A healthy revenue cycle depends on connected workflows. Eligibility affects claims. Authorization affects denials. Payment posting affects secondary billing. A/R follow-up affects cash flow visibility. Reporting affects decision-making. CG Meditrans helps practices manage RCM as a connected process instead of disconnected billing tasks.
We verify coverage, benefits, co-pays, deductibles, and authorization requirements so the billing process begins with clearer payer information. Missing or incorrect insurance information, inactive coverage, unclear benefits, and overlooked authorization requirements can all create downstream denials.
Authorization requirements are reviewed and tracked so practices can reduce preventable authorization-related denials. We help identify when authorization may be required based on payer rules and service type, and track authorization requests and statuses so teams know what is pending, approved, denied, or needing additional information.
Charges are entered and reviewed for required billing details, including date of service, CPT, ICD, modifiers, place of service, provider details, referring provider information, and payer-specific requirements. Accurate charge entry reduces downstream rejections and denials before claims are submitted.
Claims are submitted electronically through a controlled workflow. Clearinghouse rejections are monitored so corrections and resubmissions can happen quickly. Clean claim submission depends on careful charge entry, payer-specific details, coding-related review, and timely correction of rejections.
Payments, adjustments, denials, and balances are posted using ERA, EOB, EFT, insurance payment, and patient payment information. Accurate posting helps practices understand what has been paid, adjusted, denied, transferred to secondary insurance, moved to patient responsibility, or left pending for follow-up.
Rejected and denied claims are categorized, corrected, appealed where appropriate, and followed up based on payer requirements. Denials may point to eligibility gaps, authorization issues, coding mismatches, payer rule changes, credentialing problems, timely filing risks, or incomplete documentation.
Secondary claims are prepared and submitted with required primary payer information. Secondary balances identified during payment posting are reviewed and moved through the next billing step so balances are not left sitting without a clear next action.
Aging accounts are prioritized based on claim age, payer, balance, timely filing risk, and recovery opportunity. Claims in the 30+, 60–90, and 90+ day buckets are reviewed and worked through structured follow-up queues. Old A/R is reviewed to identify workable claims, payer follow-up opportunities, appeal paths, or closure reasons.
Practices receive clearer visibility into billing activity, denial trends, A/R aging, payment posting, and follow-up status. RCM reporting should make the revenue cycle easier to understand, not just produce spreadsheets. We help practices understand what is moving, what is stuck, and what is repeatedly creating problems.
Book a Free Revenue Cycle Check and tell us where billing is slowing down. We can review eligibility, denials, A/R, posting, credentialing, or reporting visibility.
Missed eligibility checks, incomplete prior authorizations, charge entry errors, clearinghouse rejections, payer denials, delayed payment posting, secondary claim gaps, and aging A/R can all create preventable revenue delays. CG Meditrans helps practices create a controlled workflow across each stage of the revenue cycle, so issues are identified, followed up, and reported with structure.
