Billing & Revenue

Get paid for the work you already did

Coding review, payment posting, contract and fee-schedule work, and the reporting that shows you where revenue is leaking.

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Most practices do not have a billing problem so much as a visibility problem. The claim went out, something came back, and nobody has the time to reconcile the difference. These are the pieces we work on, and they are usually bought in combination rather than one at a time.

ACO Contract Evaluation

Maximize your Accountable Care Organization revenue

What it fixes

  • Uncertain if ACO participation is beneficial for your practice
  • Not sure if you're meeting quality measure requirements
  • Missing opportunities to improve ACO performance and revenue
  • Complex ACO contract terms are confusing and risky

How we help

  • Comprehensive ACO participation analysis
  • Quality measure performance tracking and optimization
  • Financial impact analysis of ACO contracts
  • Contract term review and risk assessment
  • Strategic recommendations for ACO success

What’s included

ACO Participation Analysis
Comprehensive evaluation of whether ACO participation makes sense with practice readiness assessment, financial projections, and comparison with fee-for-service model.
Quality Measure Tracking
Monitor and optimize performance on ACO quality measures with benchmarking, gap analysis, and automated data collection from EHR and claims.
Financial Impact Analysis
Comprehensive analysis of financial implications including revenue projections, shared savings calculations, risk adjustment analysis, and ROI calculations.
Contract Review & Ongoing Monitoring
Detailed analysis of ACO contract terms with continuous performance tracking, quality measure monitoring, and contract compliance monitoring.

Billing Analytics & Insurance Reporting

Data-driven insights to maximize your revenue

What it fixes

  • Don't know if you're being underpaid by insurers
  • Can't identify denial patterns costing you money
  • No data to support insurance contract negotiations
  • Don't understand which codes are most profitable
  • Can't track revenue by provider, location, or service type

How we help

  • Underpayment detection and recovery
  • Denial pattern analysis and prevention
  • Contract rate audit and optimization
  • Revenue analysis by provider, payer, and code
  • Predictive analytics for revenue forecasting

What’s included

Underpayment Detection
Automatic comparison of paid amounts against contracted rates. Identifies systematic underpayments by specific payers or for specific codes.
Denial Analysis
Detailed analysis of denial reasons and patterns. Identify which codes, providers, or payers have the highest denial rates and why.
Contract Rate Audit
Review of your current fee schedules against actual payments. Identify discrepancies between contracted rates and what you're actually receiving.
Revenue Dashboard & Insights
Interactive dashboard with revenue by provider, payer, service type, and payer scorecards grading each insurance payer on payment speed and ease of doing business.

Billing Support Portal

Let patients submit billing issues online

What it fixes

  • Billing questions tie up phone lines and staff time
  • Patients frustrated by long hold times for billing inquiries
  • Billers spending time on phone calls instead of claims processing
  • No centralized system for tracking patient billing issues

How we help

  • Online portal for patients to submit billing questions and issues
  • Ticket-based system for tracking and resolving inquiries
  • Auto-routing to appropriate biller or staff member
  • Reduces phone volume, lets billers focus on claims
  • Improved patient satisfaction with faster responses

What’s included

Patient-Facing Portal
Easy-to-use online form for patients to submit billing questions with document attachment capability and mobile-friendly interface.
Ticket-Based Tracking
Every patient inquiry becomes a trackable ticket with full history, optional patient status visibility, and audit trail for compliance.
Intelligent Routing
Tickets automatically routed to the appropriate person based on patient, insurance, or issue type - reducing manual assignment and ensuring right person handles each inquiry.
Staff & Patient Benefits
Billers focus on claims processing with 50-70% phone volume reduction while patients enjoy no waiting on hold and faster resolution times.

Contract Support & Negotiation

Optimize your payer contracts

What it fixes

  • Not sure if your payer contracts are fair and competitive
  • Missing opportunities to negotiate better rates
  • Fee schedules not optimized for your practice
  • Contract terms hurting your bottom line

How we help

  • Comprehensive insurance contract evaluation
  • Negotiation preparation and strategy
  • Fee schedule optimization and analysis
  • Contract performance tracking
  • Market benchmarking against similar practices

What’s included

Contract Analysis
Identify underpaid codes and services by comparing your contracts against industry benchmarks and similar practices.
Negotiation Strategy
Get custom talking points, data, and strategies for each payer negotiation to secure better terms.
Fee Schedule Optimization
Maximize revenue by identifying underutilized codes and aligning fee schedules with contract terms.
Performance Monitoring
Track payer performance in real-time with automated alerts and regular reports to ensure compliance.

Custom Reporting & A/R Oversight

See exactly where your money is at all times

What it fixes

  • Don't know which claims are outstanding or overdue
  • No visibility into aging A/R by payer or patient
  • Manual reporting is time-consuming and error-prone
  • Can't quickly identify claims that need follow-up
  • No way to track collector or staff performance

How we help

  • Real-time A/R aging dashboards
  • Automatic claim status tracking
  • Payer performance analytics
  • Staff productivity reports
  • Custom report builder for your specific needs

What’s included

Real-Time A/R Dashboard
See all outstanding claims by aging bucket with color-coded buckets (0-30, 31-60, 61-90, 90+ days) for immediate visibility.
Payer Performance Insights
Identify slow-paying insurers, high denial rates, and underpayment patterns to address revenue leaks.
Claim Status Tracking
Track each claim from submission through payment with automated alerts for stalled or problematic claims.
Custom Reports & Delivery
Build and save custom reports with drag-and-drop interface, then schedule automatic email delivery.

Data Warehouse & Analytics

Turn your EHR data into actionable insights

What it fixes

  • Your EHR has data but it's hard to access and analyze
  • Running reports across multiple systems is slow and manual
  • You can't get the insights you need to improve practice performance
  • Data is trapped in silos - billing, clinical, and operational systems don't talk to each other

How we help

  • Automated data extraction from any EHR system (AdvancedMD, eClinicalWorks, NextGen, etc.)
  • Data parsing and normalization to create a unified data model
  • Centralized data warehouse for all practice data
  • Custom dashboards and reports for practice performance, revenue trends, and operational efficiency
  • Predictive analytics to identify opportunities and risks before they impact your practice

What’s included

Automated EHR Data Extraction
Seamlessly connect to any EHR (AdvancedMD, eClinicalWorks, NextGen) and automatically extract data on your schedule.
Data Parsing & Normalization
Transform messy EHR data into clean, consistent format, normalizing data from multiple sources for accurate analysis.
Centralized Data Warehouse
Consolidate all practice data (billing, clinical, scheduling, financial) in a secure, scalable warehouse with role-based access.
Custom Analytics & Insights
Get actionable insights with custom dashboards for revenue trends, payer performance, and practice optimization.

EOB Entry & Payment Posting

Stop wasting hours on manual payment entry

What it fixes

  • Staff spends hours each week manually entering EOB data
  • Manual entry errors lead to posting mistakes and reconciliations
  • EOBs pile up and get lost before entry
  • No easy way to match payments to patient accounts
  • Paper EOBs are hard to organize and retrieve

How we help

  • Automated EOB data extraction from paper and electronic formats
  • Digital workflows that eliminate manual typing
  • Automatic matching of payments to patient accounts
  • Validation rules to catch errors before posting
  • Complete audit trail of all posted payments

What’s included

Automated EOB Processing
Extract data from paper EOBs via OCR or electronic EOBs via direct download/email - handles both formats with high accuracy.
Intelligent Payment Matching
Automatically match EOB payments to patient accounts and claims, reducing manual matching from hours to minutes.
Error Detection & Validation
Catch errors before posting - detects transposition errors, validates amounts, and prevents duplicate posting.
Automated Posting & Archive
Direct posting to your billing system with digital archive - search by date, patient, payer, or claim number for instant retrieval.

Fee Application Automation

Automate insurance fee schedule application

What it fixes

  • Manual fee schedule application is time-consuming and error-prone
  • Using wrong fee schedules leads to claim denials and underpayments
  • Different payers require different fee schedules
  • Fee schedules change frequently and are hard to keep up with

How we help

  • Automatic fee schedule detection and application based on payer, service, and patient type
  • Real-time fee schedule updates from payer databases
  • Audit trail to track which fee schedule was applied to each claim
  • Integration with your existing billing system

What’s included

Eliminate Denials
Stop losing revenue to incorrect fee schedules. Our system automatically applies the right schedule every time, preventing denials before they happen.
Save Hours Weekly
Your billing team spends hours manually looking up and applying fee schedules. We automate this so they can focus on higher-value work.
Always Current
Payer fee schedules change constantly. We automatically update yours, so you're always using the latest rates without lifting a finger.
Full Transparency
Complete audit trail showing exactly which fee schedule was applied to each claim. Perfect for compliance, payer discussions, and internal reviews.

Fee Schedule Advising

Optimize your reimbursement with expert fee schedule guidance

What it fixes

  • Not sure if your current fee schedules are competitive
  • Missing opportunities to increase reimbursement rates
  • Complex fee schedule negotiations are overwhelming
  • Different payers require different fee schedule strategies
  • Fee schedule updates are time-consuming and error-prone

How we help

  • Comprehensive fee schedule analysis and benchmarking
  • Market rate comparisons and competitive positioning
  • Negotiation strategy development for each payer
  • Fee schedule optimization recommendations
  • Ongoing monitoring and update management

What’s included

Fee Schedule Analysis
Comprehensive evaluation of your current fee schedules against market standards with service-by-service analysis and payer rate comparisons.
Market Rate Benchmarking
Compare your rates against market data with local, regional, and national benchmarking to identify opportunities for improvement.
Negotiation Strategy Development
Expert guidance on approaching fee schedule negotiations with payers including data-driven talking points, timing recommendations, and counter-offer preparation.
Fee Schedule Optimization & Monitoring
Strategic recommendations for improving fee schedule performance with modifiers and coding optimization, plus ongoing monitoring of rate changes and market trends.

Monthly Executive Reports

Clear revenue story for practice owners

What it fixes

  • Don't have clear visibility into practice financial performance
  • Revenue data is scattered across multiple systems
  • No actionable insights from your billing data
  • Hard to track KPIs and identify trends

How we help

  • Clear revenue story, not just raw billing tables
  • Revenue trends with 6-12 month rolling data
  • Payer mix breakdown and analysis
  • Collections waterfall visualization
  • Billing efficiency KPIs
  • TKTech activity summary

What’s included

Revenue Trends Analysis
Get 6-12 month rolling revenue data with month-over-month comparisons, trend analysis, and growth projections for clear financial visibility.
Payer Mix Breakdown
Detailed revenue analysis by payer with performance comparisons, contract compliance tracking, and risk assessment.
Collections Waterfall
Visual revenue cycle representation from charge to collection with denial analysis and A/R aging breakdown.
Billing KPIs & TKTech Impact
Track collection rates, days to payment, and staff productivity with quantified revenue impact and ROI analysis of our services.

Note Language Feedback

Improve documentation and reduce audit risk

What it fixes

  • Provider notes not optimized for audit compliance
  • Denials due to poor documentation in medical records
  • Missing opportunities to improve appeal success rates
  • Inconsistent documentation across providers

How we help

  • Monthly review of provider notes for audit risk
  • Feedback on documentation improvements
  • Training on proper note language
  • Standardization across your practice
  • Improved appeal win rates through better documentation

What’s included

Monthly Note Review
Comprehensive analysis of all provider notes each month to identify high-risk audit areas with detailed feedback and improvement suggestions.
Documentation Optimization
Training and custom templates for proper note language and structure to create audit-proof documentation aligned with coding and billing.
Appeal Success Enhancement
Improve appeal win rates with better documentation strategies, historical data on what works with different payers, and reduced denials.
Practice Standardization & Compliance
Ensure consistent, high-quality documentation across all providers with practice-wide guidelines and regular compliance assessments.

Tebra & Kareo EOB to ERA Integration - Direct Payment Posting

Automated EOB to ERA conversion with direct Tebra/Kareo API posting

What it fixes

  • Spending 10+ hours weekly manually entering EOB payments into Tebra/Kareo
  • Typos and misreads causing AR aging issues in your EHR
  • Payments lagging 1-3 days behind actual deposits
  • Staff burnout from repetitive payment posting tasks
  • No easy way to reconcile EOBs with Tebra/Kareo patient accounts
  • Manual posting errors requiring time-consuming corrections
  • Difficulty tracking which EOBs have been posted

How we help

  • Automated EOB PDF ingestion from email, SFTP, or folder monitoring
  • AI-powered OCR extraction with 99.7% accuracy for Tebra/Kareo
  • Direct API posting to Tebra and Kareo patient accounts
  • Real-time claim status updates in your EHR system
  • Automatic recoupment detection and reversal posting
  • Complete audit trail of all posted payments for HIPAA compliance
  • Error detection and alerting before posting to Tebra/Kareo

What’s included

Tebra & Kareo API Integration
Direct posting to Tebra and Kareo patient accounts via their native APIs. No manual intervention required. Works with all Tebra versions including legacy Kareo.
Multi-Payer EOB Support
Handles EOBs from Medicare (all MACs), Medicaid, Blue Cross Blue Shield, UnitedHealthcare, Aetna, Cigna, Humana, and all commercial payers with custom format mapping available.
Automated Error Detection
Validates all payment data before posting. Flags outliers, mismatches, and duplicates. Manual review triggered for any anomalies before posting to Tebra/Kareo.
Recoupment & Reversal Handling
Automatically detects insurance takebacks from negative payment amounts. One-click reversal with automatic claim status reset. Appeal queue pre-assembles all context.
Automatic Claim Matching
AI matches EOB payments to correct Tebra/Kareo patient accounts. Handles multiple claims per EOB. One-click reconciliation for any mismatches.
HIPAA Compliant Processing
BAA included. All processing on your infrastructure (no cloud storage). TLS 1.3 encryption. Complete audit logs maintained for compliance.

Not sure where your revenue is leaking?

A paid assessment, and the findings are yours whether or not you hire us. We will tell you what is leaking and what it would cost to fix.

Talk to us

Or call +1.321.406.3933 | Month-to-month, no long-term contracts