Every claim, accounted for.

Revenue cycle management, dedicated billing staff and chronic care programs for physician practices. Start with one process or one person, and grow into the full cycle when it makes sense.

Book a scoping call See how we work together
A claim moving cleanly from visit to payment A claim card with each step checked off, from eligibility through payment posted, and a note showing a missing referral caught before submission. Claim for office visit CPT 99214, 93000 Paid Eligibility verified Authorization on file Coded and reviewed by a coder Accepted by the payer Payment posted and reconciled Caught before submission Missing referral flagged, fixed, then sent clean.

Follow a claim through the revenue cycle. Select a stage to see what we handle there.

    If this stage slips:

      What we do

      Use us for one function, several functions or the whole workflow.

      Full-cycle RCM

      Credentialing to collections, owned by one accountable team.

      Dedicated billing staff

      Named specialists who work only for you, inside your own PM and EHR.

      Remote patient monitoring

      Devices, RN review of readings and clean monthly billing.

      CPT 99453 to 99458, 99445, 99470

      CCM, APCM and PCM

      Monthly care coordination for chronic conditions, logged and billed correctly.

      99490 to 99491, G0556 to G0558, 99424 to 99427

      Analytics and reporting

      Data pulled from your EMR and PM, modeled in BI tools, with metrics designed for your practice. See how

      Running an RCM company?

      We add white-label delivery capacity inside your workflows and SOPs. You keep the client relationship.

      Talk to us

      Performance you can see, built around your practice

      Analytics is where we are strongest. We pull data out of your EMR, practice management system and clearinghouse, model it in BI tools, and design the metrics that matter for your specialty and payer mix. Then we measure our own work against them, every month.

      From your systems to decisions

      1. Your systems

        EMR, PM, clearinghouse and payer portals.

      2. Extract and clean

        Data pulled, matched and validated, including from older systems.

      3. Design the metrics

        KPIs chosen with you for your specialty and goals.

      4. BI dashboards

        By provider, location, payer and work queue.

      5. Review and act

        Monthly review, root causes, next priorities.

      Practice performanceLast 12 months
      Clean claim rate96.4%+1.8 pts vs baseline Benchmark 95%+
      Denial rate4.6%-2.1 pts vs baseline Benchmark under 5%
      Days in A/R33-9 days vs baseline Benchmark under 35
      A/R over 90 days13%-8 pts vs baseline Benchmark under 15%
      Net collection rate96.1%+2.4 pts vs baseline Benchmark 95%+

      A/R aging

      58%0–30 19%31–60 10%61–90 6%91–120 7%120+

      Top denial reasons

      • Eligibility31%
      • Authorization24%
      • Coding or modifier18%
      • Missing information14%
      • Timely filing7%

      Net collections vs target

      Target Month 1Month 12
      Sample dashboard with illustrative data, not client results. Every client dashboard is designed around that practice's own systems and goals.

      The core metrics we baseline before go-live

      95%+

      Clean claim rate

      Claims accepted on first submission, with no edits or resubmission.

      <5%

      Denial rate

      Claims denied by payers, tracked by reason, payer and provider.

      <35

      Days in A/R

      Average days from service to payment.

      <15%

      A/R over 90 days

      Share of receivables at real risk of becoming write-offs.

      95%+

      Net collection rate

      How much of the collectible revenue is actually collected.

      Targets shown are widely cited industry benchmarks based on MGMA and AAPC data. The right target for your practice depends on specialty, payer mix and size, so we set them with you during discovery and report against them monthly.

      Metrics designed for your practice

      Beyond the core five, we build the measures your practice actually manages by. A few examples:

      • Collections by provider, location and payer
      • Charge lag, visit to claim
      • First-pass resolution rate
      • Authorization-related denials
      • Underpayments against contract
      • Patient collections at time of service
      • RPM enrollment and monthly billable rate
      • Payer-level payment speed

      Ways to work together

      Start with one seat, one process or the whole cycle. We recommend the smallest scope that lets both teams prove the model.

      Three ways to engage

      The FTE row shows one example. You choose which seats to fill.
      Patient and insuranceEligibility and authCodingClaim submissionPayment postingDenials and A/RBalances and reporting
      Dedicated FTE team Your team Our FTE Your teamYour team Our FTE Your teamYour team
      Managed function Your teamYour teamYour teamYour teamYour team We own it, with SLAs Your team
      End-to-end RCM One accountable team across the whole cycle

      Swipe sideways to see every stage.

      DMEDICAYour team

      A controlled start, not a big-bang handoff

      Both teams learn and stabilize first. Scope grows only after service is measured.

      1. Discover

        Specialty, systems, volumes, pain points and success measures.

      2. Match and train

        Specialty-matched people trained on your SOPs and rules.

      3. Go live

        Controlled volume with daily quality checks.

      4. Stabilize

        Productivity, quality, backlog and exceptions tracked.

      5. Expand

        Add seats or functions, or stay where you are.

      Grow one step at a time

      1 dedicated FTEStart here
      2 to 3 FTEsAs volume grows
      Managed functionOne process, fully owned
      End-to-end RCMWhen you are ready

      Remote patient monitoring and chronic care management

      Recurring, code-compliant care between visits for cardiology and internal medicine panels.

      About 68% of Medicare beneficiaries have two or more chronic conditions. Most of the patients these programs serve are already on your panel.

      Daily blood pressure trend A home blood pressure reading of 132 over 84 and a line chart of readings falling toward goal over thirty days. Home blood pressure, last 30 days Goal: under 130 132/84 Latest reading, reviewed by an RN Sent to physician

      How a reading becomes care, and a clean claim

      1. Patient at home

        FDA-cleared cuff, scale or oximeter.

      2. Reading sent

        Encrypted, logged as a device day.

      3. RN review

        Alerts triaged, patient called if needed.

        Urgent alerts in 2–4 hrs

      4. Physician sign-off

        Your physician stays in charge of care.

      5. Clean claim

        Device days and minutes billed correctly.

      RPM

      Remote physiologic monitoring

      Vitals from connected devices, staff time billed monthly.

      99453 to 99458, 99445, 99470

      CCM

      Chronic care management

      Monthly care coordination, simple to complex.

      99490, 99439, 99487, 99489, 99491

      APCM

      Advanced primary care management

      One bundled monthly code, no time tracking.

      G0556, G0557, G0558

      PCM

      Principal care management

      Focused care for one serious chronic condition.

      99424 to 99427

      One enrolled patient, two monthly revenue streams

      Combined, per patient per month~$220 to $400

      Illustrative Medicare national averages. Actual amounts vary by locality and payer.

      Billed together, never counted twice

      RPM and CCM can be billed for the same patient in the same month when staff time is tracked separately. Our platform logs device days and care minutes as distinct, auditable entries.

      Only one CCM-family code per patient per month.

      Blood pressure alerts, by severity

      Stage 1130–139 / 80–89Provider notified in 24 hrs
      Stage 2140–179 / 90–119Patient contacted in 2–4 hrs
      Urgency180–219 / 120–129Provider contacted now
      Crisis220+ / 130+911 activated
      LowerHigher severity

      From referral to first reading in days

      1. Referral

        Your clinic flags an eligible patient.

      2. Consent

        Eligibility checked, consent signed.

      3. Physician order

        Co-signed, as CMS requires.

      4. Device

        Shipped or handed over.

        5 business days

      5. Onboarding call

        Nurse walks through setup.

        Baseline in 72 hrs

      6. Confirmed

        Baseline sent to your physician.

      How we work

      Automation removes repetitive work. A trained person signs off on every decision that matters.

      AI suggests, a person decides

      1. Clinical record

        Notes, reports, encounter data.

      2. AI extraction

        Diagnoses, procedures, missing details.

      3. Suggestions

        Codes, modifiers, payer-rule checks.

      4. Human review

        A certified coder validates and signs off.

      5. Submit and audit

        Every decision is traceable.

      Recurring errors go back into training, rules and claim edits, so they are fixed at the source rather than just reworked.

      What you see, starting on day one

      Daily
      • Work queues and production
      • Exceptions and urgent escalations
      Weekly
      • Volume and productivity
      • Quality findings, backlog age
      Monthly
      • KPI trends and root causes
      • Capacity and improvement plans

      Security built into daily operations

      BAA, HIPAA and NDASigned before any access
      Role-based accessLeast privilege, per person
      Audit trailsEvery action logged
      EncryptionIn transit and at rest
      Multi-factor sign-inOn the monitoring platform
      HIPAA trainingCompleted before day one

      Our leadership has operated under SOC 2 and ISO 27001 aligned controls at prior organizations. DMEDICA is not yet independently certified, and we align security requirements with each client before production access begins.

      Senior oversight on every engagement

      Your team

      • Sets priorities
      • Provides system access
      • Approves workflows
      • Reviews results

      Senior leadership

      • Client governance
      • Quality and escalation
      • Capacity planning
      • Continuous improvement

      Delivery team

      • Dedicated FTEs
      • Team leads and QA
      • Production reporting
      • Flexible staffing

      Led by operators with more than 25 years in U.S. medical billing and practice operations. One client-facing lead coordinates the team, so you always have one person to call.

      Specialties we support

      • Cardiology
      • Gastroenterology
      • Orthopedics
      • Radiology
      • Oncology
      • Anesthesia
      • Pulmonology
      • Pain management
      • Urology
      • Podiatry
      • DME
      • Physical therapy
      • Surgery and ASC
      • Internal medicine
      • Multi-specialty
      • SNF and post-acute
      • Behavioral health
      • Home health

      Specialty capability for each new engagement is confirmed during discovery, training and the controlled transition.

      For physician practices

      Fill one gap, hand off one painful process, or outsource the full cycle.

      For RCM companies

      Expand delivery capacity without expanding overhead, under your brand and SOPs.

      Let's start where it makes sense for you

      One process, one person or the full revenue cycle. Tell us what you manage today and we will suggest a focused, low-risk first step.

      Prefer email?

      dmedicabgl@gmail.com

      What are you interested in?

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