Raylance RCM helps healthcare providers maximize their revenue while focusing on patient care. Our dedicated billing team works in your existing EHR and billing software. No new software, no migration.
How our team works a claim · sample data, PHI masked
We don't sell software. Our team logs into the EHR and billing system you already use and takes over the work from eligibility to final payment, then reports back on every dollar.
Active coverage, copays, deductibles, coinsurance and plan limits confirmed before each visit, so patients and your front desk know what is owed.
VOB · 270 / 271Eligibility re-checked before service, and prior authorizations requested, tracked to approval and matched to the right visit.
Prior auth · EligibilityClaims reviewed and submitted through your billing software, then ERA and EOB payments posted line by line with underpayments flagged.
837P · 835 ERA · EOBUnpaid claims worked by aging bucket and dollar value, with every payer call and next step logged against the claim.
0–30 · 31–60 · 61–90 · 90+Each denial traced to its root cause by CARC and RARC, then corrected, resubmitted or appealed inside payer deadlines.
CARC · RARC · AppealsPatient statements, balance questions and payment plans handled, and accounts reconciled so charges, payments and adjustments match.
Statements · ReconciliationYour practice enrolled with each payer for electronic remittance and direct deposit, with payer issues chased until they are resolved.
ERA · EFTPayer enrollment applications, CAQH profile upkeep and re-credentialing deadlines tracked so your providers can keep billing.
CAQH · Re-credentialingEvery claim follows the same path. We watch the number that matters at each stage so problems are caught where they start, not three months later in A/R.
Coverage, benefits and authorization confirmed before the patient arrives.
Claims reviewed and filed electronically, denials fixed the same day.
ERA and EOB payments, adjustments and patient balances applied to each line.
Every denial worked by reason code, corrected or appealed on time.
Unpaid claims chased by aging bucket until each balance is resolved.
Patient balances billed and accounts reconciled to close out the visit.
A denial is a message from the payer. Pick a common Claim Adjustment Reason Code to see how Raylance RCM handles it and what we change upstream so it stops happening.
Move the sliders to match your practice. The estimate compares your numbers with a well-run billing operation.
Net collection rate raised to 96%
Denial rate brought down to 5%
Estimate only. Uses a 96% net collection rate and 5% denial rate as benchmark targets for a well-managed practice. Actual results depend on payer mix, specialty and contract rates; your free audit replaces this with your real numbers.
Every claim checked against payer rules before it goes out and submitted promptly, so you get paid on the first pass.
Aged balances worked down and denials resolved at the root, so money already earned is collected.
Monthly reporting on clean claim rate, denials, days in A/R and collections, with clear actions to improve each.
A named team that knows your payers, works in your own EHR and billing software, and answers to you.
Every engagement starts with a free audit of your last 90 days of claims. We quote after we've seen your data.
For practices with in-house A/R staff that need help getting claims out clean.
We only earn when you get paid. The most common choice for independent practices.
For practices with old balances after a system change, staff turnover or a backlog.
No. Raylance RCM is a services team, not a software product. We work inside the EHR and billing software you already use, under user accounts you set up for our staff, so your data stays where it is.
Most practices are live within a week. We map your payers, set up clearinghouse enrollment and ERA routing, then run in parallel with your team for the first billing cycle.
We take them over on day one. Aged claims are triaged by timely-filing deadline and dollar value, and worked alongside new submissions.
We sign a Business Associate Agreement before any access. Our staff complete HIPAA training annually and work only in your systems, with the access you grant, limited to what each role needs.
Yes. Agreements run month to month after the first 90 days, and we hand back all reports and open-claim lists if you move on.
Send us a few details. We'll review 90 days of claims and remits and show you your denial patterns, underpayments and aged A/R, whether or not you sign on.