# Rcmaxis Health Services: Full Content for LLM Indexing > Specialty medical billing and revenue cycle management (RCM) for independent physician practices and specialty groups across the United States. Contact: info@rcmaxis.com | +1 (307) 204-6032 | https://rcmaxis.com --- ## About Rcmaxis Rcmaxis is a US-based medical billing and revenue cycle management company serving independent physician practices, specialty groups, and multi-provider clinics. The team is made up of certified medical coders (CPC, CCS), credentialing specialists, and denial management experts with deep experience across more than 30 medical specialties. Key performance benchmarks: - 95%+ clean claim rate - Average AR under 35 days - No long-term contracts required - HIPAA-compliant processes across all operations Rcmaxis handles the full revenue cycle: eligibility verification, charge capture, claims submission, payment posting, denial management, patient billing, credentialing, and compliance auditing. Practices that outsource to Rcmaxis typically recover $33,000–$120,000 in previously missed or lost revenue within the first 6–12 months. --- ## What Rcmaxis Does ### Medical Billing & Claims Management End-to-end claims processing from charge entry through payment posting. Includes eligibility verification before every visit, claim scrubbing before submission, and real-time tracking through the clearinghouse. Claims submitted within 24 hours of charge receipt. Clean claim rates maintained above 98%. ### Denial Management Systematic denial analysis, root cause identification, and appeal filing. Rcmaxis tracks every denial by payer, denial reason, and provider to identify patterns, then fixes the upstream documentation, coding, or eligibility issue causing repeat denials. Average denial rate for Rcmaxis clients: under 4%. ### Credentialing & Provider Enrollment Full-cycle credentialing for new providers and re-credentialing for existing ones. Includes CAQH profile management, payer enrollment applications, follow-up, and effective date tracking. Credentialing delays cost practices $3,000–$8,000 per provider per month. Rcmaxis reduces average credentialing timelines from 90–120 days to 45–60 days. ### Compliance Auditing Internal coding audits, OIG compliance program support, documentation gap analysis, and pre-billing review. Rcmaxis identifies undercoding, overcoding, and documentation deficiencies before payers and auditors do. Services align with OIG Work Plan priorities for the current year. ### Aged AR Recovery Targeted recovery of claims 90–365+ days old. Rcmaxis works existing AR as part of standard service and can also take on historical AR cleanup as a standalone engagement. Practices typically recover 40–70% of AR that was previously written off. ### Analytics & Reporting Monthly performance dashboards covering: net collection rate, clean claim rate, denial rate by payer and reason, days in AR, first-pass resolution rate, and revenue by provider and payer. Custom reporting available. ### AI Automation Rcmaxis integrates AI tools for eligibility verification, claim status monitoring, and denial prediction. AI-assisted coding review flags potential undercoding and documentation gaps before claims are submitted. ### EHR Integrations Rcmaxis works with all major EHR platforms: Athenahealth, eClinicalWorks (ECW), Kareo, Epic, Modernizing Medicine, NextGen, Office Ally, and others. No EHR switching required. ### Medical Coding Services Outsourced coding by AAPC-certified, specialty-trained coders: CPT, ICD-10-CM, HCPCS and modifiers assigned from documentation, with written provider queries and monthly quality audits. Details: https://rcmaxis.com/services/medical-coding-services/ ### Payer Contracting & Rate Negotiation Support Contract review, rate benchmarking against Medicare and market data, underpayment analysis and negotiation preparation. Rcmaxis supports the negotiation and does not promise specific rate increases. Details: https://rcmaxis.com/services/payer-contracting-rate-negotiation/ ### Credentialing Only (standalone) Provider enrollment, CAQH and re-credentialing for practices that already have a biller. Quoted by number of providers and payers. Details: https://rcmaxis.com/services/credentialing-enrollment/#credentialing-only ### Coding Validation & Documentation Improvement (added September 2026) Pre-bill coding validation by AAPC-certified coders, plus specialty documentation feedback for providers. Reviews E/M levels, modifiers, diagnosis specificity, and medical necessity before claims are released. Details: https://rcmaxis.com/services/coding-validation-cdi/ ### Front-End Access & Prior Authorization (added September 2026) Eligibility and benefits verification, prior authorization submission and tracking, patient cost estimates, and financial clearance before the visit. Details: https://rcmaxis.com/services/front-end-access-prior-authorization/ ### Out-of-Network & No Surprises Act Dispute Support (pilot program) Claim review for No Surprises Act applicability, open negotiation, federal IDR filing, and deadline tracking. Offered to a small number of practices during the pilot. Details: https://rcmaxis.com/services/out-of-network-nsa-dispute-support/ --- ## Specialties Served Rcmaxis has dedicated billing teams for: - Cardiology (echocardiography, stress testing, cardiac catheterization, electrophysiology) - Orthopedics (fracture care, joint replacements, arthroscopy, injections) - Neurology (EEG, EMG, nerve conduction studies, sleep studies) - Gastroenterology (colonoscopy, EGD, polyp removal, capsule endoscopy) - OB/GYN (global OB package, antepartum care, delivery, gynecologic procedures) - Oncology (chemotherapy administration, drug billing, evaluation and management) - Ophthalmology (eye exams, surgical procedures, optical coherence tomography) - Mental Health / Behavioral Health (psychotherapy, medication management, telehealth) - Psychiatry (E/M coding, add-on codes, collaborative care) - Pain Management (nerve blocks, spinal cord stimulation, injections) - Pediatrics (well-child visits, immunizations, developmental screening) - Physical Therapy (timed vs untimed codes, functional limitation reporting) - Podiatry (routine foot care, diabetic shoe coverage, surgical codes) - Radiology (TC/PC modifiers, imaging codes, RVU management) - Rheumatology (infusion therapy, biologics, joint injections) - Urology (cystoscopy, TURP, urodynamics) - Dermatology (excision codes, Mohs surgery, phototherapy) - Chiropractic (CMT codes, Medicare limits, maintenance therapy rules) - Emergency Medicine (level selection, critical care, facility vs professional) - Family Medicine (E/M coding, preventive visits, annual wellness) - Anesthesia (base units, time units, modifiers, conversion factors) - ENT / Otolaryngology (endoscopy bundling, FESS, audiology) - Spine Surgery (global periods, implant billing, modifier 22) - Bariatric Surgery (BMI criteria, supervised diet requirements, prior auth) - Hematology (infusion codes, drug billing, prior authorization) - Urgent Care (E/M codes, S9083, POS 20, facility vs professional) - Skilled Nursing Facility (Part A vs Part B, physician visit codes 99304–99310) - FQHC / Community Health (prospective payment system, encounter rates) - Wound Care (debridement codes, skin substitutes, hyperbaric oxygen) - Telehealth (post-PHE rules, audio-only coverage, POS codes) - Remote Patient Monitoring / RPM (CPT 99453–99458, ongoing monitoring) --- ## Pricing Rcmaxis pricing is percentage-based, typically 2–7% of collections depending on specialty, volume, and services included. No setup fees. No long-term contracts. Practices pay only when they get paid. Full pricing detail at: https://rcmaxis.com/pricing/ --- ## Free Revenue Assessment Rcmaxis offers a no-cost revenue assessment for practices that want to understand how much they're losing to denials, undercoding, and slow AR. The assessment covers: denial rate analysis, AR aging breakdown, clean claim rate benchmark, and estimated annual revenue opportunity. Request at: https://rcmaxis.com/free-revenue-assessment/ --- ## Tools - A/R Days Calculator: https://rcmaxis.com/ar-calculator/ - Billing Cost Calculator (in-house vs outsourced): https://rcmaxis.com/billing-cost-calculator/ - Denial Rate Calculator: https://rcmaxis.com/denial-calculator/ - RCM Health Score: https://rcmaxis.com/rcm-health-score/ --- ## Blog Articles (Summary) More than 110 articles at: https://rcmaxis.com/blog/ Topics covered: specialty-specific billing guides, CPT code updates, denial management, credentialing, compliance, OIG audit risk, Medicare and Medicaid billing, telehealth, remote patient monitoring, value-based care, AI in billing, EHR integration, and RCM performance benchmarks. Recent additions: - Medicare Claim Appeals 2026 (Redetermination to Federal Court): The Five Levels, the Deadlines That Cost You the Claim, and When an Appeal Is Worth Filing: https://rcmaxis.com/blog/medicare-claim-appeals-2026/ - Code Set Update Calendar 2026 (ICD-10, HCPCS, CPT, NCCI): The Quarterly Rhythm That Keeps Claims From Rejecting: https://rcmaxis.com/blog/code-set-update-calendar-2026/ - Skin Substitute Billing 2026 (Q4xxx, 15271-15278): What Changed When Medicare Stopped Paying Skin Substitutes Like Drugs: https://rcmaxis.com/blog/skin-substitute-billing-2026/ - Part B Drug Billing 2026 (JW, JZ, ASP, NDC): Every Unit You Discard Is Either Paid or Written Off: https://rcmaxis.com/blog/part-b-drug-billing-jw-jz-asp-2026/ - Medicare Secondary Payer (MSP) Billing 2026: Who Pays First, and the Questions You Have to Ask Every Time: https://rcmaxis.com/blog/medicare-secondary-payer-cob-billing-2026/ - CARC and RARC Codes 2026 (CO, PR, OA, PI): Read the Remit Like a Biller, Not a Bystander: https://rcmaxis.com/blog/carc-rarc-denial-codes-remittance-guide-2026/ - ABN Billing 2026 (CMS-R-131, GA, GX, GY, GZ): Get the Signature Before the Service or Absorb the Denial: https://rcmaxis.com/blog/abn-billing-ga-gx-gy-gz-modifiers-2026/ - Timely Filing Limits 2026: The Denial You Can't Appeal and Can't Bill the Patient For: https://rcmaxis.com/blog/timely-filing-limits-2026/ - Medicare 60-Day Overpayment Rule 2026: The Refund Clock Starts Sooner Than Most Practices Think: https://rcmaxis.com/blog/medicare-60-day-overpayment-rule-2026/ - Prolonged Services Billing 2026 (99417, G2212, G0316): Why Medicare Won't Pay the Code Your Biller Keeps Sending: https://rcmaxis.com/blog/prolonged-services-billing-2026/ - APCM Billing 2026 (G0556-G0558): How Advanced Primary Care Management Pays Without a Stopwatch: https://rcmaxis.com/blog/apcm-advanced-primary-care-management-billing-2026/ - Cardiac and Pulmonary Rehab Billing 2026 (93797-93798, G0422-G0423, 94625-94626): Protect Every Session You Run: https://rcmaxis.com/blog/cardiac-pulmonary-rehab-billing-2026/ - Collaborative Care Billing (CPT 99492-99494): Get Paid for the Care Manager Minutes You Already Log: https://rcmaxis.com/blog/collaborative-care-bhi-billing-2026/ - Psychological & Neuropsychological Testing Billing (CPT 96130-96139): https://rcmaxis.com/blog/psychological-neuropsychological-testing-billing-2026/ - Cardiac Device Remote Monitoring Billing (CPT 93294-93299): https://rcmaxis.com/blog/cardiac-device-remote-monitoring-billing-2026/ - DSMT Billing 2026: https://rcmaxis.com/blog/dsmt-diabetes-education-billing-2026/ - Medical Coding Audit 2026: https://rcmaxis.com/blog/medical-coding-audit-2026/ - FQHC Billing 2026: https://rcmaxis.com/blog/fqhc-billing-2026/ - Urgent Care Billing 2026: https://rcmaxis.com/blog/urgent-care-billing-2026/ - Skilled Nursing Facility Billing 2026: https://rcmaxis.com/blog/skilled-nursing-facility-billing-2026/ - Chronic Care Management Billing 2026: https://rcmaxis.com/blog/chronic-care-management-billing-2026/ - Transitional Care Management Billing 2026: https://rcmaxis.com/blog/transitional-care-management-billing-2026/ - Interventional Radiology Billing 2026: https://rcmaxis.com/blog/interventional-radiology-billing-2026/ - Vascular Surgery Billing 2026: https://rcmaxis.com/blog/vascular-surgery-billing-2026/ --- ## Recent Updates (Billing & Policy Knowledge Base) Dated explainers on CMS and payer rule changes, with action checklists and source links. Hub: https://rcmaxis.com/updates/ - October 2026 HIPAA EDI front-end edits for Medicare (CR 14429): TA1 and 999 acknowledgments, 276/277 flat file update, posted October 8, 2026: https://rcmaxis.com/updates/october-2026-medicare-edi-front-end-edits/ - FY 2027 hospice payment rates corrected (CR 14557): RHC $236.33 for days 1-60, aggregate cap $36,174.75, posted October 8, 2026: https://rcmaxis.com/updates/fy-2027-hospice-payment-rates-corrected/ - October 2026 OPPS quarterly update (MM14589): 39 PLA codes, 58 Category III codes and 29 new drug codes, posted October 7, 2026: https://rcmaxis.com/updates/october-2026-opps-quarterly-update/ - CMS meets certified IDR entities on No Surprises Act dispute costs, new IDR Gateway portal due late 2026, posted October 7, 2026: https://rcmaxis.com/updates/cms-meets-idr-entities-no-surprises-act-disputes/ - Transparency in Coverage final rules (CMS-9882-F), effective December 7, 2026, posted October 6, 2026: https://rcmaxis.com/updates/transparency-in-coverage-final-rules-2026/ - Medicare $90 Part B premium rebate, direct deposits from about October 8, 2026, posted October 5, 2026: https://rcmaxis.com/updates/medicare-90-dollar-part-b-premium-rebate-patient-calls/ - CY 2027 Clinical Laboratory Fee Schedule preliminary rates (average cut of about 16%, comments due October 21), posted October 4, 2026: https://rcmaxis.com/updates/cy-2027-clinical-laboratory-fee-schedule-preliminary-rates/ - GLOBE Part B drug payment model final rule (CMS-5545-F), model starts January 1, 2027, posted October 3, 2026: https://rcmaxis.com/updates/globe-part-b-drug-payment-model-final-rule/ - UnitedHealthcare removes prior authorization on about 1,700 codes effective October 1, 2026, posted October 2, 2026: https://rcmaxis.com/updates/unitedhealthcare-prior-authorization-reduction-october-2026/ - Hospice election statement addendum mandatory October 1, 2026, with enforcement discretion through December 31, 2026, posted October 1, 2026: https://rcmaxis.com/updates/hospice-election-statement-addendum-october-2026/ - WISeR prior authorization model in 6 states and its new NPI-level exemption program, posted September 28, 2026: https://rcmaxis.com/updates/wiser-prior-authorization-model-2026/ - October 2026 NCCI PTP (v32.3), MUE and HCPCS quarterly update, effective October 1, 2026, posted September 27, 2026: https://rcmaxis.com/updates/october-2026-ncci-hcpcs-quarterly-update/ - CY 2027 OPPS and ASC proposed rule (CMS-1850-P): 2.4% update, Inpatient Only list cuts and new prior authorization, posted September 26, 2026: https://rcmaxis.com/updates/cy-2027-opps-asc-proposed-rule/ - FY 2027 IPPS final rule (CMS-1849-F): 2.3% update and the mandatory CJR-X joint replacement model, posted September 26, 2026: https://rcmaxis.com/updates/fy-2027-ipps-final-rule/ - Medicare telehealth flexibilities extended through December 31, 2027, posted September 25, 2026: https://rcmaxis.com/updates/medicare-telehealth-flexibilities-through-2027/ - FY 2027 ICD-10-CM code set (190 new, 30 deleted, 4 revised codes), effective October 1, 2026, posted September 25, 2026: https://rcmaxis.com/updates/fy-2027-icd-10-cm-code-update/ - Modifier 59 and X{EPSU} (XE, XS, XP, XU) under the 2026 NCCI Policy Manual, posted September 25, 2026: https://rcmaxis.com/updates/modifier-59-x-modifiers-2026-ncci/ - CY 2027 Physician Fee Schedule proposed rule (CMS-1848-P): conversion factor and same-day E/M payment, posted September 24, 2026: https://rcmaxis.com/updates/cy-2027-physician-fee-schedule-proposed-rule/ --- ## Legal & Compliance - HIPAA Notice: https://rcmaxis.com/hipaa-notice/ - Privacy Policy: https://rcmaxis.com/privacy-policy/ - Compliance Program: https://rcmaxis.com/compliance/