MediClarus specializes in comprehensive Revenue Cycle Management (RCM) solutions tailored for the US healthcare industry, with a particular focus on serving primary care providers. Our services streamline financial operations, accelerate cash flow, and enhance the overall financial health of primary care practices.

✅ Flexible Engagement Models (Pilot, Part-Time, FTE)

✅ HIPAA-Compliant & US Healthcare Certified Coders

✅ End-to-End RCM Support from India-Based Team

✅ 100% Focus on Primary Care Revenue Cycle

✅ Transparent Workflow & Reporting

Performance Reporting & Compliance

We provide detailed monthly reports on collections, denial trends, and payer performance. Our insights help you make informed decisions, and stay audit-ready and compliant with CMS and payer policies.

Eligibility Verification & Prior Authorization

We verify patient insurance coverage before the visit and manage prior authorization requests for diagnostic services, procedures, and referrals to reduce denials at the front-end.

Patient Billing & Statement Services

We send timely, easy-to-read patient statements and offer support for questions about balances and co-pays. We also provide optional online payment portal setup.

Denial Management & Appeals

Our team tracks and analyzes claim denials in real time, resolves root causes, and resubmits corrected claims promptly. We also handle appeals for medical necessity, coding, and eligibility denials.

Accounts Receivable (AR) Follow-Up

Our AR specialists actively follow up with payers to ensure outstanding claims are resolved quickly. We reduce your Days in AR and improve cash flow through persistent payer engagement.

MediClarus RCM Services for Primary Care

At MediClarus, we specialize in providing comprehensive Revenue Cycle Management (RCM) services tailored to the needs of healthcare providers. With a deep understanding of the intricate processes involved in healthcare revenue management, we offer end-to-end solutions that optimize revenue streams, streamline operations, and ensure compliance with industry regulations.

Medical Coding

We provide accurate, compliant, and specialty-aligned CPT, ICD-10, and HCPCS coding tailored to primary care visits. Our certified coders ensure correct E/M level selection, reducing audit risk and improving reimbursement rates.

Medical Billing

We handle complete charge entry, claim creation, and electronic claim submission to all major payers. Our team ensures timely billing with clean claims and minimal rejections.

Key Metrics for Primary Care RCM

Metric Details:

Clean Claim Rate: A higher percentage reflects efficient billing processes and fewer rejections.

Days in A/R: Shorter cycle times indicate faster reimbursement and improved cash flow.

First Pass Resolution Rate: High rates show effectiveness in initial billing quality.

Denial Rate: Lower denial rates reduce rework and payment delays.

Net Collection Rate: Measures how effectively practices collect revenue that should be collected.

Patient Collection Rate: Important for the increasing share of patient out-of-pocket payments.

Charge Lag Days: Minimizing lag ensures prompt claims processing and revenue recognition.

By integrating advanced technology, proven processes, and specialized expertise, MediClarus consistently outperforms industry benchmarks, resulting in maximized revenue, reduced administrative burdens, and improved financial health for primary care practices.

Client-Centric Approach

Scalable Solutions: Services are tailored and scalable, allowing primary care practices of all sizes to benefit from top-tier RCM without one-size-fits-all compromises.

Dedicated Support: Each client receives proactive account management, ongoing process reviews, and rapid response for all billing inquiries.

Specialized Primary Care Expertise

Primary Care Focus: MediClarus understands the nuanced billing, coding, and payer challenges unique to primary care. Dedicated specialists optimize workflows specifically for primary care environments.

Patient Engagement Solutions: Tools such as digital statements, reminders, and flexible payment options improve patient satisfaction and increase patient-responsible collections.

Data Transparency & Real-Time Insights

Custom Dashboards: Clients enjoy real-time dashboards that present actionable revenue cycle metrics, keeping physicians and administrators informed and empowered.

Scheduled Reporting: Transparent, easy-to-read reports highlight financial performance and pinpoint areas for improvement.

Proactive Denial Prevention

Robust Coding Audits: Systematic chart audits and compliance reviews ensure correct coding, reduce costly errors, and minimize risk of payer denials.

Root-Cause Analysis: Continuous denial tracking and data analytics identify patterns, enabling process improvements and a sustained decrease in denial rates.

Superior Financial Performance

Faster Collections: Accelerated workflows and ongoing payer follow-up result in industry-leading low Days in Accounts Receivable (A/R), improving cash flow and financial predictability for primary care practices.

High Collection Rates: Aggressive underpayment tracking, efficient appeals, and enhanced patient financial engagement yield higher net and patient collection rates than industry averages.

How MediClarus Delivers Value

Partner With MediClarus

Let MediClarus help your primary care practice thrive with industry-leading revenue cycle performance and support tailored to your needs. Contact us for a consultation and discover how we can optimize your financial health.

Why Choose MediClarus for Primary Care RCM?

Why Primary Care RCM Is Critical

Primary care practices face unique operational and reimbursement challenges. Timely billing, accurate coding, and proactive denial management directly impact their ability to provide high-quality care. With a dedicated RCM partner, primary care providers can reduce administrative burden, optimize collections, and focus more on patient care.