Revenue Cycle Management
All 6 Stages Covered
Stop Losing 40% of Revenue to Billing Gaps & Denials
Most practices unknowingly lose thousands each month to uncollected claims, coding errors, and unworked denials. Nexus Claim Solutions manages your entire revenue cycle — every stage, every claim, every dollar recovered.
98% net collection rate — industry average is 82%
Denial rate under 2% — national average is 18%
Claims resolved in under 30 days — not 52
1,000+ providers trust Nexus Claim Solutions RCM nationwide
Get Your Free Revenue Cycle Audit
Find out exactly how much revenue your practice is leaving uncollected — at zero cost, zero obligation.
HIPAA Secure
No Commitment
Reply in 24 hrs
$500M+
Revenue Managed Annually
98%
Net Collection Rate
<30 Days
Average Days in AR
1000+
Providers Trust Us
The Full Revenue Cycle
6 Stages — We Manage Every One
Most billing services handle 2–3 of these stages. Nexus Claim Solutions RCM manages all 9, eliminating the gaps where revenue leaks and delays occur.
01
Insurance Eligibility & Benefits Verification
Real-time eligibility checks confirm active coverage, deductibles, co-pays, and any restrictions before each appointment — preventing denials before they happen.
02
Claim Scrubbing & Submission
Every claim is scrubbed against 3,000+ payer-specific edits before submission. Our 99.5% clean claim rate means the vast majority are paid on first pass.
03
Payment Posting & Reconciliation
ERA and manual EOB payments posted accurately and on time. Every contractual adjustment is validated, and underpayments are flagged for immediate follow-up.
04
Denial Management & Appeals
Every denial triggers a root-cause analysis. We file targeted appeals with supporting documentation and track each appeal to final resolution — nothing falls through.
05
Accounts Receivable & Collections
Proactive AR management across all aging buckets. We segment by payer, identify stalled claims, and escalate before timely filing limits expire. Patient balances are also managed with empathy.
06
Reporting, Analytics & Optimization
Monthly performance dashboards surface KPIs, denial trends, payer performance, and revenue forecasts. Data-driven recommendations keep your revenue trajectory moving upward.
Why Full RCM Integration Matters
Disconnected Billing Creates Revenue Gaps. Integration Closes Them.
When registration errors aren't caught in eligibility, coding isn't aligned with documentation, or denials aren't tracked back to root causes — revenue leaks at every seam. Full RCM eliminates those seams.
Single point of accountability
One team owns the full cycle — no finger-pointing between billing and coding departments.
Upstream error prevention
Problems caught at registration never become denial costs downstream — measurably reducing write-offs.
Unified reporting across all 9 stages
See where revenue is at any moment — not just what was billed, but what was collected and why.
Get a Free RCM Audit
Eligibility Verification
Claim Submission
Payment Posting
Denial Management
AR & Collections
Analytics & Reporting
Revenue Impact
What Happens When You Optimize Your Revenue Cycle
Practices that switch to Nexus Claim Solutions RCM's full Revenue Cycle Management see measurable improvements within the first 60–90 days.
+30%
Average increase in collections within 90 days
−50%
Reduction in operational billing costs vs in-house teams
<2%
Denial rate — versus the 15–20% national average
24 Days
Average AR cycle — down from 45–60 days for most new clients
Before vs. After Nexus Claim Solutions RCM
Collection Rate
81%
→
98%
Days in AR
52 days
→
24 days
Clean Claim Rate
80%
→
99.5%
Denial Rate
18%
→
<2%
Monthly Reporting
None
→
Live dashboard
Our Methodology
A Four-Phase Approach to RCM Excellence
Beyond billing — a strategic framework for sustainable revenue growth and operational efficiency.
01
Discover & Audit
We perform a full revenue cycle audit — analyzing your current workflows, payer mix, denial patterns, AR aging, and coding accuracy. The gaps we find become your roadmap to recovery.
02
Configure & Integrate
We integrate with your EHR, configure payer-specific workflows, complete credentialing, and establish your dedicated account team. Go-live in as little as 2 weeks.
03
Execute & Collect
Full cycle management begins. Every claim is submitted, every payment posted, every denial appealed, every dollar pursued. Real-time tracking keeps you informed throughout.
04
Analyze & Optimize
Monthly performance reviews with actionable insights. We identify payer behavior patterns, coding opportunities, and process improvements that continuously raise your revenue ceiling.
Ready to start the Discover & Audit phase?
Schedule Your Free RCM Audit
Software & Integrations
Works With the Systems You Already Use
We integrate with all major EHR and Practice Management platforms. No system replacements, no disruptions to your existing workflow.
Epic
Full integration
Athenahealth
Native workflow
Kareo
Direct integration
eClinicalWorks
Full integration
AdvancedMD
API integration
NextGen
Full integration
Practice Fusion
Direct API
ModMed
Full Integration
Don't see your system? Contact us — we integrate with virtually every major platform and many specialty-specific systems.
Why Choose Full RCM
What Makes Nexus Claim Solutions RCM Different from a Billing Service
A billing service submits claims. A Revenue Cycle Management partner does that and everything before and after it — with strategic oversight, dedicated staff, and measurable accountability at every stage.
Single point of accountability
HIPAA-compliant
Real-time performance dashboard
Dedicated account manager
Denial root-cause tracking
Scales with practice growth
Monthly strategy reviews
No long-term contracts
Start Your Free Assessment
1000+
Healthcare providers trust Nexus Claim Solutions RCM with their full revenue cycle
$500M+
Revenue managed annually across all clients
15+
Medical specialties covered with certified expertise
2 Weeks
Average onboarding time from contract to go-live
24/7
Monitoring, support, and claim status visibility
Security & Compliance
Your Revenue Cycle, Secured at Every Step
PHI moves through 9 stages of your revenue cycle. We protect it at every one with enterprise-grade security and full HIPAA compliance.
HIPAA Compliance Across All 9 RCM Stages
Every team member, system, and process is governed by strict HIPAA protocols. We sign Business Associate Agreements, enforce MFA across all systems, and conduct quarterly third-party security audits — giving you a fully compliant RCM partner from day one.
Data Encryption
AES-256 encryption for all data in transit and at rest. No PHI is ever transmitted over unsecured channels.
Role-Based Access Control
Staff access is strictly limited to only the data and systems required for their role. All access is logged and audited.
Business Associate Agreements
We sign BAAs with every client, creating a legally binding commitment to protect PHI with the highest standard of care.
Regular Security Audits
Quarterly third-party security assessments identify and remediate vulnerabilities before they can be exploited.
Disaster Recovery
Automated daily backups and a tested disaster recovery plan ensure zero data loss and minimal downtime in any scenario.
Secure Remote Access
VPN-required remote work environments. No personal devices on production networks. Endpoint security on all workstations.
HIPAA Compliant
BAA Included
Quarterly Audits
Client Results
Real Numbers from Real Practices
These aren't case studies — they're client outcomes from the first 90 days of full RCM management.
Verified Client Result
+34%
Increase in monthly revenue collected
“
We had three separate vendors for billing, coding, and AR — each pointing fingers at the others when things went wrong. Nexus Claim Solutions RCM consolidated everything. Now there's one team, one report, and clear accountability. Revenue is up 34% and I actually understand where every dollar goes.
LM
Lisa Martinez
Practice Administrator — Multi-Specialty Group, Dallas TX
Verified Client Result
22 Days
AR cycle — down from 54 days
“
Nexus Claim Solutions RCM didn't just take over our billing — they overhauled our entire revenue cycle. Prior auth denials dropped to near zero, and our AR is now at 22 days. I had no idea how much money we were leaving uncollected.
DK
Dr. David Kim
Cardiology Group — Houston, TX
Verified Client Result
<2%
Denial rate — was 21% previously
“
The monthly reporting alone is worth every penny. I can see exactly what was billed, collected, where denials came from, and what's outstanding — in one dashboard. My previous billing company gave me a single number once a month.
RN
Dr. Robert Nguyen
Internal Medicine — Seattle, WA
Frequently Asked Questions
Revenue Cycle Management — Your Questions Answered
Understanding what full RCM looks like before you engage a partner.
What is the typical cost of medical billing services per claim or per provider?+
We offer a flat fee structure tailored to your practice. Costs can vary based on practice size, specialty, and the range of services needed.
What services does your medical billing company provide?+
Our medical billing company handles a variety of services, including provider enrollment, insurance eligibility checks, charge entry, claim submission, payment posting, accounts receivable follow-up, denial and appeal management, patient invoicing, reimbursement monitoring, and collections.
How can I evaluate the performance of a medical billing service provider?+
We provide customized reports daily, weekly, or monthly based on your needs. These include claim submission timelines, denial rates, collections, and payer trends. You will always have clear visibility into how your billing is performing.
How does outsourced medical billing help increase practice revenue?+
Outsourced medical billing reduces overhead costs by eliminating the need to recruit, train, and retain in-house billing staff. It also improves revenue through accurate coding, timely claim submissions, and proactive denial management.
How does your medical billing company manage claim reimbursements and denials?+
We make sure claims are submitted correctly the first time, using payer-specific rules to avoid rejections. From there, we track every claim until it’s resolved. If a claim is denied or underpaid, we investigate the reason, file appeals when needed, and follow up consistently.
Take the First Step
Get Your Free Revenue Cycle Audit
In a 30-minute call, our RCM specialists will audit your current billing workflows, identify your biggest revenue recovery opportunities, and present a clear roadmap for improvement — at zero cost and zero obligation.
Free assessment • No commitment • Results within 90 days or we make it right