Complete Provider Credentialing
Seamless onboarding and panel credentialing across all major commercial insurance and regional provider networks.
Revenue Cycle Management
Stop Losing Revenue to Billing Friction.
High-performance medical billing, panel credentialing, and claims optimization engineered to maximize collections for behavioral health and medical practices.
HIPAA-compliant workflows · Business Associate Agreement signed before any PHI is exchanged · Works inside your existing EHR
A complete revenue cycle, engineered end to end
Eligibility Verification & Authorization
Real-time coverage validation before care is delivered to slash denial rates and lower front-end friction.
Medical Coding & Code Audit Optimization
Rigorous, expert compliance scrubs and quality assurance tracking to guarantee immaculate claim submissions.
Electronic Claims Engine
Accelerated processing across paper and digital networks, delivering reliable, prompt insurance collections.
The money isn't missing. It's stuck.
In most practices we review, the problem isn't volume — it's what happens to a claim after it's submitted, and who follows up when it doesn't pay.
Denials nobody works
A denied claim that isn't appealed inside the payer window is simply revenue you gave away. Most practices never see the aggregate.
Coding that undersells the visit
Chronic down-coding out of caution costs more over a year than the occasional audit risk it's meant to avoid.
Patient AR that quietly ages
Higher deductibles moved a large share of collections to patients. Statements sent late collect far less.
Eligibility checked too late
Coverage verified after the visit turns preventable rejections into write-offs.
Client testimonial
“Working with NEXACC has been the most rewarding decision my company has ever made. Our books finally reconcile every month and I know where we stand before the close is even finished.”
Dushime Ines
Founder & Owner · Professional services firm
Trustpilot Verified ReviewEverything from the encounter to the deposit
Charge capture & coding review
We review documentation against submitted codes, flag under- and over-coding, and get modifiers right before the claim leaves.
Eligibility & benefits verification
Coverage, deductible status, and authorization requirements confirmed before the visit, not after.
Clean claim submission
Scrubbed claims submitted on a daily cadence through your clearinghouse, with rejections corrected same-day.
Denial management & appeals
Every denial is categorized, worked, and appealed inside payer timelines — and the root cause gets fixed upstream.
Payment posting & reconciliation
ERA and EOB posting reconciled against expected reimbursement so underpayments surface instead of settling in.
Patient AR & statements
Statements, payment plans, and patient billing calls handled with the tone you'd use yourself.
Credentialing & payer enrollment
Panel applications, revalidations, and roster maintenance so new providers bill from day one.
Monthly collections reporting
Collections, days in AR, denial rate by payer and reason, and net collection rate — in plain language.
Transitioning billing without dropping a single claim
- 01
Revenue review
We analyze recent claims, denials, and AR aging and show you where the leakage is — before you sign anything.
- 02
Scope & agreement
A written rate, defined scope, and a signed Business Associate Agreement.
- 03
System & payer access
Read/write access in your existing EHR, clearinghouse connections, and payer portal credentials.
- 04
Parallel run
We take over new claims while working your legacy AR, so nothing drops during the handoff.
- 05
Steady state
Daily submission, active denial work, and monthly reporting with a standing review call.
Free analysis
Free Revenue Leakage Analysis
Send us a recent AR aging report and a denial summary. We'll return a written analysis of your denial patterns by payer and reason, days in AR against specialty norms, and the specific fixes we'd make first. No cost, no obligation, and the findings are yours either way.
Please send de-identified reports only — no PHI until a Business Associate Agreement is in place.
Built for
- Behavioral health and substance use programs
- Primary care, therapy, and specialty groups
- Multi-site and multi-provider practices
- New practices building a revenue cycle from zero
<5%
Target denial rate
96%+
Clean-claim submission rate
<35 days
Target days in AR
How engagements work — Percentage of collections or flat per-claim pricing, depending on volume and specialty. Free 90-day AR and denial audit before you commit.
The problems we solve
Denials pile up and never get worked.
Every denial is worked within 48 hours, categorized by root cause, and fed back into front-end edits so it stops repeating.
You don't know what's actually collectible.
Weekly AR aging by payer and bucket, with a written plan for anything past 60 days.
Claims go out with documentation gaps.
Pre-submission scrubbing against payer rules, plus coding and documentation reviews with your clinical team.
Underpayments go unnoticed.
Contracted fee schedules loaded and every remit compared against expected reimbursement.
Full scope of work
Front end
- Eligibility and benefits verification
- Prior authorization tracking and renewals
- Charge entry and CPT/ICD-10 code review
- Clean-claim scrubbing before submission
Back end
- Electronic claims submission and clearinghouse management
- ERA/EOB posting and reconciliation to the ledger
- Denial resolution, corrected claims, and appeals
- Patient statements, payment plans, and collections handoff
Oversight
- Weekly AR aging and collection rate reporting
- Payer mix, reimbursement, and underpayment analysis
- Utilization review support for behavioral health
- HIPAA-aligned workflows and documentation audits
Where the money comes back
Every engagement is scoped against a return: cost removed, margin recovered, cash pulled forward, or exposure closed.
Clean-claim rate lift
Front-loading eligibility checks and coded charge review cuts payer rejections before submission. On $3M in annual charges, moving clean-claim rate from 85% to 96% is roughly $60,000 in avoided rework and delayed reimbursement.
Denial leakage recovery
Most practices write off 3-5% of charges to denials that were never appealed. On $3M in annual charges, recovering three points of denial leakage is $90,000 that would otherwise disappear into an adjustment code.
Faster days in AR
Working AR by aging bucket instead of by memory shortens the average collection cycle. Pulling days in AR from 55 to 40 on $3M in charges frees roughly $164,000 in cash tied up in unpaid claims.
Underpayment and contract drift
Payer fee schedules change without notice and underpayments blend into normal variance. A quarterly contract comparison against posted allowables catches systematic underpayment before it compounds across a full fee schedule cycle.
What actually lands in your inbox
Clean-claim submission batch
DailyCharges entered, coded, and eligibility-checked claims submitted through the clearinghouse within 48 hours of the encounter closing.
Denial worklist and appeals filed
WeeklyEvery denial triaged by reason code, corrected or appealed within five business days, with a running log of outcomes by payer.
AR aging report by bucket
WeeklyClaims sorted into 0-30, 31-60, 61-90, and 90+ day buckets with the dollar amount and next action attached to each.
Patient statement run
MonthlyStatements generated for patient-responsibility balances after insurance posts, with a defined dunning cadence for unpaid balances past 60 days.
Payer contract and fee-schedule review
QuarterlyPosted allowables checked against contracted rates for your top five payers, flagging any systematic underpayment for renegotiation or appeal.
Documentation and compliance audit
QuarterlySample chart-to-claim review confirming code selection matches documentation, reducing audit exposure and downstream takeback risk.
What working with us feels like
Named billing specialist, not a queue
One person owns your account, knows your payer mix, and answers directly. No ticket routing through a shared inbox or a different rep every time you call.
48-hour claim submission window
Charges entered and eligibility-verified claims go out within two business days of visit close, not batched at month end when timely-filing deadlines are already tight.
Weekly denial and AR touchpoint
A standing 30-minute call or async summary each week covers denials worked, appeals filed, and AR movement, so nothing sits unaddressed for a full billing cycle.
Low-lift onboarding
We pull historical claims data and payer contracts directly from your existing PM system and clearinghouse; your staff spends under two hours on the transition, not weeks.
Benchmarked against the usual option
DimensionTypical optionWith NEXACC
- Claim submission timingBatched weekly or at month close, risking timely-filing missesSubmitted within 48 hours of visit close, daily
- Denial handlingWritten off after one rejection or left unworkedTriaged and appealed within five business days, every time
- AR visibilityAggregate AR total reported monthly, no bucket detailWeekly aging by bucket with a named next action
- Account ownershipRotating reps or offshore claims mill with no single contactOne named specialist who knows your payer mix
- Contract oversightFee schedules assumed accurate, rarely checkedQuarterly allowable-versus-contract review on top payers
Your first 90 days
- Week 1
Data pull and clearinghouse setup
Historical claims, payer contracts, and PM system access transferred; clearinghouse connections tested with a sample batch before live submission begins.
- Day 30
Baseline denial rate established
First full cycle of claims run through the new workflow; denial reasons categorized to identify the top three recurring rejection codes in your payer mix.
- Day 60
Aged AR backlog worked down
Pre-existing 90+ day claims triaged and either collected, appealed, or written off with documentation, clearing the backlog inherited from the prior process.
- Day 90
Clean-claim rate and days-in-AR review
First quarterly performance review comparing clean-claim rate and days in AR against the Day 1 baseline, with adjustments to charge-entry or coding workflow.
Platforms included
Configuration, integration, and day-to-day administration are part of the fee — you are not billed to keep your own systems running.
The cost of leaving it alone
Denials written off instead of appealed
Unworked denials become permanent revenue loss; on $3M in charges, a 3% unappealed denial rate is $90,000 gone every year.
Timely-filing deadlines missed
Late submission past a payer's filing window forfeits the claim entirely, regardless of medical necessity or documentation quality.
Fee-schedule underpayment goes unnoticed
Without a periodic allowable check, systematic underpayment on a common CPT code compounds silently across every claim for that service.
How we run it
- 01
Audit
We review 90 days of claims, denials, and AR to quantify what is being left on the table.
- 02
Stabilize
Aged AR is worked and front-end edits are installed to stop new denials.
- 03
Operate
Daily claims, daily posting, weekly AR review with your practice manager.
- 04
Optimize
Contract, fee schedule, and payer-mix analysis to raise reimbursement per visit.
Why clients choose us over the firm down the street
Billing and books together
Most billing companies stop at the remit. We post it straight into your financials — one source of truth.
Behavioral health depth
Kipu, TheraNest, Avea, ICANotes, BestNotes — we know the systems and the payer behavior.
Credentialing under the same roof
Enrollment delays are a billing problem; we fix both instead of pointing at each other.
Root-cause denial loop
We report why denials happened and change the intake process, not just resubmit.
Medical billing questions
Find out what your billing is leaving behind.
Thirty minutes with an RCM specialist who will look at your actual denial and AR data and tell you what's fixable.
Get my free revenue leakage analysis