Claims that get paid, and a report that shows why they didn't.
Telehealth revenue cycle management is where insurance programs quietly lose 10% or more in year one. We run virtual care RCM every week, report it every month, and carry claims risk while you bill under our PC.
The unglamorous half of insurance revenue
Most of RCM is not clever. It is done every week or it is not done. We do it every week.
- Coding review against charting standards that survive an audit
- Claim submission under the right entity, automatically, as volume migrates
- Denial management and appeals, with reasons tracked by payer
- AR worked by aging bucket and by payer, not by whoever is loudest
- Monthly report: clean-claim rate, denial rate, days to pay, by payer
Documentation that holds up
Time-based codes
Start and stop times, total minutes, and the service description that matches the code billed. Templates per EHR.
Supervision and incident-to
Which clinician can bill what, under whom, in which state. The rules differ and the audits find the gaps.
Medical necessity
Diagnosis, plan, progress, and the link between them. The three flags auditors look for and how to chart past them.
Questions, answered
Who carries claims risk during the rental phase?
Anvil. Claims are billed under our PC. If a claim is denied and not recoverable, that is our problem, not yours. It is also why we care about coding and charting standards on day one.
What denial rate should we expect?
First-year in-house programs commonly run 10% or more. Mature programs run around 5%. We report clean-claim and denial rates monthly by payer so you can see where you are.
Do you handle patient responsibility?
We calculate it and can collect it through your existing payment processor. Statements and reminders are configurable. No PHI crosses this website.
Which specialties do you code for?
Behavioral health in depth (psychotherapy, psychiatry, ABA, IOP and PHP, collaborative care), plus primary care and the E/M and chronic care codes most virtual care companies bill. Interventional psychiatry, in-home care, and school-based programs as well.
What do we see?
Collections by entity, payer, state, clinician, and code. Contracted rate and platform fee separated. AR aging by payer. Denials by reason. Exports and a reporting API.
See what a clean claim looks like on your codes.
Send us your top ten codes and payers. We will tell you what we would flag before the first claim goes out.