Clarity. Intelligence. Results.
You Deliver Excellent Care. We Make Sure You Get Paid for It.
Denied Claims
We fix root causes and reduce denial rates across your top payers.
Aged A/R
We shorten the payment cycle and turn stalled dollars into real cash.
Staff Gaps
We fill skill gaps with expert advisors and transparent reporting.
We’re Not a Billing Company. We’re Your RCM Advisory Team.
Advisors First
We don’t just process claims—we elevate your operation with weekly KPIs, open dashboards, and measurable outcomes.
Real-World Experience
Decades inside provider organizations.
Transparency
Weekly KPIs, open dashboards, measurable outcomes.
Onshore Expertise
100% U.S.-based analysts and advisors, fluent in your workflows.
Our Playbook for a Healthier Revenue Cycle
Assess
Baseline your current denials, A/R days, and collection rate.
Optimize
Redesign workflows and address bottlenecks at their source.
Manage
Operate with precision, accountability, and real-time reporting.
Improve
Continuous auditing and performance improvement — every month.
Full-Service Revenue Cycle & Advisory Support
A modular model for independent practices, behavioral health, and home health agencies.
Billing & Collections
End‑to‑end claim management with a clean‑claim bias and aggressive follow‑up to reduce A/R and increase net collections.
- Eligibility, charge capture, edits & scrubs
- Denial management, appeals & timely filing protection
- Claim submission and clearinghouse management
- Payment posting
- Payer performance monitoring and payment integrity
Coding & Compliance
Chart audits, coder education, and documentation standards that safeguard compliance and capture legitimate revenue.
- Quality program support (CPT II, HEDIS alignment, payer incentives)
- ICD-10 code accuracy to reflect severity, risk, and medical necessity
- Modifier validation to ensure correct payment and prevent denials
- Documentation standards to support compliant billing and quality reporting
- Order accuracy & medical necessity checks (labs, imaging, referrals)
Payer Contracting & Credentialing
Negotiate smarter and enroll faster with a former-provider-side team.
- Provider credentialing & payer enrollments (new providers, new locations, roster management)
- Contract acquisition, review & negotiation (fee schedules, carve-outs, escalations)
- CAQH maintenance & hygiene (attestations, documents, cleanup)
- Network participation strategy (which plans to join, when, and why)
- Payer relations & escalation management when issues stall or go silent
Analytics & Reporting
Transparent dashboards and KPI scorecards — weekly and monthly.
- AR aging, NCR, denial rate
- Root-cause analytics
- Executive readouts
Practice Optimization
Staffing models, workflows, and technology to scale performance.
- Structured workflow architecture with clear ownership
- Service-level design (queues, turnaround times, escalation models)
- Optimized staffing model supported by training & competency plans
About Madison RCM
Our Mission
Help independent providers thrive by turning revenue cycle into a reliable, data-driven engine.
What We Believe
Transparency, measurable outcomes, and respectful partnership. Onshore teams. Professional standards.
Credentials
Leadership with advanced degrees (MBA, MHA, CPA) and multi-specialty experience across 35+ fields.
Knowledge That Pays — Literally.
Today’s Tip
3 ways to reduce denials for behavioral health claims.
The Answer
- Verify eligibility & auths: Catch visit limits, referrals, and expired authorizations upfront.
- Use correct CPTs & modifier: Especially for telehealth — 95, GT, POS codes, and time-based notes.
- Build payer-specific rules: Each payer is different. Use matrices and EMR edits to stop bad claims before they go out.