ClainetRCM is an outsourced medical billing company serving physicians, dental practices, clinics and group practices in all 50 states. We handle medical and dental billing, coding, provider credentialing, hospital privileging, denial management and AR follow-up, starting at just 2.29% of monthly collections. AAPC/AHIMA certified coders. HIPAA compliant with a signed BAA. No setup fee and no long-term contract.
Works seamlessly with all major EHR & EMR platforms
ClainetRCM provides end-to-end revenue cycle management for physicians, dental practices, group practices, hospitals and healthcare organizations across the United States, from medical and dental coding through claim submission, denial appeals, provider credentialing and hospital privileging. Certified billing specialists and coders work to maximize your reimbursements, reduce claim denials, and keep your practice financially healthy.
Fast, accurate provider credentialing and payer enrollment for physicians and healthcare organizations. We manage the entire credentialing process including CAQH profiles, insurance enrollments, and re-credentialing so your practice gets paid from day one without delays.
Learn MoreReal-time insurance eligibility verification before every patient visit. We eliminate coverage surprises, reduce patient balance write-offs, and improve upfront collections by confirming deductibles, co-pays, and prior authorization requirements in advance.
Learn MoreOur dedicated authorization specialists handle all prior auth requests, payer follow-ups, and appeals. We prevent treatment delays, reduce authorization-related denials, and ensure your clinical team can focus on patient care without administrative disruption.
Learn MoreAAPC and AHIMA certified medical coders providing accurate ICD-10-CM, CPT, and HCPCS coding across all specialties. Precise medical coding maximizes claim approval rates, ensures audit compliance, and directly improves your reimbursement levels.
Learn MoreLive and asynchronous medical scribing that takes clinical documentation off the provider's plate. Our trained scribes capture notes in real time so charts are closed the same day instead of at 9pm, and providers spend their attention on the patient in front of them rather than the keyboard.
Learn MoreFull-service medical billing starting at just 2.29% of collections. Our billing experts submit clean claims electronically, track payments, post EOBs, manage patient statements, and follow up on unpaid claims, ensuring maximum reimbursement with minimal delay.
Learn MoreAggressive AR management to recover outstanding balances efficiently. We analyze aging reports, prioritize high-value claims, and implement targeted follow-up strategies that consistently reduce your days in AR and accelerate cash flow for your practice.
Learn MoreWe work every denial rather than just the easy ones. Specialists identify the root cause, correct the coding, file the appeal with the documentation the payer actually requires, and then fix the upstream process so the same denial stops recurring.
Learn MoreStrategic practice management covering workflow optimization, payer contract analysis, fee schedule benchmarking, and operational efficiency improvements. We help healthcare practices run more profitably with less overhead and a better patient experience.
Learn MoreComplete end-to-end revenue cycle management from patient registration and eligibility verification through medical coding, billing, payment posting, denial management, and detailed financial reporting. One trusted RCM partner. Measurably better financial outcomes.
Learn MoreHighly trained healthcare virtual assistants who handle front-desk tasks, insurance calls, prior auth follow-ups, and patient inquiries. Reduce overhead costs while maintaining a professional, responsive experience for every patient and insurance representative.
Learn MoreEfficient patient scheduling services that minimize no-shows, reduce appointment gaps, and improve patient access to care. Our team manages inbound calls, online booking, reminders, and cancellations, keeping your practice running at maximum capacity.
Learn MoreState medical licensure, DEA and state controlled substance registrations, and multi-state licensing for telehealth. We prepare each board application, follow the primary source verifications through, and keep every license, DEA and CSR renewal on a tracked calendar so nothing lapses.
Learn MoreEntity formation, EIN, organizational NPI, CLIA and state facility registrations, and Medicare or Medicaid group enrollment. We file them in the sequence each one depends on, so your payer enrollment is never held up by a missing or mismatched identifier.
Learn MoreOutsourced dental billing for general dentists, DSOs, orthodontic and oral surgery practices. We post to your PMS, bill CDT codes correctly, handle medical cross-coding for surgical and sleep-apnea cases, chase insurance aging, and work the narratives and attachments dental payers demand before they will pay a claim.
Learn MoreWe prepare and submit your providers' privileging applications to hospitals, surgery centers and telehealth facilities, for both initial appointment and reappointment. We compile the packet, chase the primary source verifications and peer references the hospital asks for, complete the delineation of privileges request, and follow the file through the medical staff office and credentials committee until privileges are granted.
Learn MoreHealthcare providers who partner with ClainetRCM consistently see faster payments, fewer denials, lower overhead costs, and significantly more time to focus on delivering exceptional patient care.
ClainetRCM submits clean insurance claims electronically within 24-48 hours of receiving your encounter data. Every claim is scrubbed before submission, and our proactive follow-up keeps payers moving so your days in AR come down and cash flow steadies. AR is reviewed every 14 days, so nothing sits and ages unnoticed.
The national average denial rate runs 15-25%. We work to keep yours well below it: every claim is scrubbed before submission, coded by AAPC/AHIMA certified staff, checked against real-time eligibility, and measured against continuous monitoring of payer policy changes across all major insurance carriers. Denials are worked, not written off.
Consistent collections give your practice the financial stability to grow, invest in new staff, and improve care delivery. Our structured billing cycle eliminates payment unpredictability, enabling smarter financial planning, better staffing decisions, and sustainable long-term practice expansion.
Billing tasks, prior authorization requests and denial follow-ups stop landing on your desk and your front-desk staff's. How many hours that gives back depends on your volume and how much of it you are absorbing today. Our free audit will tell you what it is actually costing you now.
Every claim processed by ClainetRCM adheres to strict HIPAA, CMS, and payer-specific compliance requirements. We conduct regular compliance audits, maintain current AAPC/AHIMA coder certifications, and use encrypted, secure data systems to protect your practice from costly violations and patient data breaches.
Maintaining an in-house billing department costs the average practice $50,000 - $100,000+ annually in salaries, benefits, training, software, and office overhead. ClainetRCM delivers superior billing performance at a fraction of that cost, starting at just 2.29% of collections with no contracts and no hidden fees.
No three-month transition, no parallel billing for a quarter. We run a defined sequence, you approve each stage, and your existing AR keeps getting worked the whole time.
Send us 90 days of remittance data. We return a line-by-line view of what was denied, underpaid, or never worked, and what is realistically recoverable.
We sign the BAA, agree the scope and rate, and get read access to your EHR or PM system. Nothing touches PHI before that paperwork is in place.
Your account manager is named, AAPC/AHIMA coders are matched to your specialty, and we map your charge capture, payer mix and documentation flow.
Claims start going out in 24-48 hours of charge capture. Your first AR review lands at day 14, with denial trends and a recovery plan for the legacy aging.
We're not just another billing company. ClainetRCM is a true revenue cycle partner built specifically for US healthcare providers who demand accuracy, full transparency, and measurable revenue growth.
A small, senior team of AAPC/AHIMA certified coders with hands-on experience in US medical billing, credentialing, and payer relations. You work directly with the people handling your claims, not a call queue.
Claims filed in 24-48 hours and tracked daily. AR is reviewed on a 14-day cycle so aging claims get worked while they are still collectible.
Complete HIPAA compliance with encrypted data transmission, multi-factor access controls, and regular third-party security audits protecting your practice and patients.
Every ClainetRCM client receives a named, dedicated account manager who knows your practice inside out, monitors performance metrics, and communicates proactively.
Access live dashboards showing claim status, collection rates, denial trends, and AR aging, full financial visibility into your revenue cycle at any time.
Unlike generalist outsourcing firms, ClainetRCM works exclusively with medical practices, giving us unmatched depth in clinical billing nuances and payer requirements.
Our billing specialists are available around the clock to address urgent claim issues, payer disputes, and time-sensitive authorization requests, day or night.
Cleaner claims, faster filing, and systematic denial follow-up. We will review your current collections and denial data and show you, line by line, where revenue is leaking before you sign anything.
We use cutting-edge practice management software, AI-assisted claim scrubbers, and automated eligibility tools to minimize errors and maximize first-pass acceptance rates.
From a solo practitioner billing $20K/month to a multi-location hospital network, our services scale seamlessly to your volume without compromising quality or accuracy.
We earn your business every single month. No lock-in contracts, no cancellation penalties, just consistent, measurable results that keep clients working with us long-term.
AAPC/AHIMA certified coders, a signed BAA before any PHI moves, every claim scrubbed before submission, and AR reviewed every 14 days. You get the reporting to verify all of it.
Every medical specialty carries unique billing complexities, distinct CPT codes, specialty-specific modifiers, payer policies, and authorization requirements that generalist billers consistently get wrong. ClainetRCM's specialty-trained billing teams are certified and experienced in their specific clinical fields.
Whether your practice focuses on cardiology, behavioral health, orthopedic surgery, or emergency medicine, our coders and billing specialists bring the deep specialty knowledge needed to maximize reimbursements and maintain full compliance with payer-specific billing guidelines.
Explore All SpecialtiesClainetRCM delivers customized medical billing and revenue cycle management solutions designed for the specific operational and financial needs of every type of US healthcare provider.
Comprehensive inpatient and outpatient RCM for multi-specialty hospitals, improving coding accuracy, reducing claim backlogs, and maximizing DRG-based reimbursements across all departments.
Learn moreTailored billing, credentialing, and virtual front-desk support that streamlines clinic operations, reduces administrative costs, and minimizes the claim denials that drain practice revenue.
Learn moreAffordable full-service billing for independent providers who need the expertise of a large billing team without the overhead, delivered at just 2.29% of monthly collections.
Learn moreScalable RCM for multi-provider group practices, including provider-level performance reporting, multi-location credentialing, payer contract analysis, and AR benchmarking.
Learn moreSpecialized lab billing with accurate CPT and HCPCS coding, ABN management, and payer-specific compliance protocols to maximize reimbursement for every diagnostic test ordered.
Learn moreHigh-volume urgent care billing with rapid claim turnaround, real-time insurance verification at check-in, and proactive AR management to keep collections moving efficiently.
Learn moreOverflow billing support, specialty-specific coding services, and RCM consulting for sister billing organizations looking to expand capacity or improve operational performance.
Learn moreSpecialized home health and hospice billing covering Medicare, Medicaid, and private payers with expertise in OASIS documentation, PDGM compliance, and hospice claim processing.
Learn moreClainetRCM is a virtual billing company, so we can serve healthcare providers in all 50 states with HIPAA-compliant medical billing and RCM. Our billing specialists work with state-specific Medicaid rules, regional payer networks, and local compliance requirements, giving providers a knowledgeable partner who understands their market.
Every client gets live visibility into the same numbers we work from. No monthly PDF that arrives three weeks late, no guessing which claims are stuck.
Still managing billing in-house? See why healthcare providers across the US are making the switch to ClainetRCM, and never looking back.
| Criteria | In-House Billing Team | ClainetRCM |
|---|---|---|
| Annual Cost | $50,000 - $100,000+ (salaries, benefits, software) | Starts at 2.29% of monthly collections |
| Claim Accuracy Rate | 75-85% (errors, gaps, staff turnover) | Every claim scrubbed and QA-reviewed before submission |
| Claim Submission Speed | 3-7 business days average | Filed within 24-48 hours of receiving encounter data |
| Denial Rate | 15-25% national average | Denials worked and appealed, AR reviewed every 14 days |
| Staff & Training Burden | Constant hiring, training & turnover | Certified billing team included, zero HR overhead |
| HIPAA Compliance | Requires active compliance management | Fully HIPAA-compliant by design |
| Specialty Coding Expertise | Limited to current staff knowledge | AAPC/AHIMA certified coders matched to your specialty |
| Reporting & Analytics | Manual, basic, time-delayed reports | Real-time dashboards and KPI reporting |
| Support Availability | Business hours only, Mon - Fri | 24/7 dedicated billing support |
| Scalability | Slow and costly to scale | Instantly scalable to your practice volume |
| Time to Launch | 3-6 months (hire, onboard, train) | Go-live in just 1-2 weeks |
| Free Practice Audit | Not available | Complimentary RCM analysis included |
The questions US practices ask us most often before they switch billing companies.
Talk to a certified medical billing specialist about your denial rate and your days in AR. The RCM analysis is free and carries no obligation: we review your current numbers and show you exactly where revenue is leaking. No setup fee, no long-term contract, onboarding in 7-14 business days.
