Make billing invisible with DelonHealth’s US RCM

In US healthcare, great clinical care isn’t enough—you need a revenue engine that runs quietly in the background, turning encounters into cash without draining staff time or patient goodwill. That’s what “billing made invisible” means: front-desk teams aren’t firefighting eligibility errors, providers aren’t wrestling with codes, and patients get clear statements with easy ways to pay. Money moves; clinicians focus on care.

DelonHealth delivers this reality for US practices by combining certified people, battle-tested processes, and modern technology into one seamless revenue cycle management (RCM) system. Whether you’re a solo practitioner or a multi-site specialty group, we plug into your EHR and operations, reduce denials, accelerate cash flow, and elevate patient experience—without adding management overhead.

This guide explains exactly how we do it, step by step, across the revenue cycle. Use it as a blueprint to evaluate your current process and as a roadmap for making billing truly invisible.

Why Make Billing “Invisible”?

• Fewer touchpoints, fewer errors: Every manual handoff multiplies risk. Invisible billing minimizes friction by integrating tasks and automating handoffs.
• Faster cash, predictable cash: Clean claims out fast; denials worked scientifically; patient responsibility collected with compassion and clarity.
• Happier staff and patients: Front desk workflows that work, documentation that “just fits” coding, statements that make sense, and payment methods people actually use.
• Compliance without anxiety: Built-in controls that satisfy HIPAA, CMS, OIG, payer contracts, and state rules—so audits are non-events.

Insurance Eligibility Verification

Eligibility is the first and most common point of failure. The smallest mismatch (subscriber ID, plan, COB) can cascade into denials and write-offs.

What we do:

Verify patient insurance: Ensure that patient insurance information is verified prior to the provision of any medical services. This will help prevent any issues with claims processing later on.

Result: Higher point-of-service collections, fewer eligibility denials, and less rework.

Medical Terminology

Precise language in documentation is the bridge between clinical care and compliant coding.

What we do:

• Quick-reference guides by specialty to align provider notes with payer expectations.
• Micro-trainings embedded in your EHR workflow to standardize terminology that supports medical necessity.
• Clinician feedback loops from coding audits (e.g., E/M leveling signals, common modifier triggers).

Result: Documentation that effortlessly supports appropriate codes and payment.

Medical Coding

Coding is where revenue is either realized or lost. Under-coding leaves money on the table; over-coding invites audit risk.

What we do:

• Specialty-aligned, certified coders (behavioral health, primary care, women’s health, therapy, cardiology, pain, ortho, and more).
• Pre-bill audits to catch E/M level mismatches, NCCI edits, and missing/incorrect modifiers

Result: Higher first-pass acceptance and compliant revenue

Claims Processing

Fast, accurate submissions keep days in A/R low and cash flowing.

What we do:

• Clear clearinghouse rejections within 24–48 hours; maintain zero aged rejection queues.
• File within payer timely filing limits and document evidence for corrected claims.

Result: Clean claim rates climb, rework falls, and cash lands sooner.

Claim Denials

Denials are a signal—a map to your next improvement sprint.

What we do:

• Classify denials by taxonomy (CO-, PR- codes) and payer; monitor root causes and recurrence.
• Playbooks for top denial families: eligibility, authorization, documentation, bundling, duplicate, and medical necessity.
• Timebound appeals with evidence packets, citations, and escalation paths.
• Close the loop: fix the upstream workflow so the same denial doesn’t return.

Result: Denial rates trend down; overturn rates trend up; predictability improves.

Patient Statements

After insurance adjudication, patient responsibility must be clear, timely, and simple to pay.

What we do:

• Plain-language statements with “how we calculated this” callouts and itemization.
• Rolling statement cycles (not batch-monthly) for faster collections.
• Digital delivery (email/SMS), branded payment portals, card-on-file, and payment plans.
• Support teams trained to resolve questions quickly and empathetically.

Result: Fewer billing calls, faster payments, and a better patient experience.

Electronic Health Records (EHRs)

Billing becomes invisible when your EHR and RCM truly work together.

What we do:

• We are EHR-agnostic and optimize what you already use.
• Tune templates for documentation sufficiency and speed; enable charge capture, eligibility, and claim scrub features you may not be using.
• Establish interfaces and roles to reduce swivel-chair tasks and duplicate entry.

Result: Less friction for staff, fewer avoidable edits, faster throughput.

Compliance

Protect revenue by protecting the rules.

What we do:

• HIPAA-aligned operations, role-based access, encryption, and BAAs.
• Coding compliance checks, internal QA audits, incident response playbooks, and audit prep.
• Adherence to CMS, OIG, payer contracts, No Surprises Act, and state regulations.

Result: Audit-ready documentation and defensible revenue.

Revenue Cycle Management (RCM)

RCM is not a department—it’s a system.

What we do:

• One operating model from front desk through back-end AR.
• KPI dashboards: Clean Claim Rate, First-Pass Acceptance, Denial Rate, Net Collection Rate, Days in A/R, DNFB (Discharged Not Final Billed).
• Weekly huddles and monthly executive reviews; quarterly roadmap sprints to attack the top constraints.

Result: A compounding engine that gets better the longer it runs.

Outsourcing

When does outsourcing make sense—and how do you do it without losing control?

When to consider it:

• Rapid growth or staffing gaps.
• New service lines (telehealth, behavioral IOP/PHP, advanced procedures).
• Persistent denial spikes or aged AR backlogs.

How DelonHealth does it:

• Flexible models: full outsourcing, co-sourcing, or project-based cleanup.
• Transparent SLAs, outcome tracking, and your data in your systems.
• Dedicated US-market teams that integrate with your workflows and culture.

Result: Capacity on demand with clear accountability.

Duplicate Billing

Small mistake, big consequences.

What we do:

• System rules to block duplicates at submission and segregate corrected claims from originals.
• Work-queue design and staff training to prevent status confusion.
• Root-cause analysis (timing issues, resubmission logic) and fix.

Result: Fewer payer flags, faster acceptance, less wasted effort.

Technology in Medical Billing

Automate the repeatable. Escalate the exceptional.

What we do:

• Analytics to expose denial drivers, payer behavior, underpayments, and AR aging by payer/CPT/location.
• Secure portals, audit trails, and role-based access to protect PHI.

Result: Teams spend time on high-value work—not busywork

KPIs We Obsess Over

• Clean Claim Rate (CCR): % of claims that pass clearinghouse and payer edits the first time.
• First-Pass Acceptance: Payer accepts without denial or rework.
• Denial Rate & Top Denial Families: Trend down; prevention up.
• Days in A/R (overall and by payer): Cash speed and predictability.
• Net Collection Rate: What you collect vs. what you should collect.
• Underpayment Recovery: Captured variance vs. contractual allowed amounts.

Specialties We Serve

• Primary care, behavioral & mental health, women’s health, PT/OT/ST, urgent care, cardiology, pain, orthopedics, podiatry, and more. If your specialty isn’t listed, ask—chances are we already have a playbook.

Frequently Asked Questions

• Do you work with our EHR and clearinghouse?
  Yes. We’re EHR-agnostic and integrate with major clearinghouses. Our first step is to optimize your current stack.
• Can you help with credentialing?
  Absolutely—new enrollments, revalidations, and CAQH maintenance to keep your payer panel healthy.
• How do you price?
  Transparent models: percentage of collections for full RCM, or fixed fees for defined workstreams (coding only, AR cleanup, denial management, credentialing).
• Will we lose visibility if we outsource?
  No. You’ll have dashboards, weekly touchpoints, a single point of contact, and full data access. We operate as an extension of your team.

Action Plan: Make Billing Invisible in 30 Days

1. Eligibility & Front-Door Fixes
   • Turn on automated verification and PA screening at scheduling.
   • Train front desk on scripts and COB capture.
2. Coding & Scrub Uplift
   • Run a pre-bill audit; deploy modifier and NCCI edit rules.
   • Launch targeted micro-trainings for providers.
3. Denial Blitz
   • Classify top three denial families; implement playbooks and appeals timelines.
4. Patient Payments Modernization
   • Switch to rolling statements; enable digital delivery, portal, and payment plans.
5. Governance & KPIs
   • Stand up weekly huddles, monthly executive reviews, and a dashboard that everyone shares.

Why DelonHealth

• US-grade expertise with certified coders, denial and AR specialists.
• Proven playbooks tuned by payer and specialty.
• Data-driven operations that raise CCR, lower denials, and pull cash forward.
• Patient-first billing that improves satisfaction and collections.
• Security & compliance baked in: HIPAA, BAAs, audit trails, and role controls

Let’s Make Your Billing Invisible

Your clinicians deserve to focus on care. Your patients deserve clarity. And your business deserves a revenue cycle that quietly performs.

Get a free revenue cycle assessment and see where cash is leaking—and how quickly we can fix it.

• Request an AR/denial trend review.
• Pilot DelonHealth on a single payer or service line and compare results.
• Keep your EHR and data; gain a partner that makes it all work.

DelonHealth | US Medical Billing & Revenue Cycle Management
Fewer denials. Faster payments. Happier patients. Invisible billing.

Whether you’re a primary care provider, endocrinologist, or weight management clinic, our medical billing expertise helps you focus on patient care while we handle the financial side.

📞 Learn more about our medical billing solutions:
Visit: www.delonhealth.com
Email: info@delonhealth.com
Call: +1 (508) 455-0015 | +1 (508) 455-0095