heillerRevenue Cycle Management

Foundation of the
new digital epoch

Designing products, powering ecosystems and laying the foundation of a decentralized web for enterprises, builders and communities alike.

Contact Us
01 — The leak

No single catastrophic event costs a practice its margin. It goes a claim at a time — a missing modifier, an expired authorisation, an appeal window that closed on a Friday. By the time it shows up in a monthly report, the money is already unrecoverable.

The problem: revenue leakage in the healthcare revenue cycle

  • 12%

    of claims are denied on first pass

    Industry average across commercial payers

  • 65%

    of denials are never reworked

    Because the appeal costs more than the claim

  • $118B

    lost annually to administrative waste

    US healthcare, billing and insurance-related costs

Figures are illustrative industry benchmarks shown for context. Replace with cited sources before publishing.

02 — Complexity

Why healthcare revenue cycles are complex

  1. Payer rules that move

    Every payer publishes its own edits, modifiers and medical-necessity policies — and revises them quarterly. Your billers are chasing a moving target.

  2. Documentation drift

    A note written for the clinician and a note written for the payer are not the same artefact. The gap between them is where revenue quietly disappears.

  3. Eligibility that expires

    Coverage verified on Monday is not coverage on Thursday. Front-desk errors surface 45 days later as a denial nobody owns.

  4. Handoffs without memory

    Registration, coding, billing and collections each hold one fragment of the truth. No single system remembers the whole claim.

03 — Automation

Take one function or take the whole cycle. Either way you get the same operating model: measured handoffs, a named owner for every claim, and a feedback loop that pushes every failure back to the step that caused it.

Revenue cycle management services

  • Medical Coding

    AAPC- and AHIMA-credentialed coders working your specialty, with a second-pass audit on every high-value encounter.

    ICD-10 · CPT · HCPCS

  • Charge Entry

    Same-day capture with automated charge reconciliation against the schedule, so nothing rendered goes unbilled.

    24h turnaround

  • Eligibility Verification

    Real-time benefit checks and prior-authorisation tracking before the patient is roomed, not after the claim is denied.

    Pre-visit, every visit

  • Claim Submission

    Payer-specific scrubbing against a live edit library, with electronic submission and acknowledgement reconciliation.

    Clean-claim first pass

  • Denial Management

    Root-cause coding of every denial, appeals filed inside payer windows, and a feedback loop back into the front end.

    Appeal + prevent

  • A/R Follow-Up

    Aged receivables worked by dollar-weighted priority rather than by date, so the recoverable balance moves first.

    Value-ranked queues

  • Payment Posting

    ERA and manual posting with contractual-allowance validation — underpayments are flagged, not absorbed.

    ERA + EOB reconciled

  • Credentialing

    Enrolment, re-validation and CAQH upkeep managed on a calendar, so a lapsed credential never freezes a provider.

    Zero-lapse tracking

  • Revenue Analytics

    A live view of yield by payer, provider and CPT — with the variance explained, not just plotted.

    Daily refresh
04 — Workflow

Every claim carries its full history from registration to reconciliation. When something fails, the cause is already attached to it.

The heiller revenue cycle workflow

  1. Patient

    Day 0

    Demographics and coverage captured once, validated at the source, and carried forward without re-keying.

  2. Verification

    Day 0

    Benefits, deductibles and authorisation requirements confirmed against the payer before the encounter.

  3. Coding

    Day 1

    Documentation abstracted to ICD-10, CPT and HCPCS, with specificity and modifier logic reviewed by a second coder.

  4. Claim Submission

    Day 1–2

    Scrubbed against payer-specific edits, submitted electronically, and reconciled against the 277 acknowledgement.

  5. Insurance Processing

    Day 3–21

    Claim status polled through adjudication. Silence is treated as a signal, not as progress.

  6. Payment Posting

    Day 21–30

    Remittances posted line-by-line, with every allowance checked against the contracted rate.

  7. Reporting

    Continuous

    Yield, denial reason and A/R ageing surfaced by payer, provider and procedure — refreshed daily.

  8. Optimisation

    Continuous

    Every denial reason routed back to the step that caused it. The cycle gets measurably tighter each quarter.

05 — Security

Every control below is verifiable, not asserted. If your compliance officer wants the evidence, we hand over the artefacts — policies, logs, attestations and the last penetration test.

Security and compliance

  • Encryption

    AES-256 at rest, TLS 1.3 in transit. Keys rotated on a fixed schedule and never co-located with the data they protect.

  • HIPAA Compliance

    Executed BAAs, an annually reviewed Security Risk Analysis, and a documented breach-notification runbook.

  • Audit Trails

    Every read and write against PHI is written to an append-only ledger with actor, purpose and timestamp.

  • Secure Cloud

    Isolated tenancy, private networking, and infrastructure defined in code so drift is impossible to introduce quietly.

  • Access Control

    Role-based, least-privilege access with mandatory MFA and quarterly entitlement reviews.

  • Continuity

    Point-in-time recovery, geographically separated replicas, and restore drills that are actually run.

See every control, attestation and subprocessor
06 — Revenue & analytics

Yield by payer, provider and procedure — refreshed daily, with the reason attached. A dashboard that only shows you the shape of a problem has moved the problem, not solved it.

Revenue optimisation and analytics results

  • Clean claim rate

    98.4%

    +6.2 pts

    First-pass acceptance across managed payers

  • Denial rate

    3.1%

    −41%

    Reduction within two quarters of onboarding

  • Days in A/R

    21

    −17 days

    Median across the active book of business

  • Net collection rate

    97.2%

    +9.4 pts

    Collected against contractually allowed amount

Collections vs denials

Net collectionsDenial rate

Denials by root cause

Reasons routed back upstream, last 90 days

  • Elig.
  • Auth
  • Code
  • Doc.
  • Timely
  • Other

Figures shown are placeholders. Replace with audited client outcomes before publishing.

Interactive

Turn it over.

Every figure your team acts on, in one surface. Drag to look at it from another angle — which is roughly what we do to a revenue cycle before we touch it.

Drag the dashboard to rotate it.

Selected clients

Northline Health
Cedarpoint Medical
Vantage Care Group
Arbor Physicians
Meridian Clinics
Halcyon Health
07 — Trust

Client testimonials and compliance credentials
  • We had three people doing nothing but reworking denials. Six months in, that queue is a report nobody has to open — and our A/R is the shortest it has been in a decade.
    Dr. Anita RaghavanManaging Partner · Meridian Clinics
  • What changed was not the collections work. It was that every denial finally had a cause attached to it, and the cause got fixed upstream.
    Marcus BellVP, Revenue Operations · Northline Health
  • Our credentialing used to be a spreadsheet and a prayer. Now a lapse is impossible to reach — it gets flagged ninety days out.
    Priya DesaiPractice Administrator · Arbor Physicians
HIPAACompliantSOC 2Type IIHITRUSTAlignedISO 27001Aligned
More about who we are and how we work

Client names and testimonials shown are placeholders for layout purposes. Replace with permissioned, attributable references before launch.

08 — Start here

Request a free revenue audit

A free revenue audit. We review 90 days of claims, quantify the leakage by root cause, and hand you the findings — whether or not you work with us.

No PHI in this form, please. We reply within one business day.

Or reach us directly

If it is easier to talk it through, we are happy to. No deck, no discovery call script.

Mon–Fri · 09:00–19:00 IST