends get reported to your team with recommendations, so upstream issues get seen and worked.
A/R follow-up
Receivables worked by age and payer. The 90-plus bucket sits on a named work list with call notes, not in a report nobody opens.
Payment posting
ERAs and paper EOBs are posted to the appropriate encounters. Underpayments get flagged against the fee schedule and pursued, not absorbed.
Patient statements
Patient statements are generated according to the agreed billing schedule, and patient billing questions are coordinated with your team.
Groups that also want bookkeeping and accounting handled alongside the billing bring in our healthcare financial management team under the same roof.
Enterprise RCM: Multi-State Groups, Networks, Health Systems
The inquiries that reach us from networks and management organizations rarely open with a rate question. They open with a denied-claims backlog somebody inherited, a billing platform the group has outgrown, or an outsourcing evaluation already in motion.
Multi-state and multi-facility billing means payer rules that change at every border and provider rosters that change every month. We run billing operations across every tax ID in the group with consolidated reporting for leadership, and we hold the denial and A/R disciplines steady across all of it.
A regional healthcare organization engaged SMCG after its revenue cycle operation had fallen significantly behind. Claims sat unsubmitted, denied claims accumulated, and timely filing deadlines were approaching across multiple payers. Revenue that should have been collected was instead being written off because the billing operation could not keep pace. Following a comprehensive billing assessment, SMCG assumed responsibility for the organization's revenue cycle under a multi-year agreement. Our implementation focused on restoring disciplined billing workflows, prioritizing claims at risk of timely filing, organizing aging accounts receivable into structured work queues, strengthening denial management, and delivering executive reporting that provided leadership with clear operational visibility.
Networks that also need enrollment kept current across states run provider credentialing through the same engagement.
RCM Take-Over Work: Denied Claim Backlogs, Aging A/R, Billing Switches
Billing rescues follow patterns we know well, and each one has a first move that protects revenue while the rest gets rebuilt.
The billing company stopped performing.
Collections drifted down for two quarters and answers got vague. We take the operation over mid-stream, keep claims moving during the transition, and give you the denial and A/R picture your last firm stopped sharing.
The in-house biller left.
One resignation should not stall a practice's cash. We step in on the existing system, work the queue where it stands, and stay on either as the permanent operation or until you rebuild in-house.
Denied claims piled up.
Backlogs get triaged in timely-filing order so recoverable dollars do not expire while older paper gets sorted. Appeals go out with the documentation the payer's own policy asks for.
The group is switching billing platforms.
Practices changing platforms keep collections moving while the systems change underneath them. We run the old queue down and the new queue up, and nothing sits unbilled between the two.
A/R past 90 keeps growing.
Aging receivables are an ordered work problem. We sort what is collectible from what is not, work the collectible list by payer behavior, and show you both numbers weekly.
Rates & Team Structure
Monthly RCM Rates and Engagement Tiers
Rates are set monthly and confirmed after the billing assessment, based on claim volume, staffing, provider count, reporting requirements, complexity, and systems. The tiers below show how engagements are typically shaped. Every tier runs the same five disciplines; the difference is depth of reporting and the size of the team on your account.
Solo & Small Practice
We handle the billing operations that your practice does not have in-house
- Claims submission and daily rejection work
- Denial management with monthly pattern report
- A/R follow-up with 90-plus work list
- Payment posting and patient statements
- Monthly collections report by payer
Group & Multi-Specialty
Everything in Solo & Small Practice, plus depth by specialty
- Coding review, scoped by engagement
- Underpayment identification and pursuit
- Reporting by provider, location, and payer, shaped to the engagement
- Payer performance reviews by engagement
Network & Enterprise
The billing operation for large, multi-entity groups
- Everything in the Solo and Group tiers
- Dedicated account team
- Billing operations across multiple tax IDs, consolidated reporting
- Backlog and transition take-over management
- Multi-state payer rule coverage
Rates Confirmed After the Billing Assessment
Monthly Rates Based on Claim Volume, Staffing, and Scope
Same Five Disciplines in Every Tier
Schedule an RCM ConsultationPut Your Billing in Front of Us
Send the consultation request and attach nothing. The first call is a short discovery with our team, and the billing assessment that follows sets out what we would take over first and what the engagement looks like. SMCG runs the business behind the medicine.
Free consultation. No obligation.
