Service 01 — Revenue Cycle Management
Revenue cycle, end to end
From the moment an appointment is booked to the day the balance hits zero, we own the workflow: eligibility, coding, submission, denial resolution, posting and patient balances.
In short
Cannixus is a US-focused medical billing and revenue cycle management (RCM) company. We handle eligibility verification, medical coding, charge capture, claim scrubbing and submission, denial management and appeals, payment posting, AR follow-up and patient billing for hospitals, clinics, dental practices and private practitioners — working inside your existing EHR and clearinghouse. Call +1 (813) 742-6713 or email info@cannixus.com.
Capabilities
What the team owns
Eligibility & prior auth
Real-time benefit verification and authorisation tracking before the patient is seen, so front-end errors never reach the claim.
Medical coding
Certified coders across specialties — CPT, ICD-10-CM, HCPCS and modifier accuracy with documentation review.
Claim scrubbing & submission
Payer-specific edits applied before submission, with clearinghouse rejections resolved same day.
Denial management
Every denial coded to a root cause, appealed with supporting documentation, and fed back into front-end fixes.
Payment posting & AR
ERA/EOB posting, underpayment detection against contracted rates, and disciplined AR follow-up by aging bucket.
Analytics & reporting
Clean-claim rate, days in AR, denial mix, net collection rate and payer performance in one recurring review.
Scope
Included in every engagement
Front end
- Patient demographics and insurance capture QA
- Real-time eligibility and benefits verification
- Prior authorisation initiation and tracking
- Charge entry and charge capture reconciliation
Mid cycle
- Specialty-specific CPT / ICD-10 coding
- Documentation and medical-necessity review
- Payer-rule claim scrubbing and edits
- Primary, secondary and tertiary submission
Back end
- ERA and manual payment posting
- Denial categorisation, appeal and re-submission
- Contract-rate variance and underpayment recovery
- Patient statements, balances and support
Outcomes
What changes for you
Cleaner claims
Fewer rejections at the clearinghouse because errors are caught before submission rather than after denial.
Shorter AR
Aging buckets are worked on a schedule, so cash arrives in weeks rather than quarters.
Fewer surprises
Monthly reviews show exactly where revenue leaked and what has been changed to stop it.
Questions
Medical billing and RCM questions
What does Cannixus do as a medical billing company?
Cannixus manages the full revenue cycle: insurance eligibility and prior authorisation, medical coding, charge entry, claim scrubbing and submission, denial management and appeals, ERA/EOB payment posting, AR follow-up and patient statements — plus reporting on clean-claim rate, days in AR and net collections.
How much does outsourced medical billing cost?
Most engagements are priced as a percentage of net collections, with FTE and per-claim models available for staffing-style or project work. Pricing depends on specialty, claim volume and how much of the cycle we own. We quote after reviewing a sample of your claims and AR aging.
Do we have to change our EHR or practice management system?
No. We work inside your existing EHR, practice management system and clearinghouse. Our IT team handles access, interfaces and any reporting gaps.
How quickly can you take over an existing AR backlog?
Discovery and access setup typically take two weeks. Production work on aged AR starts in week three, with the first denial root-cause read-out at day 45.
Which specialties and provider types do you support?
More than 40 specialties, including primary care, behavioral health, orthopedics, cardiology, radiology and imaging, urgent care, ambulatory surgery centers, home health and hospice, DME, laboratories, telehealth and dental practices.
Are you HIPAA compliant?
Yes. Role-based access, audited logins, secured workstations and HIPAA-aligned policies apply to every workflow, with a Business Associate Agreement signed before any PHI moves.
Send us one month of denials
We will categorise them, show you the root causes and outline what we would change first.