Revenue cycle management
One Revenue Cycle. Every Step Connected.
Kitronixe provides comprehensive revenue-cycle and operational support across the patient-to-payment journey - from front-end verification and billing workflows through claims, denials, A/R recovery, reporting and specialized healthcare services.
Front end
- Eligibility checks due42
- Authorizations pending18
Mid-cycle
- Claims ready to submit148
- Held for documentation17
Back end
- Denials requiring action31
- Follow-up due today64
Illustrative data for a fictional practice, showing how revenue-cycle work can be organized by phase. Not a Kitronixe result or a client’s figures.
The revenue cycle
Twelve stages. Each one runs on the one before it.
A claim is only as good as the work upstream of it. Choose any stage to see what it depends on and what depends on it.
Revenue Cycle Management
Stage 01 of 12
Patient Access
Demographics and insurance captured at scheduling and registration.
- Depends on
- Reporting
- Feeds
- Eligibility
- 01
Patient Access
Demographics and insurance captured at scheduling and registration.
- 02
Eligibility
Coverage confirmed for the date of service, before the visit.
- 03
Prior Authorization
Approval secured before the service, where the payer requires it.
- 04
Documentation
The provider note that supports what is billed.
- 05
Coding
Codes and modifiers that match the documentation.
- 06
Charge Capture
Every billable service turned into a charge, promptly.
- 07
Claims
Claims scrubbed, submitted and tracked to a response.
- 08
Payments
Remittances posted and reconciled against what was expected.
- 09
Denials
Denied claims worked by root cause, not one appeal at a time.
- 10
A/R
Open balances followed up by priority, not simply by age.
- 11
Patient Billing
Patient statements once insurance has paid its share.
- 12
Reporting
Where revenue is waiting, and why - fed back upstream.
Three operating layers
Front end, mid-cycle, back end - run as one
Most revenue-cycle problems start in one layer and surface in another. Kitronixe works across all three, or the part of them you choose.
Layer 1
Front-end RCM
Before the encounter is billable.
- Scheduling
- Registration
- Eligibility
- Authorization
- Patient Access
Layer 2
Mid-cycle RCM
Turning care delivered into a clean claim.
- Documentation
- Charge Capture
- Coding
- Claim Scrubbing
- Claim Submission
Layer 3
Back-end RCM
From payer response to resolved balance.
- Payment Posting
- Denials
- A/R Follow-Up
- Underpayments
- Patient Balances
- Reporting
RCM services
Engage the whole cycle, or the part that needs it
- Revenue Cycle Management
Revenue Cycle Management
Front end to final payment, run as one connected operation.
Explore Revenue Cycle Management - Revenue Cycle Management
Physician Billing
Professional-fee billing built around the provider encounter.
Explore Physician Billing - Revenue Cycle Management
Medical Billing
Claims, denials, A/R and posting, worked end to end.
Explore Medical Billing - Revenue Cycle Management
A/R Recovery
Aging receivables organized into a worked recovery list.
Explore A/R Recovery - Revenue Cycle Management
Laboratory Billing
From test order to claim resolution.
Explore Laboratory Billing - Revenue Cycle Management
Hospital Billing
Connected facility workflows for complex encounters.
Explore Hospital Billing - Revenue Cycle Management
Imaging Billing
Order, authorization and component billing for imaging.
Explore Imaging Billing
Value-Added Services
Extend the Revenue Cycle With Operational Support
Workforce support for the office, and operational and billing workflow support for chronic care management and remote patient monitoring programs - each with a clear line between what Kitronixe supports and what stays with your practice.
Staffing & Workforce Services
Operational support for selected front-office and RCM roles.
What we support
- Front desk and registration
- Eligibility and authorizations
- Billing, A/R, denials and posting
- Queues, ownership and reporting
Stays with your practice: Clinical work - administrative and revenue-cycle support only.
Explore Staffing & Workforce ServicesChronic Care Management
Workflow and billing support for monthly CCM programs.
What we support
- Enrollment and consent tracking
- Monthly activity tracking
- Documentation workflow
- Billing readiness and reporting
Stays with your practice: Clinical decisions, care planning and clinical services.
Explore Chronic Care ManagementRemote Patient Monitoring
Workflow and billing support for eligible RPM programs.
What we support
- Enrollment and device workflow
- Missing-data follow-up
- Documentation workflow
- Billing readiness and reporting
Stays with your practice: Clinical interpretation and medical decision-making.
Explore Remote Patient Monitoring
RCM intelligence
Outstanding work, visible before it becomes a problem
Claims waiting, denials to work, balances to follow up: the operational view that lets a team act on what is outstanding today rather than reading about it at month end.
Sample RCM operations view
One fictional practice, one working day
Claims ready
148
Scrubbed, awaiting submission
Rejected claims
12
Back from the clearinghouse
Needs attention
Authorization pending
23
Visits waiting on approval
Denials requiring action
31
Sorted by root cause
Needs attention
Outstanding A/R
$318K
All open insurance balances
Payments posted
$96.4K
This week, reconciled
Patient balances
$41.3K
After insurance
Missing documentation
17
Held for a provider query
Needs attention
Follow-up required
64
Due today or overdue
Illustrative data only: invented figures for a fictional practice, showing the kind of operational view an RCM team works from. They are not Kitronixe results, client figures or benchmarks.
Why connected RCM matters
A revenue cycle is only as strong as its weakest handoff
A problem rarely shows up where it starts. These are five of the handoffs where revenue most often gets stuck - and where each one is actually fixed.
Handoff 1 of 5
Where it starts
Eligibility issue
Where it shows up
Claim problem
Coverage that lapsed or changed is billed to the wrong plan, and the claim comes back rejected or denied weeks after the visit.
Fixed where it starts: Verify at scheduling, and again before the visit.
Eligibility issue leads to Claim problem
Where it starts
Eligibility issue
Where it shows up
Claim problem
Coverage that lapsed or changed is billed to the wrong plan, and the claim comes back rejected or denied weeks after the visit.
Fixed where it starts: Verify at scheduling, and again before the visit.
Authorization gap leads to Denial risk
Where it starts
Authorization gap
Where it shows up
Denial risk
A service performed without an authorization the payer required can be denied, however good the rest of the claim.
Fixed where it starts: Check requirements when the service is ordered.
Documentation issue leads to Coding / claim delay
Where it starts
Documentation issue
Where it shows up
Coding / claim delay
A note that does not support the service stalls coding, or produces a claim that will not survive review.
Fixed where it starts: Query the provider before the claim is built.
Posting issue leads to Incorrect balance
Where it starts
Posting issue
Where it shows up
Incorrect balance
A payment posted without checking it against the expected amount leaves the wrong balance - on the ledger and on the patient’s statement.
Fixed where it starts: Reconcile remittances line by line.
Unworked denial leads to A/R aging
Where it starts
Unworked denial
Where it shows up
A/R aging
A denial left in a queue ages into A/R until it reaches a filing or appeal limit.
Fixed where it starts: Work denials by root cause, on a clock.
Find where your revenue cycle is getting stuck
An RCM assessment reviews your workflows, denials, A/R and reporting, and tells you where to start.