Comprehensive RCM Solutions

Medical Billing, Credentialing & Revenue Recovery

Specialized revenue cycle management services designed to maximize your practice's financial performance. From specialty medical billing to provider credentialing and denial management – we handle it all.

What We Offer

End‑to‑End Revenue Cycle Management

We provide a complete suite of RCM services that cover every stage of the revenue cycle – from patient registration and eligibility verification to claim submission, denial management, and final payment reconciliation. Our specialty‑focused approach ensures that every service is tailored to your unique coding and payer requirements.

Specialty Medical Billing

We handle the full billing lifecycle – from charge capture and coding to claim submission, payment posting, and patient collections. Our certified coders are trained in specialty‑specific CPT codes, modifiers, and payer policies to maximize your reimbursements.

  • 98% clean claim rate – fewer denials, faster payments
  • Specialty‑specific coding for orthopedics, cardiology, anesthesia, ENT, urgent care, behavioral health, hematology, and general surgery
  • Real‑time eligibility verification and prior authorization support
Learn about specialty billing →

Provider Credentialing

Getting credentialed with Medicare, Medicaid, and commercial payers is one of the most time‑consuming tasks for new and growing practices. We manage the entire process so you can start billing sooner – typically in 45–60 days instead of the industry average of 90–120 days.

  • CAQH profile creation and ongoing management
  • Medicare, Medicaid, and commercial payer enrollment
  • Hospital privileges and facility credentialing
  • Re‑credentialing and ongoing maintenance

Result: 150+ providers credentialed in 12 specialties.

Get credentialing support →

Denial Management & Appeals

Denied claims are the single largest drain on practice revenue. On average, 10‑15% of claims are initially denied, and without a systematic process, many are never appealed. Our denial management team combines data analytics, payer intelligence, and persistent follow‑up to recover lost revenue and prevent future denials.

  • AI‑powered claim scrubbing before submission
  • Root‑cause denial analysis by payer and reason code
  • Aggressive appeals with payer‑specific strategies
  • Recover 40%+ of previously denied claims

Result: $2.4M+ recovered for clients in 2025.

Start recovering denials →
Our Specialties

Specialty‑Focused Medical Billing

Each specialty has its own unique coding nuances, modifier requirements, and payer policies. Our certified coders are trained in the following specialties to ensure maximum reimbursement and compliance.

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Orthopedic Surgery

Orthopedic billing involves complex CPT codes for fracture care, joint replacements, arthroscopies, and spinal procedures. We specialize in modifier usage (-LT, -RT, -50, -59) and bundled payment models like CJR for total joint replacements. Our coders ensure compliance with Medicare's NCCI edits and workers' compensation requirements.

Key codes: 27447, 29881, 25500, 27130

Read our orthopedic billing guide →
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Cardiology

Cardiology billing requires precise capture of echocardiograms, stress tests, cardiac catheterizations, and electrophysiology procedures. We handle split‑billing between professional and technical components and integrate with EHRs for automated charge capture. Our team stays current with CPT updates for device implants (pacemakers, ICDs).

Key codes: 93306, 93015, 93571, 93620

Read about cardiology RCM →
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Anesthesia

Anesthesia billing is time‑based and relies on base units, time units, and physical status modifiers. We manage medical direction (-QK, -QX) and supervision rules, including the 1:4 ratio for Medicare. Our team integrates with anesthesia information management systems (AIMS) for accurate time capture and audit‑ready documentation.

Key codes: 00100-01999, modifiers P1‑P6

Learn about anesthesia billing →
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ENT Surgery

ENT billing covers a wide range of procedures from sinus surgery and tympanoplasty to tonsillectomies and septoplasties. We handle bilateral procedures (modifier -50), multiple procedure bundling (modifier -51), and prior authorizations for advanced procedures like cochlear implants and balloon sinuplasty.

Key codes: 31256, 69631, 42820, 30520

Read ENT billing insights →
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Behavioral Health

Behavioral health billing requires navigating 42 CFR Part 2, HIPAA, and the Mental Health Parity Act. We handle psychotherapy codes, crisis intervention, medication management, and telehealth billing (POS 02, modifier -95). Our team ensures compliance with consent requirements and payer‑specific documentation standards.

Key codes: 90837, 90834, 90847, 90791

Explore behavioral health billing →
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Urgent Care

Urgent care clinics require efficient E/M coding, front‑end patient collections, and tight payer contract management. We optimize E/M level selection (99213 vs 99214) based on medical decision making and time. Our team also helps with fee schedule analysis and renegotiation to maximize reimbursement per visit.

Key codes: 99213, 99214, 99203, 99204

Read urgent care optimization →

Plus: Hematology/Oncology, General Surgery, and more. Contact us about your specialty.

More Than Billing

Additional RCM Solutions

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EHR Integration & Analytics

We integrate seamlessly with major EHRs including Epic, Cerner, Athena, and NextGen. Our HL7 and FHIR interfaces automate charge capture, eligibility verification, and claim submission. You get a real‑time dashboard showing KPIs like days in A/R, net collection rate, and denial trends – all specific to your specialty.

  • Automated charge capture from clinical documentation
  • Real‑time eligibility verification at front desk
  • Custom KPI dashboards with specialty benchmarks
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Compliance & Audit Support

Stay audit‑ready with our compliance frameworks. We help you navigate OIG work plans, Medicare's NCCI edits, and payer‑specific billing guidelines. Our internal audit reviews identify coding risks before they become liabilities.

  • HIPAA and OIG compliance assessments
  • Regular coding audits and provider education
  • Risk mitigation strategies for surgical billing
FAQs

Common Questions About Our Services

Which specialties do you support?

We currently support orthopedics, cardiology, anesthesia, ENT, urgent care, behavioral health, hematology/oncology, and general surgery. We also accommodate other specialties – just ask.

Do you work with small practices?

Absolutely. Our model is designed for small and mid‑sized practices with 1‑20 providers. We provide enterprise‑level RCM capabilities at a cost that makes sense for smaller groups.

How do you charge for services?

We typically work on a percentage of collections basis, with transparent monthly reporting. We also offer fixed‑fee models for credentialing and consulting services. Contact us for a custom quote.

What makes you different from other RCM companies?

Our specialty‑first approach, aggressive denial recovery (40%+), and commitment to transparency. We also offer free revenue audits with actionable insights – no obligation.

Ready to Maximize Your Practice Revenue?

Schedule your free, no‑obligation revenue audit. We'll analyze your current billing, credentialing, and denial patterns – and show you exactly where you can improve.

📧 a.kazmi@ezcuresolutions.com