U.S. HEALTHCARE RCM SOLUTIONS
Healthcare Revenue Cycle Management built for operational clarity.
Operational support across provider and payer revenue-cycle workflows for U.S. healthcare organizations.
Service focus
Revenue-cycle operations
Overview
A practical approach to Healthcare Revenue Cycle Management
U.S. healthcare revenue cycle support across provider RCM, payer operations, medical coding, claims, denial management, A/R follow-up and analytics. Services span patient access, coding, billing, collections, claims adjudication, risk adjustment, appeals and reporting.
Designed around your operating context.
IXORA shapes delivery around the systems, people and processes that matter to each organisation. Scope, responsibilities and engagement expectations are discussed with each client.
Talk to our teamProvider RCM services
Revenue-cycle support across the patient-to-payment workflow.
Patient access, scheduling and eligibility verification
Coding and charge entry
Claims processing and submission
Denial management
Accounts receivable follow-up
Reporting and analytics
Provider RCM workflow
A connected operational sequence.
The workflow can be adapted to the systems and responsibilities agreed for each engagement.
Intake / Scanning / EDP System
Coding
Demographic Entry
Charge Entry
Claims Submission
Payment Posting
Denial Management
A/R Follow-Up
Reporting & Analytics
Payer services & analytics
Support for payer-side revenue operations.
Claims processing
Claims processing, adjudication support and error correction
Risk adjustment support
Risk adjustment support, including HCC/MRA coding audits and chart reviews
Appeals
Appeals, audit queries and post-payment validation
Payment trend analysis and provider reimbursement benchmarking
Payment trend analysis and provider reimbursement benchmarking
Provider enrollment and credentialing support
Provider enrollment and credentialing support
Delivery model
Flexible engagement structures.
Client-provided delivery models include hybrid team structures, staff augmentation, managed services, FTE, transaction-fee and hybrid approaches, subject to agreed scope.
Hybrid team structure
Client portal and real-time reporting
Quality management
Frequently asked questions
Questions to discuss with our RCM team.
Does IXORA support provider and payer workflows?
The healthcare offering includes provider revenue-cycle workflows and payer-side services and analytics.
What coding standards are referenced?
Client-provided material references CPT, ICD-10 and HCPCS, with coders certified through AAPC and AHIMA.
Are KPI outcomes guaranteed?
No. Metrics should be agreed as engagement-specific targets or benchmarks, not presented as guaranteed IXORA results.
How is the delivery model defined?
The team can discuss the appropriate structure, reporting model, quality approach and scope for your organisation.
Build a support model around the work that matters.
Discuss a practical scope with IXORA Global Services.
Talk to IXORA