Eligibility & prior auth
Insurance verified before the visit; prior authorizations secured.
End-to-end RCM outsourcing — eligibility verification, coding, claims submission, denial management, AR follow-up and payment posting — with certified specialists and clear reporting.
RCM breaks down across many small steps — eligibility checks, prior auths, coding, charge entry, claims, denials, AR follow-up, payments. When different teams or systems own each step, revenue leaks at the seams: denials grow, AR ages, clean claim rates drop and cash flow becomes unpredictable.
Opervics runs RCM outsourcing as an end-to-end managed function — eligibility verification, coding, claims submission, denial management, AR follow-up and payment posting — with certified specialists and reporting that shows the whole cycle.
Insurance verified before the visit; prior authorizations secured.
Certified coders and clean charge capture feeding the claim.
Claims scrubbed, validated and submitted to payers and clearinghouses.
Denials worked, appeals filed and root causes trended for prevention.
Aged AR worked across 30/60/90/120+ buckets; payments posted and reconciled.
Clean claim rate, denial rate, days in AR, collections and payer trends.
These are the same operational issues we see across clients — and the same ones our process is designed to remove.
Front, mid and back-end RCM owned by different teams — handoffs drop.
Claims denied on submission — cash flow slows and rework grows.
Receivables sit unworked — collections drop and write-offs rise.
Appeal windows missed and payer patterns never addressed at source.
RCM teams turn over — institutional knowledge walks out.
Nobody sees the whole cycle — decisions are made on partial data.
Every service inherits the same baseline security posture, then adds service-specific controls on top.
Access, change management, monitoring and incident response aligned to HIPAA.
PHI access, redaction and audit logging defined with your compliance team.
Role-based access across the revenue cycle — scoped, audited and reviewed.
Clean claim rate, denial rate, days in AR and collections reported weekly.
Eligibility verification, prior authorization, coding, charge entry, claims submission, denial management, AR follow-up, payment posting and reporting.
Both — most practices start with one or two components and expand as we demonstrate results.
Primary care, cardiology, orthopedics, radiology, oncology, behavioral health, surgical specialties and multi-specialty groups.
BAAs, PHI handling rules, role-based access, audit logging and least-privilege permissions — with your compliance team.
Clean claim rate, denial rate, days in AR, AR aging, collections and payer trends — reported weekly.
Percentage of collections, per claim, per FTE, or a monthly retainer — agreed upfront.
A short conversation is usually enough to scope the cycle and propose a starting point.