Complete Revenue Cycle
Management Services
From the first eligibility check to the final payment post — Silverbridge handles every step of your revenue cycle with precision, accountability, and full transparency.
Most billing problems don't come from one single failure — they come from a chain of small gaps that compound over time. An eligibility check skipped. A code submitted without the right modifier. A denial that aged past the appeal deadline. A payment posted to the wrong account. Each gap is a revenue leak, and they add up fast.
Silverbridge closes every gap. We manage your complete revenue cycle as a single, integrated workflow — not a disconnected set of tasks handed off between departments. Here's exactly what that means for your practice.
Real-Time Eligibility
The most expensive billing error is the one that happens before a single claim is submitted. Silverbridge verifies insurance eligibility for every scheduled patient, every day — automatically.
- Active policy status & effective dates
- Plan type (HMO, PPO, EPO, Medicare Advantage, Medicaid)
- Deductible amounts & year-to-date met
- Co-pay & co-insurance percentages
- Out-of-pocket maximum tracking
Prior Authorization
Prior authorization is one of the biggest administrative time-sinks in a medical practice. Silverbridge manages the PA process end-to-end.
- Identify which services require authorization
- Submit to correct payer (portal, phone, fax)
- Follow up on pending authorizations
- Document approvals for claim submission
Problems We Solve
- Claims denied because insurance was inactive
- Patient billing disputes from unknown co-pays
- Delayed payments from missing prior auth
- Front desk spending 2-3 hours daily on calls
Certified Medical Coding
Medical coding sits at the exact midpoint between clinical care and financial reimbursement. Every encounter is coded by a CPC-credentialed coder.
- ICD-10-CM Diagnosis Codes
- CPT Procedure Codes
- HCPCS Level II
- Modifiers (25, 57, 59, 50, 51, 80, 81)
Compliance & Quality
We code what the documentation supports — and flag gaps before submission.
- 2021 AMA E&M Guidelines (MDM or total time)
- Payer LCD/NCD compliance checks
- Quality review for high-value claims
- Periodic coding audits
Our Coding Process
- Step 1: Documentation Review
- Step 2: Code Assignment
- Step 3: Payer Rule Check
- Step 4: Quality Review
Clean Claim Submission
Claims scrubbed and validated before they leave our system. 98% first-pass acceptance rate.
- Pre-submission multi-layer scrubbing
- Electronic submission to all major payers
- CMS-1500 and UB-04 support
Real-Time Tracking
Every claim has a visible status. We monitor every claim at every stage.
- Real-time claim status tracking
- Rejection resolution (24-48 hours)
- NPI and taxonomy verification
Claim Lifecycle
- Clean Path: Submitted → Accepted → Paid
- Rejection Path: Rejected → Corrected → Resubmitted
- Denial Path: Denied → Appeal → Resolution
Denial Management
Every denial is recoverable revenue until the appeals process is exhausted.
- Denial receipt & categorization
- Appeal preparation with documentation
- First-level and second-level appeals
- Peer-to-peer review coordination
Denial Reporting
Monthly reporting on denial trends to fix systemic issues at the source.
- Timely filing denial recovery
- Medical necessity appeals
- Retro authorization requests
- Denial pattern reporting (monthly)
Denial Types We Handle
- CO-4/CO-11 — Code inconsistency
- CO-16 — Missing claim information
- CO-50/CO-97 — Non-covered service
- PR-96 — Non-covered charge
- Prior Auth — Missing authorization
Accurate Payment Posting
Every payment reconciled against the original claim. Every discrepancy caught.
- ERA (Electronic Remittance Advice) posting
- EOB (Explanation of Benefits) manual entry
- Contractual adjustment verification
- Patient balance identification
Reconciliation
Short-pays, overpayments, and discrepancies flagged and resolved before becoming write-offs.
- Secondary claim generation
- Short-pay identification
- Overpayment identification
- Daily & month-end reconciliation
AR Aging Management
Accounts receivable is a living pipeline requiring active management to convert into cash.
- AR aging analysis (0-30, 31-60, 61-90, 90+ days)
- Payer-level systematic follow-up
- High-balance claim prioritization
- Payer trend analysis
Monthly Analytics Reporting
Complete visibility into your revenue cycle performance.
- Total charges & collections
- Denial rate & top 5 reasons
- AR aging distribution
- Payer-level performance
- First-pass acceptance rate
- Appeal success rate
Ready to Take Control of Your Revenue Cycle?
A 30-minute discovery call costs nothing and shows you exactly where your revenue is leaking — and how Silverbridge can fix it.
Book Your Free Discovery Call →