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You Did the Work. Your Billing Didn't.(optional) You treated the patient, documented the visit, earned the payment. Then the claim got denied, delayed, or shorted, and now your staff is on hold with a payer instead of running your practice. We fix that. Qualigenix runs your entire revenue cycle so every dollar you earned gets collected, without the chase.
Outsourcing to Qualigenix raises the share of claims paid on first submission to 98% and cuts the average collection cycle to 36 days, which lifts practice cash flow by 29 to 32%. Your team stops spending clinic hours on coding, denials, and payer follow-up, since specialty-certified coders and dedicated billers handle it inside your existing system across 133 EMR and EHR platforms. Denials get appealed instead of written off, aged accounts receivable get worked (Qualigenix has recovered $50M+ for client practices), and you get monthly reporting where every number carries its definition. Onboarding takes 6 days on average, so there is no revenue gap during the switch.
| Metric | Result |
|---|---|
| cash-flow improvement, average across client practices | 0 |
| clean-claim rate on first submission | 0 |
| average collection cycle | 0 |
| A/R recovered for client practices | 0 |
| Metric | Result |
|---|---|
| cash-flow improvement, average across client practices | 0 |
| clean-claim rate on first submission | 0 |
| average collection cycle | 0 |
| A/R recovered for client practices | 0 |
Qualigenix owns each step of the billing cycle so nothing falls between your front desk and the payer. Specialty-certified coders and dedicated billers handle the work inside your system, not a bolt-on portal.
Verify patient coverage, benefits, eligibility, and authorization requirements upfront to prevent avoidable denials and ensure accurate billing.
Specialty coders check every charge against documentation before it becomes a claim, so undercoding and miscoding get caught at the source rather than at denial.
Every claim runs through payer-specific edits before it goes out. This is what holds the 98% first-pass clean-claim rate instead of relying on rework.
Denials are worked to appeal with the corrected documentation, not written off. Root-cause patterns feed back into coding so the same denial does not repeat.
Aged claims are chased down by payer and age bucket. Qualigenix has recovered $50M+ in A/R that practices had effectively given up on.
Payments and adjustments are posted against expected reimbursement, so underpayments surface instead of quietly closing the balance.
BAA and agreement executed; a <strong>named onboarding owner</strong> is assigned to your account
We collect NPIs, tax IDs, contracted payers, fee schedules, and every service location
We connect to your EMR or PM system across supported platforms, <strong>no software change</strong>
Current A/R snapshot pulled so nothing in flight gets dropped
We verify your existing payer enrollments, confirming payer IDs and effective dates, not just approvals
Every service location and place-of-service code is mapped to the right rostered site
Fee schedules, self-pay pricing, and no-show policy loaded into the system
Specialty-certified coders matched to your specialty mix
Claim-scrub edits configured against your highest-volume payers
Taxonomy codes verified to match your specialty across every enrollment
Clearinghouse connected and EDI enrollment redirected to Qualigenix, tracked per payer since every plan handles it differently
We confirm claims route to the correct payer ID, ERAs land in posting, and EFT matches remittance
A test transaction proves the pipe before any real claim goes out
First batch coded, scrubbed, and run against expected reimbursement in a parallel check
Pre-first-claim checklist cleared: correct rendering NPI, matching taxonomy, confirmed payer IDs and effective dates
Any payer not yet effective is moved into a hold-and-release plan so no claim goes out early to be denied
Live claims coded, scrubbed, and submitted daily under Qualigenix
Denials worked to appeal; payments posted against expected reimbursement
Your legacy A/R work plan begins in parallel so old money keeps coming in
Monthly reporting cadence and your named account contact are set
A medical billing company handles the full claim lifecycle for a practice: coding review, claim scrubbing, submission to payers, payment posting, denial appeals, accounts receivable follow-up, and patient statements. Qualigenix runs this as an outsourced revenue cycle for practices across 38+ specialties, submitting on a 98% clean-claim accuracy standard on first submission.