Madison RCM

Services

Full-stack revenue cycle and advisory support for independent practices. Clarity. Intelligence. Results.

Core Service

Billing & Collections

End-to-end claim management with a clean-claim bias and disciplined follow-up to reduce A/R and increase net collections.

What we handle

  • Eligibility checks and clean charge capture
  • Claim scrubbing, edits, and submission
  • Denial management and appeals
  • Payment posting and reconciliation

How We Work

  • Shared KPIs and clear reporting cadence
  • A/R playbooks to prevent aging and write-offs
  • Tight feedback loops with front-office and clinical teams
  • Hands-on EMR/PM configuration support

Outcomes

↑ Net collections

More cash on the same volume.

↓ A/R days

Faster conversion from visit to payment.

↓ Takebacks

Fewer payer audits and recoupments.

Better documentation

Cleaner notes with less provider frustration.

Safeguard revenue

Coding & Compliance

Practical coding guidance and documentation standards that protect compliance and capture legitimate revenue.

Focus areas

  • ICD-10 accuracy to reflect acuity and risk
  • Modifier use to support correct payment
  • Quality coding (CPT II, incentive measures)
  • Medical necessity and documentation alignment

What we deliver

  • Targeted chart reviews and coding audits
  • Provider and staff education sessions
  • Template and workflow updates in your EMR
  • Quality program readiness reviews

Outcomes

↑ Quality scores

Better capture of incentive-linked measures.

↑ Risk accuracy

ICD-10 supports acuity and value-based models.

↓ Denials

Cleaner front-end and fewer reworks.

Less noise

Fewer billing fires for providers and staff.

Network strategy

Payer Contracting & Credentialing

Former provider-side operators who negotiate realistically, model impact, and keep credentialing moving.

What we handle

  • Provider enrollment and re-credentialing
  • New locations and roster management
  • Contract intake, review, and redline support
  • CAQH hygiene and document upkeep

How We Work

  • Structured follow-up so nothing stalls in a black hole
  • Rate and term reviews grounded in your data
  • Clear communication with payers and your team
  • Regular status reporting for leadership

Outcomes

Faster enrollment

Quicker time from hire to in-network.

Stronger terms

Rates and language aligned to your strategy.

↓ Eligibility issues

Cleaner rosters, fewer “not on file” denials.

↑ Network stability

Less chaos when providers join or leave.

Scorecards & insight

Analytics & Reporting

Scorecards and dashboards that move beyond raw data and help leaders make decisions.

Dashboards

  • Executive-level snapshots with drill-downs
  • Payer, provider, and site-level views
  • Trend lines for denials, A/R, and cash

Cadence

  • Weekly operations huddles
  • Monthly executive reviews
  • Quarterly strategy checkpoints

Outcomes

↑ Visibility

Shared view of performance across the practice.

↑ Insight

Clear root causes behind trends and outliers.

↓ Leakage

Gaps identified and prioritized for action.

Aligned scorecards

Metrics that connect providers, staff, and Madison.

Operations support

Practice Optimization

From intake to month-end close: workflows, staffing, and technology tuned for throughput and patient satisfaction.

Operations

  • Front desk training
  • Staffing models tied to volume and complexity
  • Patient panel enhancement

Systems

  • EMR/PM configuration and cleanup
  • Rules, automations, and templates that stick
  • Eligibility and clearinghouse optimization

Outcomes

↑ Throughput

More visits without burning out staff.

↓ Rework

Fewer loops and manual fixes.

↑ Staff satisfaction

Less chaos, clearer expectations.

Smoother patient flow

From scheduling to checkout and beyond.

Who we support

Specialties We Serve


We specialize in independent primary care and extend across 35+ specialties, with dedicated programs for primary care, behavioral health, and gynecology.

Primary Care

Family medicine, internal medicine, and pediatrics — visit-heavy, denial-sensitive workflows.

Behavioral Health

Auths, parity nuances, telehealth, and multi-payer benefit coordination.

Gynecology

Women’s health coding, authorizations, and payer policy nuances.

+ More

Gastroenterology, cardiology, orthopedics, multi-specialty groups, and MSOs.

FAQ

Frequently Asked Questions

Do you replace our current systems?

No, we optimize your existing EMR/PM and clearinghouse to keep your workflows and data intact. However, if you need a new billing platform, we can provide that through our preferred technology partners.

What does onboarding look like?

30‑60‑90 day plan: baseline → stabilize → optimize. Weekly touchpoints and a named engagement lead.

How do you price services?

Our pricing is competitive and tailored to each client’s needs. Pricing varies based on factors such as organization size, specialty, scope of services, and level of support required. For advisory services or project-based work, we offer flexible pricing options, including hourly rates, fixed-fee engagements, and monthly retainers.

Can you help with payer negotiations?

Yes — we model contract impact, pursue escalations, and maintain credentialing/rosters.

Is your team onshore?

Yes. Our analysts and advisors are 100% U.S.‑based.

Will we see results quickly?

Most clients see measurable improvements in 60–90 days; full optimization typically follows over subsequent quarters.

Ready to get started?

Let’s baseline your metrics and build a specialty‑tuned plan.