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SERVICES
HOW IT FITS TOGETHER
CORE RCM SERVICES
Insurance Enrollment
We help providers and facilities become and remain in-network with local and national payers, including Medicaid, Medicare, commercial plans, and supplemental health plans. For out-of-network billing, we verify assignment of benefits (AOB) requirements and help ensure your organization is properly positioned for reimbursement.
We also proactively manage re-credentialing to prevent enrollment lapses and revenue disruptions.
Included with RCM Agreement: CAQH & PDMS maintenance, contract negotiation, and re-credentialing.
Fee-for-Service: Provider enrollment, payer applications, contracting, and ongoing payer follow-up to help expedite approvals and keep applications moving through the enrollment process.
Onboarding & Implementation
Our onboarding process establishes payer relationships, configures EFT and clearinghouse connections, enrolls your organization in payer portals, and builds billing workflows tailored to your operations.
Whether through EHR integration, charge capture tools, or customized census tracking, we create a streamlined and compliant revenue cycle designed around your practice or facility.
Included with RCM Agreement: Full Revenue Cycle Configuration & Onboarding.
Verification of Benefits (VOB)
Every new patient and re-admission is verified before services begin. Copays, deductibles, authorization requirements, level-of-care criteria, session limits, and covered services are reviewed to identify issues before they become denials.
Included with RCM Agreement: Real-time eligibility verification, benefit summaries, prior authorization support, and authorization tracking throughout the patient’s episode of care.
Fee-for-Service: Verification of Benefits services are available for practices and facilities without an RCM agreement.
Revenue Integrity
ERAs and EOBs are posted and reconciled daily. We verify payments against contracted rates, identify underpayments, and pursue discrepancies to ensure your organization receives every dollar it has earned.
Includes: ERA/EOB posting, contractual adjustment review, underpayment recovery, and deposit reconciliation.
Revenue Recovery
Every denial is categorized, investigated, and worked. We file timely appeals, identify root causes, and implement corrective actions to reduce recurring denials and recover lost revenue.
Includes: Denial analysis, appeals filing, payer escalation, root-cause reporting, and denial prevention.
Aging Claims Management
Every aging claim is actively worked. Our team follows up on unpaid claims, resolves payer delays, and pursues reimbursement long after most organizations have written the balance off.
Includes: Daily A/R worklists, payer calls, claim status reviews, and aging analysis.
Patient Financial Services
Patient statements are delivered on a consistent cadence through an integrated payment platform. We manage patient balances with professionalism and sensitivity while providing secure payment options and responsive support.
Includes: Statements, patient portal, payment plans, payment processing, and patient support.
Revenue Reporting
Subheading: Financial Performance Analytics
Meaningful reporting goes beyond spreadsheets. We provide actionable insights into collections, A/R aging, denial trends, payer performance, and operational metrics to support informed decision-making.
Includes: Monthly reporting, KPI dashboards, review meetings, and ad-hoc reporting.
Prior Authorization & Continued Stay
Our utilization review clinicians advocate for patients at every level of care. From initial authorizations to continued stay reviews, we work to maximize treatment access, support appropriate lengths of stay, and reduce barriers to care.
Included with RCM Agreement: Prior authorizations, concurrent reviews, authorization management, retro-authorizations, single case agreements, appeals support, and clinical documentation guidance.
Audit Preparation & Documentation Review
Strong documentation protects both patient care and reimbursement. Our team reviews medical records for compliance, prepares organizations for payer audits, and identifies documentation gaps before they become financial risks.
Included with RCM Agreement: Audit preparation, chart review, compliance monitoring, documentation support, and clinical charting education.
Fee-for-Service: Audit preparation and clinical documentation training are available as standalone ancillary services for organizations without an RCM Agreement. Contact us to learn more.
CORE RCM SERVICES
Revenue cycle management is more than medical billing. We support the operational systems that drive reimbursement, from credentialing and contracting to eligibility verification, utilization review, claims management, patient billing, compliance, reporting, and revenue recovery.
EHR PLATFORMS
Simple Practice
A popular choice for solo providers and group practices. SimplePractice makes it easy to manage scheduling, documentation, telehealth, and patient communication while our team manages the revenue cycle.
Therapy Notes
Designed specifically for behavioral health, TherapyNotes provides robust documentation, scheduling, and practice management tools that support clinicians and administrative teams alike.
Kareo / Tebra
Continue using Tebra for scheduling, documentation, and patient management while Access Revenue Hawaii manages the billing and revenue cycle process independently. No need for the expensive billing fees Tebra charges you can leave the clunky billing hardware behind!
Other EHRs & EMR Systems
Don't see your platform listed? We work with a wide range of behavioral health EHRs and EMRs. Even when direct integration is unavailable, we can typically develop a workflow that keeps your revenue cycle running smoothly.
Upheal, Partice Q, and Other EHR
Newer behavioral health platforms often provide modern workflows and open integration capabilities. Many can connect to our revenue cycle software through third-party integration tools, allowing you to keep the software you love while streamlining billing operations if you want to. Simple 3rd-party integration tools like Morf make this possible, but aren't necessary.
FAQs
In most cases, yes. We support direct integrations with many behavioral health EHR and practice management systems and can provide alternative workflows when integration is not available.
No. We can often work within your existing workflows and software. During onboarding, we evaluate your current systems and recommend the most efficient billing process for your organization.
Yes. We provide standalone credentialing and contracting services as well as credentialing support for our full-service billing clients. Services include provider enrollment, recredentialing, CAQH management, PDMS management, and payer contracting.
Yes. We support authorization workflows, concurrent reviews, continued stay reviews, and utilization review activities for many behavioral health programs and levels of care.
Our team proactively reviews aging claims and accounts receivable on a recurring basis. Claims that exceed normal payer processing timelines are investigated and followed up on to accelerate reimbursement and reduce revenue leakage.
Each client is assigned a dedicated point of contact and receives regular reporting, operational updates, and access to our team for billing, payer, credentialing, and revenue cycle support.
Our Comprehensive Revenue Cycle Management Services Include:
From patient intake to final reimbursement, we manage every stage of the revenue cycle to help
Absolutely. Denial management and appeals are included in our revenue cycle management services. Our team investigates denials, gathers supporting documentation, submits appeals, and works to recover revenue whenever possible.
Yes. We provide patient billing, collections support, payment processing, and integrated patient payment tools. We accept inbound patient billing calls and perform outbound follow-up regarding balances, payment methods, eligibility, benefits, and financial responsibility.
Both options are available. Our team can serve as an extension of your practice by handling patient billing inquiries directly while keeping your staff informed and involved as needed.
We proudly support organizations of all sizes, including:
We work with a broad range of commercial, Medicare, Medicaid, TRICARE, VA, and managed care plans. Our team has extensive experience with Hawaii payers and national payer networks. If your facility or practice wants to accept a health plan, then we will work with them!
Yes. Behavioral health is our sole specialty. We support mental health, substance use disorder, eating disorder, psychiatric, IOP, PHP, residential, inpatient, outpatient, CIS, and medical/psychiatric respite providers. Our workflows, payer expertise, and compliance programs are built specifically for behavioral healthcare.
Yes. We support organizations ranging from solo practitioners to large multi-site behavioral health facilities, including outpatient clinics, treatment centers, hospitals, and specialty programs.