Healthcare BPO (Medical Billing, RCM) that Stays Compliant & Accurate
HIPAA-compliant medical billing, revenue cycle management, and claims processing. Specialist BPO support built for the precision healthcare demands.
Proven Performance Metrics
Why Healthcare BPO Matters Now
The Old Way
Without dedicated RCM support
The Intelegencia Way
With Intelegencia
How We Run Revenue Cycle
Three tightly coordinated disciplines cover every dollar from the point of care to final payment. Each discipline runs on documented payer rules, certified expertise, and daily scrubbing routines, so nothing slips between the billing and collections handoff.
Charge Capture & Coding
Accurate charge entry and specialty-matched coding before a single claim leaves your practice.
- ICD-10 and CPT coding by credentialed coders
- Modifier review to prevent under- and overbilling
- Daily charge reconciliation against encounter data
- Coding audit sampling for continuous accuracy checks
Claims & Denials
Clean claims submitted on time and denied claims worked within payer-required appeal windows.
- Payer-rule scrubbing before submission
- Electronic and paper claim routing by payer
- Denial categorization and root-cause tracking
- Appeal letter generation with supporting documentation
Patient Collections
Respectful, compliant patient balance follow-up that protects the care relationship while recovering revenue.
- Statement generation and mailing cadence
- Payment plan setup and tracking
- FDCPA-compliant outreach across phone and portal
- Balance write-off workflow with supervisor approval
Revenue Cycle, End to End
We manage every step of your revenue cycle, from charge capture and ICD-10/CPT coding through electronic claims submission, denial appeals, and patient balance collection. When a claim is denied, our team categorizes the root cause, drafts the appeal, and resubmits within the payer's window, so revenue you have already earned does not sit in an aging bucket.
HIPAA-Compliant by Design
Every claim passes through a payer-rule scrubbing routine before submission, catching modifier mismatches, missing authorizations, and eligibility gaps that would otherwise trigger a denial. Coders are credentialed for your specific specialties, and all workflows run inside HIPAA-aligned, access-controlled environments with audit logging, so your practice stays compliant without adding internal oversight burden.
Driving Measurable Business Outcomes
Explore the specialized capabilities within this service, each engineered to deliver measurable business outcomes at enterprise scale.
Eliminate denials at the source. Our AAPC-certified coders pair ICD-10 and CPT precision with AI-driven claim scrubbing, catching errors before submission so reimbursements land on the first pass and your revenue cycle stops leaking.
Your RCM Onboarding Roadmap
A structured four-stage onboarding designed to protect revenue continuity from day one. Each stage has defined hand-off criteria so you are never in a gap between your old process and ours.
- 01
Discovery & Access
We map your payer contracts, fee schedules, EHR setup, and current denial trends before touching a single claim.
- 02
Configuration & Training
We configure workflows inside your PM/EHR system and train our team on your specialty, payers, and charge-entry rules.
- 03
Parallel Run
We process a live claim cohort alongside your existing team to validate accuracy and resolve edge cases before full transfer.
- 04
Full Handoff
Your practice billing shifts fully to our team. Weekly AR reviews and a shared dashboard keep your team informed throughout.
The RCM Delivery Operating Model
Four operational disciplines that govern how every account is run, month in and month out. These are not project phases but standing functions that keep your revenue cycle accurate, auditable, and compliant regardless of claim volume or payer mix.
Phase 01
Govern
PHI access controls, role-based permissions, and HIPAA-aligned policies established and documented for every team member.
Phase 02
Measure
Daily AR aging, clean-claim rate, denial rate, and collection rate tracked on a shared dashboard you can access anytime.
Phase 03
Resolve
Denials, underpayments, and payer discrepancies escalated and worked within contractual and appeal deadlines.
Phase 04
Improve
Monthly root-cause analysis turns recurring denial patterns into permanent upstream fixes in coding and charge entry.
Case Studies That Deliver the Real Story
Explore our case studies to see how we empower businesses by creating unique, cutting-edge solutions that drive growth, efficiency, and success.
Ready to see what
Intelegencia can do for your business?
Let's turn your toughest challenges into measurable outcomes. Talk to our team and discover how the right partnership can accelerate your next move.
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Frequently Asked Questions
About Healthcare BPO (Medical Billing, RCM)
Here you will find answers to questions we get asked the most about our offerings.
All team members complete annual HIPAA training and sign Business Associate Agreements before accessing any PHI. Data is handled in encrypted, access-controlled environments with role-based permissions, audit logging, and no local storage of PHI on personal devices. We conduct quarterly internal audits and can provide documentation for your compliance program on request.