Revenue Cycle Management

Every claim.
Every dollar.
Recovered.

Bay RCM handles end-to-end revenue cycle management for clinics and health systems — certified billers, clean claims, and structured follow-up that keeps your practice financially healthy.

End-to-end
Billing, coding & follow-up
BAA-ready
HIPAA-conscious workflows
Specialty-trained
ICD-10 & CPT expertise
No lock-in
Month-to-month engagements
How we work
HIPAA-conscious workflows
BAA available on request
ICD-10 & CPT trained team
Transparent reporting
Month-to-month, no lock-in
What We Do

A complete RCM platform
built for modern practices

From eligibility verification to denial management — every touchpoint optimized to maximize reimbursement.

Medical Billing & Coding

Certified coders with specialty-specific expertise review every encounter — accurate ICD-10, CPT, and HCPCS assignment, every time, before a claim leaves your practice.

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Eligibility Verification

Real-time insurance eligibility checks before every appointment — eliminating front-end claim denials at the source.

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Denial Management

Systematic denial tracking, root-cause analysis, and appeals workflows that recover revenue that would otherwise be written off.

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AR Follow-Up

Proactive accounts receivable management with aging-bucket prioritization and payer-specific escalation playbooks.

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Analytics & Reporting

Custom KPI dashboards, payer mix analysis, and monthly executive reports to guide strategic financial decisions.

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Prior Authorization

Structured PA submission and status tracking across all major payers — reducing treatment delays and keeping your schedule moving without administrative bottlenecks.

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The Process

Precision at
every touchpoint

Our workflow is engineered to catch issues before they become denials.

01
Onboarding & EHR Integration

We connect seamlessly to your EHR — eClinicalWorks, Athena, Kareo, and 40+ others — typically live within 5 business days.

02
Eligibility & Pre-Authorization

Automated real-time checks run before every appointment, surfacing coverage issues while there's still time to resolve them.

03
Coding Review & Claim Submission

Certified coders review every encounter for accuracy and completeness before submission. Claims leave your practice clean and compliant.

04
Payment Posting & Reconciliation

ERA/EOB auto-posting with variance analysis flags under-payments and contractual discrepancies automatically.

05
Denials & AR Recovery

Every denial gets a root cause, a correction, and an appeal. Nothing ages off unchallenged.

Typical Client Performance
First-Pass Resolution Rate
96%
↑ 4.2%
Avg. Days in AR
18d
↓ 11d
Net Collection Rate
99.1%
↑ 2.7%
Denial Rate
1.9%
Industry: 9%
Monthly Revenue Trend
Specialties

Billing expertise across
every specialty

Deep payer and coding knowledge for the specialties that matter most to your practice.

🫀
Cardiology
120+ CPT codes
🧠
Neurology
EEG, EMG, NCS
🦴
Orthopedics
Surgery & PT billing
🔬
Oncology
Chemo & infusion
👁️
Ophthalmology
Surgical & routine
🩺
Primary Care
E&M optimization
🧬
Dermatology
Procedure & path
🏥
Urgent Care
High-volume billing
The Standard

The benchmarks that
define good RCM

These are published industry benchmarks — what well-run RCM operations consistently achieve. They're the targets we build every engagement around.

Sources: MGMA, HFMA, CMS published data

Industry benchmark
>95%
Clean Claim Rate
Top-performing billing operations submit over 95% of claims clean on first pass. The national average is closer to 75% — the gap is almost always coding and eligibility errors caught too late.
Industry benchmark
<30d
Days in AR
MGMA benchmarks healthy AR at under 30 days. Practices with aging AR above 50 days are typically losing revenue to timely filing limits and payer inaction.
Industry benchmark
<5%
Denial Rate
HFMA benchmarks an acceptable denial rate below 5%. The national average sits at 9% — and most of those denials are preventable with the right front-end process.
Our commitment
We build your engagement around these benchmarks — and we show you the numbers every month.
No hiding behind averages. Every client receives a monthly report with clean claim rate, denial rate, days in AR, and collection rate — benchmarked against industry standards so you always know where you stand.
Monthly KPI report, every client
Denial root-cause breakdown
AR aging by payer, every month
Benchmarked against MGMA & HFMA
Pricing

Pricing built around
your practice

Every practice is different — specialty mix, payer contracts, claim volume, and denial complexity all factor into what the right engagement looks like. We don't publish one-size-fits-all rates because they rarely serve anyone well.

In a 20-minute call, we'll learn about your practice and put together a straightforward proposal — what we'll do, what it costs, and what you can expect.

Performance-based structure
Our fee is tied to what we collect for you — not a flat monthly retainer. We succeed when you do.
No long-term lock-in
Month-to-month agreements. We keep your business by delivering results, not by making it hard to leave.
Full-service, not piecemeal
Billing, coding, denials, AR, and reporting are all included. No tiered feature gates or surprise add-on fees.
Free Revenue Assessment

Find out what
you're leaving behind

We audit your last 90 days of claims at no cost. Most practices discover 6–18% in recoverable revenue.