Our services
Every stage of the revenue cycle, covered.
From first-pass claim submission to complex denial appeals, Physician First RCM manages the full billing lifecycle — with dedicated teams, transparent reporting, and accountability at every step.
One partner. Complete coverage.
Most health systems work with multiple vendors to cover their revenue cycle — one for billing, another for coding, a third for denials. That fragmentation creates gaps, delays accountability, and makes it nearly impossible to diagnose root causes. Physician First RCM consolidates all of it under one roof, with a single account team that owns your results end to end.
What we deliver
Medical Billing
Accurate claims. Faster reimbursement.
Our billing team manages the complete claims lifecycle — from charge capture review through submission, adjudication follow-up, and payment posting. We work across all payer types including commercial, Medicare, Medicaid, and managed care.
What's included
- Electronic and paper claim submission across all payer types
- Charge capture review and reconciliation before submission
- Real-time eligibility verification and prior authorization support
- Payment posting and ERA/EOB reconciliation
- Patient statement generation and self-pay follow-up
Denial Management
Recover what you've already earned.
Denied claims represent revenue your organization has already delivered care for. Our denial management team systematically identifies, categorizes, and appeals denials — while feeding root-cause data back into your upstream processes to prevent recurrence.
What's included
- Denial categorization by payer, reason code, and service line
- Clinical and administrative appeal preparation and submission
- Payer escalation and peer-to-peer coordination
- Root-cause analysis and upstream process improvement recommendations
- Monthly denial trending reports with actionable insights
Coding & Compliance
Precision coding. Audit-ready documentation.
Our certified coders specialize in inpatient and outpatient coding across all specialties, with deep expertise in HCC risk adjustment, CDI, and audit defense. We ensure your coding reflects the full complexity of care delivered — maximizing appropriate reimbursement while minimizing compliance risk.
What's included
- ICD-10-CM/PCS, CPT, and HCPCS coding for all care settings
- HCC risk adjustment coding and retrospective reviews
- Clinical documentation improvement (CDI) program support
- Coding audits and compliance assessments
- Coder education and feedback loops with clinical staff
AR Recovery & Follow-Up
Systematic follow-up on every aging dollar.
Aging accounts receivable is one of the most common sources of revenue leakage in health systems. Our AR team works outstanding balances with structured follow-up protocols, payer-specific escalation paths, and clear timelines — reducing your AR days and recovering revenue before it ages out.
What's included
- Prioritized work queues based on payer, age, and balance
- Payer-specific follow-up protocols and escalation paths
- Secondary and tertiary billing coordination
- Credit balance resolution and refund processing
- Weekly AR aging reports with trend analysis
Analytics & Reporting
Full visibility into your revenue performance.
Revenue cycle performance is only improvable when it's measurable. We provide every client with a custom reporting suite — from daily operational dashboards to monthly executive summaries — giving your leadership team the data they need to make informed decisions.
What's included
- Custom KPI dashboards tailored to your organization's goals
- Monthly executive summary reports with trend analysis
- Payer performance benchmarking and contract analysis
- Denial and underpayment analytics by service line
- Quarterly business reviews with senior leadership
How we work
A structured onboarding. A lasting partnership.
Discovery & Assessment
We begin with a thorough review of your current revenue cycle performance — payer mix, denial trends, AR aging, and coding patterns — to establish a baseline and identify the highest-impact opportunities.
Dedicated Team Assignment
Your account team is assembled based on your service lines, payer mix, and volume. You'll have named contacts at every level — from billing specialists to senior leadership.
System Integration & Go-Live
We integrate with your EHR and practice management systems, establish reporting cadences, and go live on a structured timeline — typically within 30 days of contract execution.
Ongoing Optimization
Revenue cycle performance is never static. We meet with your leadership team regularly to review results, address emerging issues, and continuously refine our approach.
Not sure which services you need?
Our team will walk you through a no-obligation revenue cycle assessment and identify the highest-impact opportunities for your organization.
Schedule a Free Assessment