Get paid for every claim, faster.
ClaimEdgeSolutions runs your revenue cycle end to end: billing, coding, credentialing, denials and A/R. You get cleaner claims, quicker payments and a team that reports to you every month.
We work inside the systems you already use
Eight stages. Every one can cost you money.
Select a stage of the revenue cycle to see the most common leak and how ClaimEdgeSolutions closes it.
Everything between the visit and the payment
Choose full revenue cycle management or the individual services your team needs most.
Medical Billing & Coding
Certified coders and billers who turn every encounter into a clean, compliant claim.
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Revenue Cycle Management
End-to-end RCM from patient scheduling to the final zero balance.
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Credentialing & Enrollment
Get providers enrolled with payers faster, and keep them active.
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Denial Management
Work every denial, win the appeal, and fix the root cause.
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A/R Recovery & Follow-Up
Turn aging receivables into cash, starting with the highest-value claims.
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Eligibility & Benefits Verification
Know coverage, copays and deductibles before the patient walks in.
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Prior Authorization
Authorizations requested, tracked and approved before care is delayed.
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Patient Billing & Collections
Clear statements, easy payment options and respectful follow-up.
Explore serviceClinical & specialty programs
Virtual Medical Scribe
Trained remote scribes who document in real time so providers can focus on patients.
Learn more ProgramWorkers' Comp Billing
Specialized billing, collections and litigation support for work-injury claims.
Learn more ProgramCCM & RPM Programs
Launch and bill Chronic Care Management and Remote Patient Monitoring correctly.
Learn more ProgramTranscription & Document Indexing
Accurate transcription and organized, searchable patient records.
Learn moreSee every claim, every dollar, every day
Your account manager walks you through collections, denials and A/R every month. No black box, no surprises.
- Collections, denials and A/R by payer and provider
- Root causes for every denial, with the fix
- Monthly review call with your account manager
Illustrative dashboard. Figures are examples, not client results.
Four KPIs decide your cash flow
These are the industry benchmarks we manage your revenue cycle toward. Your monthly report tracks every one.
Claims accepted on first submission without edits.
Average time from service to payment.
Share of claims denied on first pass.
Collected out of everything you are owed.
Benchmarks reflect commonly cited industry targets for well-run practices. Results vary by specialty and payer mix.
Live in weeks, accountable every month
Free revenue audit
We review your A/R aging, denial history, payer mix and coding patterns, then show you what is recoverable.
Onboarding
BAA signed, secure system access set up, workflows mapped and your dedicated team assigned.
Daily operations
Claims, payments, denials, A/R and patient billing are worked every business day.
Monthly review
A KPI report and a call with your account manager covering results and next steps.
Drag to see what a clean revenue cycle looks like
A typical practice before outsourcing, and the picture we manage toward. Illustrative example.
A/R aging
A/R aging
Specialty-trained billing for 26+ fields of medicine
Every specialty has its own codes, modifiers and payer rules. Your coders will know yours.
Cardiology
Cardiology billing combines high-value procedures, diagnostic testing and frequent E/M visits, often…
Behavioral HealthMental Health
Behavioral health billing runs on time-based codes, frequent authorizations and payer carve-outs. We…
Behavioral HealthPsychiatry
Psychiatric practices bill E/M visits with psychotherapy add-ons, medication management and growing…
Primary & MedicalInternal Medicine
Internal medicine practices manage complex, chronic patients with high visit volume. Accurate E/M…
Primary & MedicalFamily Practice
Family medicine sees every age and payer mix, from well-child visits to Medicare wellness. We keep…
Primary & MedicalUrgent Care
Urgent care centers live on volume and speed. We verify walk-in coverage quickly, code visits and…
Surgical & ProceduralOrthopedics
Orthopedic billing involves surgery with global periods, DME, injections, imaging and therapy. We code…
Surgical & ProceduralDermatology
Dermatology mixes medical visits, procedures, pathology and cosmetic services. We separate billable…
Primary & MedicalNeurology
Neurology practices bill diagnostic testing such as EEG, EMG and nerve conduction studies alongside…
Primary & MedicalOncology
Oncology billing carries high-cost drugs, infusion sequencing and constant authorization work. Small…
Surgical & ProceduralGastroenterology
GI practices bill endoscopy in the office, hospital and ASC, often with screening vs. diagnostic…
Surgical & ProceduralOB/GYN
Obstetrics and gynecology billing includes global maternity packages, prenatal visits, ultrasounds and…
Primary & MedicalPediatrics
Pediatric practices bill frequent well-child visits, vaccines, screenings and a large Medicaid/CHIP…
Surgical & ProceduralPodiatry
Podiatry billing depends on routine foot care rules, DME and wound care. We document class findings,…
Surgical & ProceduralPain Management
Interventional pain management depends on procedure coding by level and side, imaging guidance and…
Surgical & ProceduralAnesthesia
Anesthesia billing runs on base units, time units and modifiers. We calculate time correctly, apply…
Diagnostics & FacilitiesRadiology
Radiology billing covers X-ray, CT, MRI, ultrasound, mammography and nuclear medicine, often with split…
Diagnostics & FacilitiesPathology & Laboratory
Pathology and lab billing is high-volume and detail-heavy, with specimen counts, molecular tests and…
Surgical & ProceduralOphthalmology
Ophthalmology combines eye exam codes, diagnostic testing, injections and surgery. We choose between…
Surgical & ProceduralUrology
Urology billing includes in-office procedures, imaging, lab and surgery, plus drug administration for…
Primary & MedicalNephrology
Nephrology billing includes monthly ESRD capitation, dialysis visits and hospital rounding. We bill…
Surgical & ProceduralWound Care
Wound care billing depends on precise measurements, debridement depth and skin substitute rules. We…
Primary & MedicalAllergy & Immunology
Allergy practices bill testing, antigen preparation and injections in high volumes. We count units…
Diagnostics & FacilitiesAmbulatory Surgery Centers
ASC billing uses facility rules that differ from professional billing: ASC payment indicators, multiple…
Primary & MedicalPhysical Therapy
Therapy practices bill timed codes, plan-of-care rules and visit limits. We apply the 8-minute rule…
Surgical & ProceduralGeneral Surgery
General surgeons bill procedures across hospitals and ASCs with global periods, assistants and many…
What could a cleaner revenue cycle be worth?
Move the sliders to match your practice for a quick, conservative estimate.
Illustrative estimate only. It assumes denials brought toward 5% with 60% of the difference recovered, and A/R reduced toward 35 days. Your free audit gives real numbers.
Get my real numbersBuilt for practices of every size
Solo & small practices
Your own billing department without hiring one. Ideal for 1–10 providers.
Multi-specialty groups
Specialty-trained coders and one consolidated view across locations.
Behavioral health
Therapy, psychiatry and counseling practices, with credentialing included.
ASCs & facilities
Facility billing, implants, case costing and payer contract checks.
New practices
Credentialing, payer enrollment and billing set up before day one.
Workers' comp & PI
Specialized billing, liens and litigation support for injury cases.
A billing partner that answers to you
A dedicated team
One account manager plus coders, A/R and credentialing specialists who know your practice.
Transparent reporting
Monthly KPI reports and live access to the numbers. No black box.
Certified coders
AAPC/AHIMA-credentialed coders with specialty-specific experience.
HIPAA by design
A signed BAA, role-based access and encrypted workflows on every account.
Speed you can measure
Claims out within 24–48 hours and denials triaged within one business day.
Aligned pricing
Percentage-of-collections pricing: we earn when you get paid.
Frequently asked questions
Straight answers about how ClaimEdgeSolutions works with your practice.
Ask us anything01What does ClaimEdgeSolutions do?
ClaimEdge RCM Solutions LLC is a medical billing and revenue cycle management company. We handle billing, coding, credentialing, eligibility, prior authorizations, denials, A/R follow-up and patient billing for healthcare providers across the U.S.
02Which specialties do you support?
We support more than 25 specialties, including cardiology, behavioral health, orthopedics, dermatology, urgent care, internal medicine, OB/GYN, pain management, radiology and ambulatory surgery centers.
03How much does medical billing cost?
Most practices pay a percentage of monthly collections, so pricing scales with your results. The rate depends on specialty, volume and services. Request a free audit for an exact quote.
04Will we lose control of our billing?
No. You keep full access to your EHR and data, receive monthly KPI reports and have a dedicated account manager you can reach directly.
05Is ClaimEdgeSolutions HIPAA compliant?
Yes. We sign a Business Associate Agreement with every client and follow strict administrative, technical and physical safeguards.
06How quickly can we get started?
Most practices are live within 2–4 weeks of signing, depending on system access and credentialing status.
See where your revenue is leaking
Get a free, no-obligation revenue audit. We review your A/R, denials and coding patterns and show you exactly what is recoverable.