Claims worked end to end
Charge entry through submission, rejection correction, denial appeal and posting — followed to resolution rather than to submission.
Healthcare & Specialty BPO
Billing and revenue cycle, worked claim by claim
Denials, underpayments and ageing AR are not solved by software. They are solved by somebody working the queue every day against a payer's specific rules.
- Trained billing staff
- Under your compliance terms
- Queue-level reporting
How the work is run
Revenue cycle work is relentless rather than complicated. Charges entered, claims submitted, rejections corrected and resubmitted, denials appealed, payments posted and reconciled, ageing AR chased before it becomes uncollectable.
Practices lose money in the gaps: the denial nobody appealed inside the window, the underpayment nobody noticed against the contracted rate, the credentialing lapse that silently made a provider out of network.
StaffCloud staffs trained billing personnel who work inside your practice management system on your payers. Compliance obligations are yours and we work to them under your terms — business associate arrangements, access controls and training agreed with you rather than asserted here.
Capabilities
Under your compliance framework
We work to your requirements: your agreements, your access controls, your training and audit expectations. Compliance is a contractual position, not a marketing claim.
Underpayment detection
Payments checked against contracted rates, since an underpayment looks exactly like a payment until somebody compares it.
Queue-level visibility
AR ageing, denial categories and rejection reasons reported, because the categories are what tell you where the revenue is leaking.
Specialty familiarity
Staff trained on your specialty's codes and payer behaviour, which differ enough that general billing experience is not sufficient.
Documented processes
Payer-specific processes written down, so the knowledge survives a person leaving.
How the engagement runs
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01
Practice review
Current AR ageing, denial mix, rejection reasons and where the queue is actually stuck. You get this whether or not you engage us.
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02
Compliance and access
Agreements, access scoping and training completed to your framework before any patient data is touched.
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03
Process capture
Payer-specific rules and practice preferences documented before staffing.
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04
Run and report
Daily queue work with reporting on ageing, denial categories and the recurring causes behind them.
Where practices actually lose money
Not in the claims that were submitted. In the ones that were denied and never appealed.
- Denials appealed inside the window rather than written off
- Underpayments compared against contracted rates
- AR ageing that gets chased before it ages out
Platforms and tools we work in
The pod works inside your stack. These are the systems this team uses day to day — if yours is not listed, we will learn it.
- EpicEHR and practice management
- AthenahealthPractice management and billing
- eClinicalWorksEHR and RCM
- AdvancedMDPractice management
- Kareo / TebraBilling and practice management
- AvailityPayer portals and eligibility
- Clearinghouse portalsClaim status and rejections
- Payer portalsAppeals, eligibility and remittance
- Excel / Google SheetsAR tracking and denial analysis
- Your VPN or VDIWhere patient data may not leave your environment
What sits under Healthcare & Specialty BPO
2 capabilities, each staffed and documented separately. Pick the one closest to the work you need covered.
Medical Billing & Specialty Healthcare RCM
Medical billing outsourcing service for specialty practices, including ophthalmology: charge entry, claim submission and posting.
Explore this serviceHealthcare Revenue Cycle Management (RCM)
Healthcare RCM outsourcing service across medical coding, credentialing, AR follow-up and denial management for practices.
Explore this serviceQuestions buyers ask
The things worth knowing before the first call.
Not sure this is the right scope?
Describe the workload in a sentence and we will point you at the right team — or tell you honestly if it is not something we should take on.
Ask usOphthalmology is an established area. For other specialties the honest question is whether we can staff people who know your codes and payers, and we would rather assess that than take the work and learn on your claims.
Yes, with scoped access through your own user management. Working in your system rather than exporting is both safer and more accurate.
No figure from us in advance. It depends on your payer mix, your contracts and your current denial position — all of which the practice review establishes on your data.
Covered on the RCM page. Lapses are a common and expensive problem precisely because nothing announces them until claims start denying.
Yes, where you require it — VDI or VPN working with nothing copied out. It constrains tooling and throughput, and it is worth agreeing at the start rather than at contract stage.