RCM (Revenue Cycle Management)

Do your own billing, or hand it to us

Revenue cycle management is the process of tracking revenue from the first appointment through to the final payment of any balance remaining after insurance. It is complex work, and medical billing is getting more complicated rather than less — particularly with an ever-expanding ICD code set and payer rules that change without much warning.

NovoClinical is sold two ways. Some practices take the EMR and run billing with their own team, using the tools in the system. Others take the EMR and hand the revenue cycle to us. The software is the same either way — the difference is who does the work.

Your billing company usually cannot see your chart. Ours works inside it.

This is the part that makes outsourced billing frustrating. A conventional billing company sits outside your EHR. They receive a superbill or an export, they cannot see the note, and every question about documentation becomes an email to your front desk. Days pass. The claim ages.

Because our team works in the same system your clinic works in, they can see the documentation behind a charge, the eligibility check that ran before the visit, and the history of how that payer has behaved. Nothing is exported, re-keyed or waiting in someone’s inbox.

What we take on

Charge review and coding accuracy, claim submission and clearinghouse management, remittance posting, denial management and appeals, secondary and tertiary claims, patient statements, and accounts receivable management on the insurance side. Coding is maintained against current ICD and CPT rules and payer rule sets, because optimal coding is what produces clean claims — and clean claims are what produce revenue.

It is worth being clear about the boundaries as well. We send patient statements, but we do not run a phone collections operation chasing patient balances. We do not handle provider credentialing, and we do not manage prior authorizations — those stay with your practice. Most practices would rather know that in the first conversation than discover it in month two.

You keep the visibility

Outsourcing the work should not mean losing sight of it. Because everything runs in your system, you see the same aging reports, income summaries, denial patterns and collections performance we do — live, not in a monthly PDF. You can look at any claim, any payment and any denial yourself, whenever you want.

There is an AI assistant available alongside the claim itself: you can ask questions about a specific claim and its remittance in plain language and get an answer drawn from that claim’s own data. It is useful when you are trying to work out why a payer paid what they paid, without reading a remittance file line by line.

Which one is right for your practice

If you have an experienced biller and want better tools, take the EMR and keep the work in-house. If you are spending your own evenings chasing claims, or you have lost a biller and cannot replace them, the RCM service exists for exactly that. Practices move between the two as they grow, and the transition does not involve changing systems — because it is the same system either way.