We handle every step of the billing cycle so you can focus on patient care. From claim submission to payment posting, our certified billers deliver 99.5% clean claim rates and faster reimbursements.
These three problems silently drain thousands from independent practices every month. Nexus Claim Solutions RCM eliminates them.
The national average claim denial rate is 15–20%. Each denied claim requires costly rework, delays payment by weeks, and many are never resubmitted — permanently lost revenue for your practice.
In-house billing teams often carry 45–60+ days in accounts receivable. Delayed reimbursements mean you can't reinvest in staff, equipment, or growth while waiting on payers to pay.
A single in-house biller costs $45,000–$65,000/year in salary alone — before benefits, training, software, and turnover. Practices with 2–3 billing staff spend $120K+ annually with inconsistent results.
One flat rate covers the full billing cycle. No hidden fees, no add-ons — just complete, expert management of your revenue from encounter to payment.
Every claim is scrubbed against payer-specific rules before submission, eliminating errors that lead to denials. We submit electronically to hundreds of payers with same-day turnaround.
We post all ERA/EOB payments accurately, reconcile discrepancies, and flag underpayments for follow-up. Your books stay clean and balanced in real time.
Our dedicated AR team aggressively pursues outstanding claims. We segment aging by payer, identify patterns, and escalate stalled claims before they pass timely filing limits.
We identify the root cause of every denial, file timely appeals with supporting documentation, and implement process improvements to prevent the same denial from recurring.
We verify patient eligibility and benefits before each encounter, flagging coverage gaps or authorization requirements so there are no billing surprises after the visit.
Benchmarked across 1,000+ healthcare providers. These are the real results our clients experience within the first 90 days.
We recover 98 cents of every dollar billed — far above the industry average of 85%.
Claims submitted correctly the first time, reducing denials and rework to near zero.
Average days in accounts receivable under 30, versus the national average of 45–60 days.
Practices save up to 50% compared to maintaining in-house billing staff and software.
Our certified billers are trained in specialty-specific coding, payer rules, and reimbursement requirements.
See exactly how outsourcing your medical billing to Nexus Claim Solutions RCM stacks up against maintaining an in-house team.
| Comparison Factor | In-House Billing Team | Nexus Claim Solutions RCM |
|---|---|---|
| Claim Accuracy Rate | ✗ 80–85% industry average | ✓ 99.5% clean claim rate |
| Days in Accounts Receivable | ✗ 45–60+ days typical | ✓ Under 30 days average |
| Denial Rate | ✗ 15–20% average | ✓ Under 2% |
| HIPAA Compliance Management | ✗ Your responsibility, your liability | ✓ Fully managed |
| Coding Certifications (AAPC) | ✗ Rarely maintained in-house | |
| Real-Time Reporting | ✗ Manual spreadsheets, delayed | ✓ Live dashboard, monthly reports |
| Staff Turnover Risk | ✗ High — billing disruptions when staff leave | ✓ Zero — dedicated team, no disruption |
| Scalability | ✗ Hire & train for every growth phase | ✓ Instant scale up or down as needed |
We operate under the strictest HIPAA protocols with enterprise-grade security across every system and team member.
Multi-factor authentication and role-based access control on every system. No unauthorized personnel can access patient records.
All data in transit and at rest is protected with AES-256 encryption. Secure VPN access required for all remote work.
Automated daily backups with disaster recovery procedures ensure zero data loss and minimal downtime in any event.
No personal devices on office networks. All workstations are managed and monitored with enterprise endpoint security.
We sign Business Associate Agreements with every practice, creating a legally binding obligation to protect your patients' PHI.
Third-party security assessments conducted regularly. Vulnerabilities identified and remediated before they become risks.
Real results from real practices across the United States.
After switching to Nexus Claim Solutions RCM, our collection rate jumped from 81% to 97% in just 60 days. The team handled everything — credentialing, our old AR backlog, and new claims — without a single disruption to our practice.
Our denial rate dropped from 18% to under 2% within the first quarter. The monthly reports they send are genuinely useful — I can see exactly where revenue is coming from and spot issues before they compound.
We were spending $140,000 a year on a billing team that delivered mediocre results. Nexus Claim Solutions RCM costs us a fraction of that and outperforms on every metric. Days in AR went from 52 to 24 in 90 days.
Everything you need to know before getting started.
Our medical billing service covers the complete revenue cycle: patient eligibility verification, medical coding (ICD-10, CPT, HCPCS), claim submission, payment posting, AR follow-up, denial management and appeals, patient billing statements, and monthly reporting. There are no add-on fees — everything is included in the 5% performance-based rate.
Most practices go live within 2 weeks. Onboarding includes a practice assessment, credentialing review, EHR access setup, and a workflow walkthrough with your dedicated account manager. We handle the heavy lifting so your existing staff can continue their day-to-day without disruption.
Yes. We work with all major EHR and PM systems including Epic, Athenahealth, Kareo, AdvancedMD, eClinicalWorks, Practice Fusion, NextGen, Modernizing Medicine, and dozens of others. If you use a specialized or proprietary system, contact us and we'll confirm compatibility during the free assessment.
We charge 5% of collections — meaning we only get paid when you get paid. If a claim is not collected, we earn nothing on it. This performance-based model ensures our incentives are completely aligned with maximizing your revenue. There are no monthly retainer fees or setup costs.
Every denial is caught, analyzed for root cause, and appealed within payer-specific timely filing deadlines. Our denial management team writes customized appeal letters with supporting clinical documentation. We track every appeal to resolution and report denial trends monthly so your practice can identify and fix upstream issues.
No long-term contracts are required. We believe our results speak for themselves, so we operate on a month-to-month basis after an initial 90-day partnership period that allows us to fully optimize your billing processes. A risk-free trial period is available for new clients — ask your account manager for details.
Get a free practice assessment from a billing specialist. We'll analyze your current billing processes, identify your biggest revenue leaks, and show you exactly what improvement looks like — no commitment required.
No long-term contracts • Setup in 2 weeks • Risk-free trial available
