Revenue Cycle
Management (RCM)
Full Revenue Control for Practices That Need Restructuring — Not Patchwork
Revenue Cycle Management at Elite Dental Systems is designed for practices that need full operational correction and control, not just claim support.
This service is for offices where:
AR is out of control
Billing processes are inconsistent or undocumented
Old claims are unresolved
Revenue depends on who is working that day
Systems were never built — only reacted to
In this model, Elite Dental Systems acts as the biller, not an advisor on the sidelines.
We take ownership of:
Claim creation and submission
Daily billing management
Insurance follow-up
Old AR cleanup
Workflow correction
System rebuilding and team guidance
This is hands-on RCM restructuring, followed by stabilization.
What Full RCM at Elite Dental Systems Includes
Daily Billing & Claim Management
Claim creation, submission, and tracking
Insurance payment posting and adjustment accuracy
Denial identification and correction
Ongoing AR management
AR Cleanup & Recovery (First 90 Days)
Identification of unresolved and aged claims
Prioritization of collectible AR
Strategic follow-up and resolution
Workflow corrections to prevent repeat issues
Systems, Training & Documentation Support
Billing and RCM workflows
Insurance verification forms
Financial and clinical consents
Narrative and attachment guidance
Clinical note guidance to support reimbursement
Cheat sheets and reference tools for the team
Team Training & Real-Time Support
Workflow education during implementation
Guidance while systems are actively being corrected
Support designed to reduce confusion — not add work
How This Aligns to the E.L.I.T.E.™ Process
E — Eligibility & Plan Intelligence: Verification systems are rebuilt correctly
L — Legally Defensible Documentation: Notes, narratives, and consents support claims
I — Intelligent Coding & Claim Strategy: Coding is corrected and standardized
T — Timely Submission & Tracking: Old and new claims are actively controlled
E — Ethical Reconciliation & Reporting: Payments and AR reflect reality
RCM Pricing Structure
Assessment Required
RCM pricing reflects both ongoing billing management and the intensity of AR cleanup required.
Practices Collecting Under $40,000 / Month (Insurance)
Base RCM & Daily Billing Management:
Starting at $1,500 / month
This includes:
Daily claim management
Ongoing billing operations
Standard RCM oversight
AR Cleanup Adjustment (First 90 Days)
If accounts receivable over 90 days exceeds 10%, additional cleanup resources are required.
AR >10% over 90 days:
+$1,000 / month during cleanup phase (starting point - assessment required)
This reflects the labor and strategy required to resolve aged claims responsibly.
Typical RCM Engagement
Most full RCM cleanups fall into:
$2,500 / month starting point (collections under $40k)
(RCM + AR cleanup + systems rebuilding)
This includes:
Full billing control
AR cleanup over the first 90 days
Training, workflows, and documentation tools
System correction to prevent repeat AR buildup
After the Initial 90-Day Cleanup
Once systems are stabilized and aged AR is controlled:
Monthly fees typically decrease - falls into regular billing tiers
Billing transitions into ongoing managed RCM
Pricing aligns with stabilized volume and complexity
Why an Assessment Is Required
A final RCM quote cannot be given upfront because:
AR age and collectability varies
Workflow breakdowns differ by practice
Documentation risk must be evaluated
Staffing and system maturity impact scope
A structured assessment ensures:
Accurate pricing
Realistic timelines
Ethical recovery strategies
No surprises after engagement begins
Who This RCM Service Is For
Practices needing full billing takeover
Offices with unresolved AR over 90 days
Teams overwhelmed by billing backlogs
Practices transitioning billing vendors or internal staff
Owners who want control, visibility, and stability
Who This Is Not For
Practices looking for claim-only support
Offices unwilling to change broken workflows
Teams wanting shortcuts instead of systems
Full RCM restructuring requires an assessment to determine AR age, workflow breakdowns, and compliance risk. Final pricing is confirmed after review.
90-Day Revenue Cycle Management (RCM) Optimization Timeline
Purpose:
Stabilize revenue, regain control of AR, correct compliance risks, and rebuild billing systems that don’t rely on memory or individual staff.
-
Stop the bleeding. Establish control.
Primary Focus
Gain full visibility into current revenue and AR
Stop preventable delays and denials
Establish billing authority and daily control
What Happens
Secure onboarding & system access
Full AR assessment (with emphasis on 90+ day balances)
Review current billing workflows and breakdown points
Begin daily claim creation, submission, and tracking
Correct obvious coding and documentation errors
Identify compliance risks
Start resolving high-priority aged claims
Deliverables
AR status baseline
Workflow gap identification
Immediate claim corrections
Billing control established
E.L.I.T.E.™ Alignment
E — Eligibility
L — Documentation
T — Timely Submission -
Fix what’s broken. Recover what’s owed.
Primary Focus
Aggressive AR cleanup
Coding and documentation correction
Workflow standardization
What Happens
Active follow-up on aged and denied claims
Correct CDT/CPT usage and claim strategy
Implement insurance verification forms
Introduce compliant financial & clinical consents
Narrative and attachment guidance
Clinical note documentation alignment
Create internal cheat sheets and billing references
Begin team workflow training
Deliverables
Reduced AR over 90 days
Improved claim acceptance
Standardized billing processes
Team clarity and confidence
E.L.I.T.E.™ Alignment
L — Legally Defensible Documentation
I — Intelligent Coding
E — Ethical Reconciliation -
Make success repeatable.
Primary Focus
Prevent AR from rebuilding
Transition from cleanup to sustainability
Prepare for ongoing RCM management
What Happens
Finalize billing and RCM workflows
Implement SOPs and accountability checkpoints
Refine financial communication processes
Monitor payer behavior and trends
Optimize claim turnaround times
Transition from intensive cleanup to steady-state billing
Reassess pricing based on stabilized collections
Deliverables
Predictable billing workflows
Controlled AR aging
Improved cash flow
Reduced dependence on individual staff
Long-term RCM structure
E.L.I.T.E.™ Alignment
T — Timely Tracking
E — Ethical Reporting -
Lower intensity. Higher control.
AR under control
Daily billing fully managed
Ongoing RCM support
Monthly reporting and oversight
Fee typically reduces after cleanup phase
Systems in place to support growth