Full revenue cycle
One team from eligibility through to the reconciled remittance, instead of four handoffs and a gap.
- Eligibility
- Running
- Billing
- Running
- AR follow-up
- Running
- Denials
- Running
- Reporting
- Monthly
- One team, no handoffs
- ✓
One workflow, end to end
Front-end eligibility, billing, AR follow-up, denial management and reporting run as one workflow.
Payments reconciled against remittances, so an underpayment is found rather than absorbed.
Payer performance tracked over time: which plans pay, which argue, and which quietly pay short.
What actually happens
Coverage is verified and authorizations are opened before the claim exists, so the first submission is the one that pays.
Claims go out, rejections come back and are worked the same day, and nothing waits for a handoff between two teams that do not talk.
Open AR and denials are worked from the same worklist as the daily cycle, by people who already know the account.
Payments are reconciled against remittances line by line, and payer behaviour over time is tracked rather than remembered.
What we take on
Our desk- 01Running eligibility, billing, AR and denials as one
- 02Reconciling every payment to its remittance
- 03Finding underpayments rather than absorbing them
- 04Tracking payer performance over time
- 05Reporting the whole cycle on a fixed schedule
What stays yours
Unchanged- Your dispensing system and your data inside it
- Your payer contracts and your relationships
- The way a prescription gets filled at the counter
- Final say on anything written off or appealed
- The ability to see every claim we touched
Before you ask
It is the same work run as one workflow instead of five. The difference is the handoffs: nothing waits at a boundary between teams, because there are no boundaries.
Anything paid short of the contracted rate. It is found by matching the payment back to the remittance line by line, which is how a quiet shortfall gets noticed at all.
Yes. Most pharmacies start with the part that is costing them and add the rest once the reporting shows where the next leak is.
A named team that knows your account, with a standing monthly review. Not a ticket queue and not a dashboard link.
Works well alongside
Talk to us about your pharmacy
Send a month of remittances and we will show you what is being left behind before you commit to anything.