Running a clinic means juggling patient care with endless administrative tasks — and billing often falls behind. A healthy Revenue Cycle Management (RCM) process is the backbone of financial success, ensuring every claim is submitted accurately and paid on time.

The blog will explain the five must-have steps every clinic should follow:

1. Accurate Patient Registration & Eligibility Verification

   • Collect correct demographics and insurance data at the front desk.

   • Verify eligibility before service to avoid coverage denials.

   • Update insurance details regularly.

2. Precise Coding and Documentation

   • Ensure CPT and ICD-10 codes match the documentation.

   • Avoid mismatches that lead to rejections or underpayments.

   • Invest in coding audits to maintain accuracy.

3. Clean Claim Submission

   • Submit claims electronically (EDI) with all required fields completed.

   • Review claims for missing modifiers, incorrect NPI, or invalid payer info.

   • A clean claim = faster payment.

4. Proactive Denial Management

   • Track denials by reason code.

   • Identify patterns and fix root causes.

   • Don’t just resubmit — resolve the issue.

5. Continuous Performance Monitoring

   • Measure metrics like first-pass success rate, days in A/R, and denial rate.

   • Use these KPIs to identify where revenue is leaking.

How Celestix Helps

Celestix Communications supports providers by:

• Managing complete billing cycles — from charge entry to payment posting.

• Ensuring 98%+ clean claim submission rate.

• Reducing A/R aging through timely follow-ups.

• Providing regular reports on collections, denials, and cash flow.