HIPAA-compliant RCM Serving healthcare providers in all 50 U.S. states +13479929666 info@claimedgesolutions.com
Account manager meeting with a practice owner
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Who we serve

Revenue cycle support sized to your organization

From a single therapist to a multi-location surgical group, ClaimEdgeSolutions adapts its team, reporting and workflows to the way you operate.

Certified coder entering charges and codes on a laptop1–10 providers

Solo & small practices

You need a full billing department without the payroll. We become that department, with an account manager who knows your practice by name.

  • Full RCM or à-la-carte services
  • Front-desk eligibility support
  • Simple monthly reporting
Revenue cycle team working together on laptops10+ providers, multiple locations

Large & multi-specialty groups

One consolidated view across specialties and locations, with specialty-trained coders for each department.

  • Location and provider-level KPIs
  • Specialty coding pods
  • Payer contract and underpayment review
Account manager meeting with a practice ownerTherapy, psychiatry, counseling

Behavioral health organizations

Time-based codes, carve-outs and authorizations handled by people who bill behavioral health every day.

  • Credentialing for LCSW, LPC, LMFT, PsyD
  • Session authorization tracking
  • Telehealth billing
Bright modern office where the billing team worksSingle and multi-specialty ASCs

Ambulatory surgery centers

Facility billing, implants and case-rate contracts billed correctly and followed up quickly.

  • Facility and professional claims
  • Implant and device billing
  • Case costing and contract review
Team mapping a practice’s revenue cycle workflowOpening or adding providers

New practices & start-ups

Credentialing and enrollment started early so your providers can bill from the first day.

  • NPI, CAQH, PECOS and payer enrollment
  • Fee schedule setup
  • Billing workflow design
Billing team meeting to review a practice’s monthly performanceWC, PI and no-fault auto

Workers' comp & injury providers

State fee schedules, adjuster follow-up, liens and litigation support in one place.

  • State-compliant forms and reports
  • Lien filing and tracking
  • Attorney coordination
Team reviewing revenue reports in a meeting roomOverflow and backlog projects

Hospitals & health systems

Extra capacity for coding backlogs, aged A/R and denial projects without adding headcount.

  • Coding backlog projects
  • Aged A/R recovery
  • Denial root-cause programs
Billing specialist working through claims at a deskFamily, internal medicine, geriatrics

Primary care & chronic care

Preventive, wellness and care management programs billed to their full value.

  • AWV and preventive services
  • CCM, RPM, TCM programs
  • HCC risk adjustment review
Team reviewing revenue reports in a meeting room
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Find the right setup for your practice

Tell us about your organization and we will recommend the services and team structure that fit.