RCM360 Solutions manages your claims from submission to payment, so your Virginia practice collects what it has earned with fewer denials and less administrative work.
Virginia practices bill Medicare through Palmetto GBA and Virginia Medicaid through Cardinal Care managed care plans such as Anthem HealthKeepers Plus, Aetna Better Health of Virginia, Sentara Community Plan, Molina Complete Care, and UnitedHealthcare Community Plan. They also bill commercial carriers such as Anthem Blue Cross Blue Shield, Sentara Health Plans, CareFirst, Aetna, and Cigna. With a large military population in Hampton Roads and Northern Virginia, many practices also bill TRICARE. RCM360 Solutions manages every step of your revenue cycle, from verifying coverage to posting payments, so your team can focus on patients.
Open claims hold up revenue your practice has already earned. We review your outstanding balances on a regular schedule, contact insurers directly, and follow each claim until it is paid or appealed.
Our certified billers and coders know Virginia payer rules and manage each claim from submission to final payment.
When you add a provider or open another office, we take on the extra claims right away so billing stays on schedule.
Regular reports show what was billed, what was paid, what was denied, and what is still owed to your practice.
We find the cause of each denial, correct the coding or documentation error, and appeal before the insurer’s deadline.
Claims unpaid after 60 days get priority attention and direct insurer contact, so they are collected instead of written off.
From practices in Northern Virginia and Richmond to clinics in Virginia Beach, Norfolk, Roanoke, and Charlottesville, claim errors and late payments put pressure on cash flow. We focus on sending accurate claims and following up until they are paid.
Each specialty has its own codes and insurance requirements. Our billers work with your type of claims every day, so they are prepared correctly the first time.
Checkups, immunizations, and sick visits for children covered by Virginia Medicaid, FAMIS, and private plans.
Imaging claims with correct modifiers, split professional and technical charges, and prior authorization tracking.
Chemotherapy and infusion billing, accurate drug and dosage coding, and approvals for each treatment stage.
Billing for stress tests, echocardiograms, Holter monitoring, and device checks, backed by proper documentation.
You do not need to replace your software. RCM360 Solutions connects securely to the EHR and practice management system you already use, and our team handles the billing from there.
We bill Medicare through Palmetto GBA, Virginia Medicaid and its Cardinal Care managed care plans, Medicare Advantage plans, TRICARE, and major commercial insurers such as Anthem Blue Cross Blue Shield, Sentara Health Plans, Aetna, Cigna, and UnitedHealthcare.
Yes. We handle TRICARE claims alongside your Medicare, Medicaid, and commercial billing, which suits practices in Hampton Roads, Northern Virginia, and other areas with many military families.
We check each claim for coding and documentation errors before it is sent, track denial reasons by insurer, and appeal denied claims within the required deadlines.
We review all outstanding claims, sort them by age and balance, and begin insurer follow-up right away. This helps you recover money already owed to you during the transition.
Speak with RCM360 Solutions about reducing denials, getting paid sooner, and seeing clearly how your Virginia practice is performing.
