Trusted by 500+ Healthcare Providers

Stop Leaving
Revenue on
the Table.

EverCare RCM eliminates claim denials, coding errors, and billing delays so your practice gets paid faster, more, and with zero compliance risk.

HIPAA Compliant
24hr Turnaround
98% Clean Claim Rate
+34% Revenue vs previous biller
Practice Revenue Dashboard
98%
Clean Claims
1.8%
Denial Rate
$2.4M
Recovered AR
Claim Acceptance98.2%
On-time Collection94.6%
Patient Satisfaction97.1%
24hr Claim Filing Avg payment in 18 days
$42M+
Revenue Recovered Annually
98%
First-Pass Clean Claim Rate
500+
Practices Nationwide
30%
Avg Revenue Increase
15+
Medical Specialties Served
Common Billing Failures
Is Your Practice
Losing Money Right Now?

Most practices unknowingly lose 15–30% of their collectible revenue every month due to preventable billing errors. These are the exact issues we identify and resolve in your free audit.

EverCare RCM was built to permanently eliminate these revenue-destroying problems.

High Claim Denial Rates

Denied claims drain thousands monthly. Incorrect codes, missing modifiers, and authorization gaps are the top culprits — we fix them before submission.

EverCare reduces denials to under 2%

Inaccurate Medical Coding

Upcoding and undercoding both carry risk — one triggers audits, the other leaves money behind. Our certified coders ensure exact ICD-10 and CPT accuracy every time.

CPC-certified coders across 15+ specialties

Slow Reimbursements

Aging AR beyond 90 days means cash-flow problems. Late or incomplete claim submissions cause weeks of unnecessary payment delays that cripple operations.

Claims filed within 24hrs — avg payment 18 days

Insurance Eligibility Errors

Verifying eligibility after the visit leads to uncompensated care. Real-time pre-authorization and eligibility checks prevent costly surprises at claim time.

Automated real-time eligibility verification

Uncollected Patient Balances

Confusing statements and poor follow-up lead to write-offs. Patient-friendly billing, payment plans, and professional collections rescue balances that practices write off.

Up to 28% increase in patient collections

Compliance & Audit Risk

Non-compliant billing practices expose providers to OIG audits, fines, and exclusion. Our compliance-first approach protects your license and reputation proactively.

Full HIPAA + OIG compliance guarantee

Lack of Revenue Visibility

Flying blind without financial dashboards means problems fester undetected for months. Real-time KPI reporting catches drops in collections, payer trends, and denial spikes instantly.

Live dashboards with actionable analytics

Staff Bandwidth & Burnout

In-house billing consumes clinical staff time, increases overhead, and leads to errors from fatigue. Outsourcing to specialists frees your team to focus on patient care.

Dedicated billing team — no hiring costs

All these problems are identified — and solved — in your Free Revenue Audit.

What We Deliver
End-to-End RCM Services
That Actually Perform

From patient registration to final payment, EverCare handles every touchpoint of your revenue cycle with precision, speed, and accountability.

01

Medical Coding

CPC-certified coders with specialty-specific expertise. Accurate ICD-10, CPT, HCPCS, and modifier assignment to capture every dollar of reimbursable revenue.

ICD-10CPTHCPCSE&M
02

Claims Submission

Electronic claims submitted within 24 hours with full scrubbing and validation. Paper claims managed with equal precision. Real-time status tracking via our portal.

ElectronicPaperReal-time
03

Denial Management

Systematic denial root-cause analysis, correction, and rapid appeals. Payer-specific appeal strategies with documented outcomes to prevent recurrence.

AppealsRoot CausePrevention
04

AR Follow-Up

Aggressive yet professional accounts receivable management. Aging buckets monitored daily. No claim left unpursued regardless of payer or balance size.

Aging ReportsFollow-upPayer Calls
05

Eligibility & Auth

Real-time insurance verification before every patient visit. Prior authorization management to prevent claim rejections and protect patient access to care.

Real-timePrior AuthCoverage
06

Analytics & Reporting

Custom dashboards with KPIs, payer mix analysis, denial trending, and collection rate benchmarks. Weekly and monthly reports delivered to your inbox.

KPIsPayer MixBenchmarks
Specialties We Serve
15+ Medical Specialties —
One Expert Partner

Click any specialty below to see the exact services we provide, the billing issues that cost that specialty the most revenue, and how EverCare solves them.

❤️ Cardiology

Cardiac billing is among the most complex — high-value procedures, strict medical necessity rules, and frequent payer audits.

EKG, echocardiography & stress test billing (CPT 93000–93350)
Cardiac catheterization lab billing & bundling rules
Pacemaker & device implant procedure billing
Cardiac rehab program billing (CPT 93797–93798)
Remote cardiac monitoring (RPM) billing & compliance
Global surgical period management for cardiac procedures
97%
Clean Claim Rate
21d
Avg. Reimbursement
38%
Avg Revenue Lift

Top Reimbursement Issues

Medical necessity denials on echo & stress tests — payers require specific ICD-10 diagnosis linking
Bundling errors on cath lab procedures — NCCI edits frequently mismatch facility vs professional billing
Modifier -26 / TC missing on global vs split billing for imaging reads
Prior auth failures for device implants causing full claim denials
RPM billing without proper setup codes leading to non-covered claims

How EverCare Fixes ThisOur Solution

Cardiology-specific NCCI edit scrubbing before every submission
Proactive prior auth for all device and interventional procedures
Dedicated cardiac coder with CPC + cardiac specialty certification
Real-time diagnosis linking engine to satisfy medical necessity automatically

🦴 Orthopedics

High surgical volumes, implant billing, and global period management make ortho billing one of the highest-risk specialties for revenue leakage.

Joint replacement (hip, knee, shoulder) billing & implant cost reporting
Fracture care & casting/splinting procedure billing
Arthroscopic surgery CPT coding (29800–29999 range)
Global surgical period tracking & follow-up visit billing
Workers' comp & auto accident billing with proper documentation
Spine surgery & neuromonitoring billing coordination
96%
Clean Claim Rate
$1.2M
Avg AR Recovered
42%
Avg Revenue Lift

Top Reimbursement Issues

Global period violations — billing E&M visits within the global surgical window without -24 or -25 modifier
Implant pass-through billing rejected by payers without invoice documentation
Workers' comp claims denied due to missing mechanism-of-injury codes
Arthroscopy add-on codes billed without base procedure causing rejections
Incorrect laterality modifiers (RT/LT) causing claim rejections

How EverCare Fixes ThisOur Solution

Automated global period tracker flags every follow-up visit for correct modifier assignment
Implant invoice capture workflow built into onboarding process
Workers' comp specialists with state-specific fee schedule expertise
Laterality and add-on code validation in pre-submission scrubber

🧠 Mental Health

Behavioral health billing is governed by mental health parity laws, strict documentation requirements, and highly variable payer policies.

Individual & group psychotherapy billing (CPT 90832–90838)
Psychiatric evaluation & medication management billing
Telehealth/telepsychiatry billing & platform compliance
Substance use disorder & addiction treatment billing
Mental health parity compliance audits & appeals
Crisis intervention & intensive outpatient program (IOP) billing
98%
Clean Claim Rate
45d
Avg Cash Flow Stable
31%
Avg Revenue Lift

Top Reimbursement Issues

Psychotherapy add-on codes (90833, 90836) denied when billed with E&M without proper documentation
Telehealth claims denied due to incorrect place-of-service codes (02 vs 10 vs 11)
Prior auth not obtained for IOP or PHP levels of care
Parity law violations by insurers — underpaid claims not appealed
Credential mismatches — LCSWs billed under wrong NPI taxonomy

How EverCare Fixes ThisOur Solution

Behavioral health billing specialists trained in parity law compliance and appeals
Telehealth POS code database updated with every payer policy change
Credential verification workflow ensures all providers bill under correct NPI/taxonomy
Proactive parity appeals with legal documentation support

🏠 Primary Care

High patient volumes with low per-visit reimbursement mean margins are tight — and every missed charge or undercoded E&M level adds up fast.

E&M level optimization (99202–99215) with MDM documentation audit
Annual wellness visits (AWV) & preventive care billing (G0438, G0439)
Chronic care management (CCM) & principal care management billing
Transitional care management (TCM) billing post-hospitalization
In-office lab & procedure billing (EKG, UA, I&D, biopsies)
Medicare Annual Wellness & HEDIS quality measure billing
99%
Clean Claim Rate
16d
Avg Reimbursement
27%
Avg Revenue Lift

Top Reimbursement Issues

E&M undercoding — physicians defaulting to 99213 when 99214 or 99215 is documented and justified
CCM billing not set up — most PCPs leave $42–$80/patient/month uncollected
AWV vs office visit same-day billing — modifier -25 missing causing rejections
Preventive vs diagnostic visit billing confusion leading to patient billing disputes

How EverCare Fixes ThisOur Solution

Monthly E&M level audit with provider-specific feedback reports
CCM program setup — identify eligible patients and automate monthly billing
Same-day visit modifier logic built into claim scrubber
Patient-friendly EOB explanations to reduce preventive billing disputes

🚑 Urgent Care

High patient volumes, uninsured/underinsured patients, and real-time eligibility challenges make urgent care billing uniquely demanding.

Urgent care facility fee billing with correct POS 20 coding
High-volume E&M with rapid charge capture workflow
Laceration repair, splinting & minor surgical billing
X-ray, rapid lab & point-of-care testing billing
Occupational health & workers' comp billing
Copay & patient balance collection at point of service
97%
Clean Claim Rate
14d
Avg Reimbursement
24%
Avg Revenue Lift

Top Reimbursement Issues

Real-time eligibility failures — uninsured patients not identified before service, leading to write-offs
Wrong POS code (20 vs 11) causing claim rejections or reduced reimbursement rates
Rapid test codes (COVID, strep, flu) billed incorrectly or missing QW modifier
Charge capture delays in high-volume environments leading to missed claims

How EverCare Fixes This

Front-desk eligibility verification protocol with same-day confirmation workflow
Urgent care-specific POS rule engine built into all claims
POC test code library with QW modifier auto-assignment
24-hour charge capture SLA with daily volume reconciliation

🧬 Neurology

Neurodiagnostic procedures are among the most denied in all of medicine due to strict medical necessity and complex CPT bundling rules.

EEG billing — routine, ambulatory, and video EEG (CPT 95812–95830)
EMG & nerve conduction study billing (CPT 95907–95913)
Botox injection billing for migraine & spasticity (J0585)
Sleep study billing (CPT 95810, 95811) with CPAP follow-up
Intraoperative neuromonitoring (IONM) billing coordination
Multiple sclerosis infusion therapy (Tysabri, Ocrevus) billing
96%
Clean Claim Rate
22d
Avg Reimbursement
35%
Avg Revenue Lift

Top Reimbursement Issues

EMG medical necessity denials — payers require specific nerve conduction findings pre-authorization
Botox J-code claims denied due to missing diagnosis link (G43.7 for migraine)
EEG technical vs professional component billing confusion causing double-billing flags
MS infusion therapy prior auths expiring mid-treatment causing claim gaps

How EverCare Fixes ThisOur Solution

Neurology-trained coders with specific EMG/EEG bundling rule expertise
Botox J-code billing workflow with automatic ICD-10 pairing validation
Technical vs professional component tracking per payer contract
Infusion therapy auth renewal calendar with 30-day advance alerts

🩻 Radiology

Radiology billing involves complex technical/professional component splits, teleradiology credentialing, and strict AUC compliance requirements.

CT, MRI, X-ray & ultrasound professional/technical billing
Interventional radiology procedure billing (biopsies, drains, PICC)
Teleradiology billing with multi-state licensing compliance
Appropriate Use Criteria (AUC) documentation for advanced imaging
Nuclear medicine & PET scan billing (CPT 78xxx range)
Mammography screening & diagnostic billing with MQSA compliance
97%
Clean Claim Rate
19d
Avg Reimbursement
29%
Avg Revenue Lift

Top Reimbursement Issues

TC/PC split billing errors — modifier -26 and -TC misapplied causing overpayments flagged for audit
AUC non-compliance for MRI/CT orders — Medicare requires CDSM consultation documentation
Teleradiology claims denied due to state licensure mismatches
Contrast vs non-contrast study billing — wrong CPT selected from similar code pairs

How EverCare Fixes ThisOur Solution

Automated TC/PC modifier assignment based on facility vs professional billing setup
AUC compliance tracking with CDSM documentation capture workflow
Teleradiology credentialing database with state licensure expiration alerts
Contrast/non-contrast CPT code pairing validation in claim scrubber

🔬 Gastroenterology

GI procedures like colonoscopies have unique screening vs diagnostic billing distinctions that cost practices thousands monthly when miscoded.

Colonoscopy & EGD billing — screening vs diagnostic correct coding
Polyp removal, biopsy & ablation add-on code billing
Anesthesia & moderate sedation billing coordination
Capsule endoscopy & ERCP billing (CPT 43260–43278)
Infliximab & biologic infusion therapy billing (J1745)
GERD, IBD & liver disease chronic management billing
98%
Clean Claim Rate
20d
Avg Reimbursement
33%
Avg Revenue Lift

Top Reimbursement Issues

Screening colonoscopy billed as diagnostic (45378 vs 45380) — patients receive unexpected bills causing disputes
Polyp removal add-on codes not captured when multiple techniques used in same session
Biologic infusion J-codes denied without specific diagnosis + prior auth documentation
Anesthesia coordination breakdowns causing duplicate billing flags

How EverCare Fixes ThisOur Solution

Screening vs diagnostic determination engine built into charge capture
Multi-procedure session coding checklist to capture every add-on code
Biologic infusion billing team with drug-specific J-code and auth workflows
Anesthesia coordination protocol with ASC and hospital billing teams

👶 Pediatrics

Pediatric billing is complicated by age-specific coding, Medicaid complexity, vaccine administration billing, and EPSDT program requirements.

Well-child visit billing by age group (CPT 99381–99385, 99391–99395)
Vaccine administration billing (CPT 90460–90461) with VFC program
EPSDT (Early Periodic Screening) Medicaid billing compliance
Developmental screening & autism spectrum billing (96110, 96127)
Newborn hospital care billing (CPT 99460–99463)
Medicaid managed care & CHIP plan billing optimization
98%
Clean Claim Rate
18d
Avg Reimbursement
26%
Avg Revenue Lift

Top Reimbursement Issues

Vaccine administration codes billed without counseling components — missing 90460 add-ons
Medicaid EPSDT claims rejected due to missing or incorrect visit type codes
Well-child + sick visit same-day billing without modifier -25 on the sick visit E&M
Age-bracket coding errors — using wrong preventive E&M code for patient's age group

How EverCare Fixes ThisOur Solution

Pediatric-specific age-bracket coding logic auto-selects correct preventive E&M
Vaccine counseling add-on code capture workflow per administration
Medicaid plan-specific EPSDT billing rules database updated quarterly
Same-day visit modifier -25 auto-applied when preventive + sick visit documented

🏃 Physical Therapy

PT billing is governed by therapy cap rules, functional limitation reporting, KX modifiers, and tight documentation requirements for medical necessity.

PT, OT & speech therapy timed vs untimed code billing
KX modifier billing for therapy cap exceptions
Functional limitation reporting (G-codes) for Medicare patients
Therapeutic procedure bundling rules (CPT 97110, 97530, etc.)
Evaluation & re-evaluation billing with assessment documentation
Home health PT billing & OASIS documentation support
97%
Clean Claim Rate
17d
Avg Reimbursement
28%
Avg Revenue Lift

Top Reimbursement Issues

Therapy cap reached without KX modifier — Medicare claims denied above annual threshold
Timed code 8-minute rule violations — incorrect unit counts on time-based CPT codes
Medical necessity denials for extended care — inadequate functional outcome documentation
Bundling violations — billing manual therapy with therapeutic exercise without checking NCCI edits

How EverCare Fixes ThisOur Solution

Therapy cap tracker with automatic KX modifier alert when approaching threshold
8-minute rule calculator built into charge entry for all timed codes
Functional outcome documentation template aligned to payer medical necessity criteria
PT-specific NCCI edit database updated with every quarterly CMS release
Limited — Only 20 Spots/Month
Get Your Free
Revenue Audit Today

Our billing experts will analyze your current RCM process, identify revenue leaks, and deliver a custom improvement plan — completely free, no obligation.

Full claims analysis — identify your exact denial reasons and revenue gaps
Coding accuracy review — spot undercoding, overcoding, and missed charges
AR aging report review — uncover how much money you're leaving behind
Custom revenue recovery roadmap — a step-by-step plan tailored to your practice
Payer contract analysis — ensure you're being reimbursed per contract rates
Schedule My Free Audit Now

📞 Call directly: +1 (800) 555-1234  |  Response within 2 business hours

Request Your Free Audit

Takes 60 seconds. No credit card needed.

🔒 HIPAA Compliant  |  No Spam  |  No Obligation

How It Works
Our Proven 5-Step Process
1

Patient Registration

Eligibility verified, demographics confirmed, and prior auth obtained before the visit even starts.

2

Medical Coding

Certified coders assign the most accurate, optimized codes for maximum reimbursement.

3

Claims Submission

Scrubbed, validated claims submitted electronically within 24 hours of receiving documents.

4

Payment Posting

ERA/EOB posted in real-time with variance analysis. Every dollar accounted for, every discrepancy flagged.

5

Collections & Reporting

AR follow-up, denial appeals, patient balance collection, and full analytics delivered monthly.

Client Success Stories
Real Results from Real Practices

Don't take our word for it. Here's what physicians and administrators say after switching to EverCare RCM.

Revenue up 34% in 90 days

"Our denial rate dropped from 22% to under 2% within the first quarter. EverCare identified coding gaps our previous biller had been missing for years. The dashboard alone is worth it."

S
Dr. Sarah Mitchell, MD
Cardiologist — Heart Health Partners, TX
$1.2M recovered in 6 months

"Switching to EverCare was the single best business decision for our 4-location orthopedic group. They recovered $1.2M in previously uncollected AR and cut our billing staff costs by 60%."

R
Robert Chen, MD
Practice Director — OrthoElite Group, CA
Cash flow stabilized in 45 days

"Mental health billing is incredibly complex with parity laws and prior auths. EverCare handles it all flawlessly. Our cash flow is now predictable, and I finally stopped dreading month-end reports."

A
Amanda Torres, LCSW
Director — Serenity Mental Health Group, NY