Straight answers, before you talk to anyone.

Pricing depends on scope, volume and specialty, so it is quoted rather than published. An RCM assessment is the usual starting point, and you can also request pricing directly.

Usually with an RCM assessment: a review of denials, A/R, workflows and reporting to see where revenue is getting stuck. The first changes go where a problem starts, not only where it shows up.

Yes. Some practices hand over the whole cycle; others keep front-desk or coding work in-house and use Kitronixe for the rest. Ownership of each workflow is agreed up front, so nothing falls between the two teams.

Medical billing concentrates on turning encounters into paid claims. Revenue cycle management covers the whole path - including the front-end work that decides whether a claim can be paid and the reporting that shows where revenue is being lost - and runs it as one operation.

Front-end work (scheduling, registration, eligibility and authorization), mid-cycle work (charge capture, coding, claim scrubbing and submission) and back-end work (posting, denials, A/R, patient balances and reporting). The exact scope is agreed for each engagement.

Days in A/R, denial rate, clean claim rate and net collection rate, monthly and against an agreed baseline. If performance slips you will see it in a report before you hear it in a meeting.

It depends on volume and how many payers are involved. We transition in stages rather than all at once, so nothing stops while the changeover happens.

Yes. Kitronixe works in your EHR and practice management system rather than requiring a migration. Your data stays where it is.

Yes. The program can be tracked and reported by provider and location.

The workflows can be supported together. Whether both programs apply to the same patient in the same period depends on current program, payer and documentation requirements.

Yes: enrollment status, device setup status, data availability, review outstanding, follow-up required, documentation outstanding and billing readiness, by provider and location. No clinical outcome reporting is implied.

Yes, where billing is in scope: a workflow readiness review, claim submission and follow-up. Whether a period is billable depends on program, documentation and coverage requirements; readiness review does not guarantee payment.

Yes. Patients with no or limited data are identified and followed up operationally, and the practice is told. Anything clinical is escalated to the practice’s clinical team.

Yes - tracking eligible device setup, assignment and readiness for each enrolled patient. Kitronixe does not manufacture or supply devices.

Yes. Consent and enrollment are tracked to completion. Which patients are appropriate for the program is a clinical decision made by the practice.

No. Clinical interpretation and medical decision-making remain the responsibility of appropriately qualified healthcare professionals. Kitronixe supports the operational and billing workflow around the program.

No. Being connected does not make a device eligible for an RPM program. Device eligibility depends on the applicable program and payer requirements. Continuous glucose monitoring, for example, has its own coding and coverage considerations and should not automatically be treated as RPM.

Remote patient monitoring programs use eligible connected devices to collect patient-generated physiologic data between visits, which the practice’s clinical team reviews. Program, device and coverage requirements vary by payer and change over time.

Yes. CCM support can stand alone, sit alongside remote patient monitoring support, or be part of a wider revenue cycle management engagement.

Yes. The program can be tracked by provider and location, with each provider’s panel and outstanding tasks reported separately.

Yes: program census, enrollment status, care-plan workflow, monthly activity status, documentation outstanding, billing readiness and follow-up required, by provider and location.

Yes, where billing is in scope: a workflow readiness review, claim submission and follow-up. Whether a month is billable depends on documentation, program and coverage requirements; readiness review is not a guarantee of reimbursement.

Yes. Each month’s program activity is tracked against the program’s requirements, so the practice can see what is documented and what is still outstanding.

Yes. Kitronixe tracks whether each care plan is in place, current and awaiting action. Creating and approving the care plan remains with the clinical team.

Yes. Enrollment and consent status is tracked for each patient, with outstanding items followed up and recorded.

Yes - by organizing patients the practice may want to consider into a review list. Whether a patient is appropriate for the program is a clinical decision made by the practice, depending on current program, payer and patient requirements.

No. Clinical decisions, care planning and clinical services remain the responsibility of appropriately qualified healthcare professionals, unless specifically included in an approved clinical-services agreement. Kitronixe supports the workflow around that care.

The operational and billing workflow around a chronic care management program: patient review lists, enrollment and consent tracking, care-plan workflow status, monthly activity tracking, documentation workflow, billing readiness and program reporting, within the agreed scope.

Yes. Workforce support can stand alone, cover selected functions alongside your team, or sit within a full revenue cycle management engagement.

Through defined queues with an owner for each item, and regular reporting on work completed, work outstanding, aging and escalations.

Yes. Queues can be organized by location, with each location’s rules and contacts recorded in the workflow.

Yes. Many practices start with one queue - eligibility, authorizations or A/R, for example - and add others once the hand-offs are working.

Access is role-based and limited to the agreed scope, granted through your own systems and permissions, and revocable by the practice at any time.

Yes. Work is done inside your existing practice management, EHR and payer systems, with access you grant and control.

Yes. Billing, claim-status, rejection, denial, posting and A/R workflows can all be supported, either as workforce support inside your process or as part of full revenue cycle management.

Yes. Eligibility and benefits are checked before the visit, and authorizations are submitted, tracked to a decision and checked for expiry. Requirements vary by payer and service, and an authorization does not guarantee payment.

Yes, where they are part of the agreed scope - registration, insurance capture, scheduling tasks and administrative patient communication. Anything clinical is routed back to the practice.

Administrative and revenue-cycle workforce support: front-desk and registration workflows, eligibility, prior authorization administration, billing, claim status, denials, payment posting, A/R, patient communication and reporting. Kitronixe does not provide clinical staffing.

Where the billing data carries modality or service information, reporting can be broken down by modality, alongside payer, location and age.

Yes. Open imaging claims are prioritized by status, payer response, filing limits, balance and age. No outcome can be guaranteed.

Yes. Requests are tracked, the documentation and reports are gathered and sent, and the claim is followed until the payer responds.

Yes. Denials are worked by cause - including authorization-related denials - and corrected, appealed where appropriate, or closed with a reason.

Yes. Modifiers such as those used for technical or professional components are reviewed where applicable, based on the arrangement, documentation and payer requirements.

Broadly, the technical component is the equipment and technical side of performing the service, and the professional component is the physician’s interpretation. Whether a service is billed by component or globally depends on the actual circumstances and payer rules - there is no single rule for every case.

Yes, where they apply. How an imaging service is billed depends on who performed which part of it, the setting, ownership and contractual arrangements, the payer and the documentation.

Yes. Authorization requirements are checked before the service and again against what was performed. Requirements vary by payer and service; for a dedicated authorization service, see Prior Authorization.

Yes. Radiology billing workflows are supported the same way - built around the study, its authorization, its interpretation and its documentation.

Billing workflow support: orders, eligibility, authorization coordination, documentation and interpretation workflow, coding coordination, component and modifier considerations, claims, rejections, denials, records requests, posting, A/R and reporting - depending on the agreed scope. Kitronixe does not perform imaging or interpret studies.

Yes. Hospital Billing can be scoped on its own, or as part of a wider revenue-cycle engagement.

Yes. Reporting can show claims by status and payer, denials, records requests, payment activity, A/R by age and payer, outstanding documentation and outstanding work queues.

Yes. Physician and provider billing is available separately as Physician Billing, and can be scoped alongside facility billing or on its own.

Outpatient hospital services can be part of the scope. The billing workflow depends on the services, the setting and the payer.

Yes. Payer requests are tracked, the documentation is gathered from the responsible department and sent, and the claim is followed until the payer responds.

Yes. Denials are worked by cause - corrected, appealed where appropriate, or closed with a reason - and the pattern is reported back.

Yes. Open facility claims are prioritized by status, payer response, filing and appeal limits, balance and age, and followed up. No outcome can be guaranteed.

Yes, where they are part of the agreed scope. Institutional claims have their own format and requirements, and the workflow is set up for them specifically.

Facility billing covers the hospital or facility’s services; physician billing covers the professional services of the providers. A single encounter may involve one or both, depending on the services performed, the provider arrangement, the setting and the payer.

Hospital billing - also called facility billing - is billing for the facility’s own services: the setting, equipment, supplies and staff involved in an encounter. It uses its own claim workflow, separate from the professional billing for the physicians involved.

Yes. Laboratory Billing can be scoped on its own, or combined with services such as A/R Recovery.

Yes. We work inside the billing and clearinghouse systems you already use, with access set up to your policies.

Yes. Reporting can show claims submitted and rejected, denials, records requests, payments, A/R by payer and age, and unresolved work - and A/R by test or service category where that information is available.

Yes. Older claims are reviewed by status, payer response, filing and appeal limits and documentation. Age alone does not decide what can be done, and no outcome can be guaranteed.

Yes. When a payer requests records, the request is tracked, the documentation is gathered from your team and sent, and the claim is followed until the payer responds.

We review the diagnosis information provided with the order against what is being billed, and route questions back to the ordering side. Diagnosis itself is a clinical matter for the provider.

Yes. Ordering or referring provider details are reviewed where the claim or payer requires them, and gaps are routed back for correction before submission.

Yes. Denials are worked by their cause: corrected, appealed where appropriate, or closed with a reason, and the pattern is reported back.

Yes. Rejections are corrected at the front end - usually a missing or mismatched detail - and the claim is resubmitted.

Billing workflow support: patient, insurance and ordering-provider information review, diagnosis and coding coordination, claim validation and submission, rejections, denials, records requests, payment posting, A/R and reporting - depending on the agreed scope. Kitronixe does not perform testing or interpret results.

Pricing depends on scope, volume and specialty, so it is quoted rather than published. An RCM assessment is the usual starting point, and you can also request pricing directly.

Patient balance workflow can be part of the scope, handled after insurance has done its part so the amount a patient is asked for is the amount they actually owe.

By what a balance is worth and how much time it has left: payer, age, balance, claim and denial status, documentation issues and timely-filing risk. An aging report shows where money is; a prioritized worklist decides what to do about it first.

Yes, where they are part of the scope. Denials are worked by root cause, appeals are prepared with the documentation the payer needs, and patterns are reported back so the cause can be fixed upstream rather than appealed again next month.

A rejection is returned before the payer processes the claim - usually by the clearinghouse, for a formatting, data or eligibility problem - and can often be corrected and resubmitted the same day. A denial is a processed claim the payer has decided not to pay, which needs investigation and often an appeal. Treating one like the other puts work in the wrong queue.

It depends on the scope you choose. An engagement can cover the full revenue cycle - eligibility, authorization, coding, claims, denials, posting, A/R and reporting - or a defined part of it. The scope is agreed up front, so you know exactly what is and is not included.

Yes. Reporting can show charges, claims, denials, documentation pending and outstanding work by provider and by location.

Yes. Outstanding professional claims are prioritized by payer, age, balance and filing limit and followed up. For a focused A/R project, see A/R Recovery.

Denials on professional claims are worked by root cause - corrected, appealed or closed with a reason - and the pattern is reported back so it can be addressed upstream.

Yes. Secondary and crossover claims are followed through once the primary payer has processed the claim, rather than left open.

Yes. The place of service on the claim is checked against where the service was performed. The correct setting and billing depend on the service, the documentation and the payer’s requirements.

We can track encounters from note to sign-off and raise documentation that is incomplete or unsigned, so it is resolved before billing rather than after a denial. Clinical documentation itself remains the provider’s.

Professional claims for services performed in hospital and other facility settings can be part of the scope. Setting, documentation and payer requirements decide how each is billed.

Yes. Workflows are organized by provider and location, so each provider’s encounters, claims and follow-up stay distinct, and reporting can be broken down the same way.

Physician billing covers the professional service; facility billing covers the hospital or facility’s own charges. They use different claim workflows and are often billed separately for the same encounter. Kitronixe supports professional billing, and facility workflows only where they are within the agreed scope.

Physician billing - also called professional-fee billing - is billing for the services a physician or advanced practice provider performs. The claim is built from that provider’s encounter and documentation, and it is separate from any facility claim for the same visit.

Coding is handled by experienced medical coding professionals, working from your clinical documentation.

Yes. A/R Recovery can be engaged on its own - alongside your in-house billing team, or as a project on an existing backlog.

Reporting shows open A/R by age, payer, provider, location and issue, what was worked, what was resolved and what is still outstanding. It does not include a recovery percentage or promise.

Yes. When a payer asks for records, the request is tracked, the documentation is gathered from your team and sent, and the claim is followed until the payer responds.

Yes. Secondary balances are followed through once the primary payer has processed the claim.

Payments below the expected amount can be flagged for review as part of A/R work. Structured contract-rate analysis is covered by Revenue Intelligence and Underpayment Recovery.

Yes. Claims with no payer response are researched and escalated with the payer rather than resubmitted indefinitely.

Yes. Denial-related balances are worked by the denial’s cause - corrected, appealed where appropriate, or closed with a reason.

Yes. Claims are followed up with payers by phone, portal or correspondence, and every action and response is recorded.

By what each balance needs next: claim status, denial status, timely-filing considerations, documentation requirements, payer, balance and age. An aging report is one input, not the whole picture.

Yes. Older claims are reviewed like any other - their status, the payer’s response, filing and appeal limits, and documentation decide what can be done. Age alone does not decide whether a claim is worth working, and no outcome can be guaranteed.

A/R recovery is the organized work of resolving outstanding insurance receivables: researching claim status, following up with payers, correcting or appealing where appropriate, and closing each balance with a clear outcome.

Yes. Legacy A/R cleanup is often a separate project alongside ongoing work, because the two need different strategies.

Yes. Kitronixe provides revenue-cycle services from eligibility through A/R, underpayments and reporting, so system recommendations can be made in the context of how your billing actually runs.

Yes. Workflows change, staff change and new functionality becomes available, so ongoing support is offered as a scoped engagement based on what your organization needs.

Kitronixe can support approved 340B reporting, data preparation and operational reporting workflows, based on your program needs and the data available. It is reporting and data support only: Kitronixe is not a 340B administrator, does not provide legal or compliance advice, and cannot certify or guarantee compliance.

Yes. Kitronixe designs reports and dashboards around the operational questions your leadership actually asks, across revenue cycle, clinical operations, productivity and patient access, using eBO and reporting tools where they are available to you.

Where healow products are part of your agreement and enabled for your organization, Kitronixe can help configure and optimize the related workflows - portal, digital intake and patient communication among them.

Yes. Work queues and operational dashboards can be designed around ownership, priority and follow-up, so outstanding work is visible without a separate spreadsheet.

Yes, including billing rules that catch predictable errors before a claim leaves the practice, set up around the patterns your own denials and rejections show.

Yes. Kitronixe can help design and configure clinical rules, alerts and decision-support logic. Clinical content and thresholds are always decided by your clinicians - the work is the configuration, not the clinical judgement.

Yes, including order sets, questionnaires and Smart Forms, designed around the visit types and data your practice needs to capture.

Yes. Kitronixe can help design and configure progress note templates and structured documentation workflows around how your providers work, within the configuration access your organization provides.

Yes - this is often the starting point. What is available to you depends on your agreement, the products and modules you have purchased and enabled, and your permissions, so the audit establishes that first rather than assuming it.

Yes. The review works within the access your organization grants, and looks at settings, preferences, templates, rules and workflow configuration against how the practice actually operates.

A review of how your environment is configured and how each team uses it: clinical documentation, front desk and patient access, billing and RCM workflows, work queues, rules, reporting and any engagement tools in use. The output is a prioritized list of improvements with the reasoning behind each, which you can act on with your own team or with Kitronixe.

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