With complete RCM from Bela Claim, every billing step after scheduling is handled and tracked by one team, and you receive reports on what was billed, paid, denied and still owed, on a schedule agreed during setup.
What a practice can expect: eligibility checked before visits, claims submitted after checks for missing information, payments and remittances posted, every denial worked with its reason recorded, unpaid claims followed up by age and payer, patient statements sent, and a report you can read in a few minutes.
This is how a claim moves through end-to-end RCM, and who owns each step. The steps and terms below describe U.S. billing, where payment advice arrives as an ERA (electronic remittance advice) or a paper EOB. Canadian provincial billing works differently; see physician billing support in Canada.
Before the visit we confirm active coverage, plan type, copay or deductible status, and whether the service needs a referral or prior authorization. Problems go to your front desk while the patient can still fix them.
Bela Claim checks · your front desk collects copays and updated insurance cardsOnce your provider has documented and coded the visit, we check the claim for missing or mismatched details (patient demographics, subscriber ID, rendering and billing provider, place of service, diagnosis pointers) and submit it through your clearinghouse.
Your providers document and code · Bela Claim reviews and submitsClaims that fail clearinghouse or payer edits are corrected and resubmitted, and the cause is noted so the same error does not repeat.
Bela ClaimWe post payments and adjustments from ERAs and EOBs, match deposits, move patient responsibility to the patient balance, and flag payments below the expected amount.
Bela Claim posts · your practice confirms bank deposits if neededEvery denial is read, categorized by reason and worked: corrected claim, missing information sent, or an appeal prepared for your review when documentation supports it.
Bela Claim works the denial · your provider supplies records or signs appealsUnpaid claims are followed up by age and dollar value. We check status on payer portals or by phone, act on what we learn, and set the next follow-up date on the account.
Bela ClaimAfter insurance has paid, remaining patient balances go out on statements on a regular cycle that you approve, with questions routed the way you prefer.
Bela Claim prepares · your practice sets the collection policyYou receive regular reports and a short list of decisions only the practice can make, such as write-offs or recurring documentation gaps.
Bela Claim reports · your practice decidesThese are illustrative examples of the kind of work involved, not client case studies.
No payment after 30 days. The payer acknowledged the claim but nothing has posted. A status check shows it is pended for medical records. We send the records, note the reference number and set a follow-up date, instead of resubmitting a duplicate that would be denied.
Denied for missing information. The remittance shows the claim lacked information needed to process it, such as a referring provider. We add the missing detail, send a corrected claim and record the cause so new claims for that payer include it.
A pattern, not a one-off. The monthly report shows several authorization denials from one payer for the same service. Rather than appealing each one, we raise it with the practice so the front desk can request authorizations before the visit.
A report should answer three questions quickly: what came in, what is stuck and what you need to decide. Reports are agreed during setup and typically include:
Choosing between this and lighter support? Compare all three service models. Specialty-specific issues are covered on the primary care and mental health pages.
End-to-end revenue cycle management (RCM) means one partner handles every billing step after the patient is scheduled: eligibility and benefits verification, claim submission, payment posting, denial management, accounts receivable follow-up, patient statements and reporting. Clinical documentation and front-desk check-in stay with the practice.
A rejection is a claim that fails clearinghouse or payer edits before it is processed, often because of a format or data error such as a wrong member ID. It is corrected and resubmitted. A denial is a processed claim the payer has refused to pay, and it needs a corrected claim, more information or an appeal.
The reporting schedule is agreed during setup, for example weekly or monthly. Reports cover claims submitted, payments posted, denials by reason, AR by age and payer, and items that need a decision from the practice.
We discuss your current practice management system, EHR and clearinghouse in the consultation and confirm how access would work before recommending a start. The goal is to work within your setup rather than make you migrate.
In a free 30-minute consultation we walk through each step above with your actual workflow and show where a partner would take over and where your team stays in control.