End-to-End Medical Billing &
Revenue Cycle Management Services
MiraiCure pairs certified clinical specialists with intelligent claim scrubbing to accelerate cash velocity, eliminate billing bottlenecks, and keep days in A/R under 45 days across the entire claim lifecycle.
Front-End RCM (Patient Access)
Objective: Intercept billing rejections before the clinical encounter occurs.
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Real-Time Eligibility Verification: Instant EDI 270/271 electronic checks to validate active benefits, co-pay tiers, deductibles, and secondary coverage before check-in.
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Rapid Prior Authorization: Dedicated authorization specialists handling clinical documentation submittals, payer portal tracking, and peer-to-peer coordination.
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Intake & Demographic Hygiene: Automated patient data hygiene and address scrubbing to eliminate front-desk registration errors and returned mail.
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Upfront Out-of-Pocket Clarity: Accurate pre-service liability estimates provided directly to the patient, cutting uncollectible self-pay bad debt.
Prevents up to 94% of registration-related denials and accelerates point-of-service patient collections.
Mid-Cycle RCM (Coding & Integrity)
Objective: Capture true clinical acuity without audit exposure or code down-leveling.
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Specialty Chart Coding: Direct chart review and coding led by AAPC and AHIMA credentialed specialists aligned directly with your clinical discipline.
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Electronic Claim Submission: Daily electronic batch generation and clearinghouse transmission (EDI 837) with sub-24h turnaround.
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Clinical Documentation Improvement (CDI): Provider documentation queries and chart reviews that ensure medical necessity is fully substantiated.
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Modifier Compliance & Defense: Bulletproof application and validation for complex surgical, bilateral, and separate-encounter modifiers (25, 59, XE/XP, 26/TC).
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Charge Capture Scrubbing: Automated cross-reconciliation between clinic schedules, operative logs, and billing rosters to prevent missed encounter charges.
Recovers an average of 8%–14% in previously overlooked billable volume while insulating the practice from payer recoupment audits.
Back-End RCM (Cash Flow & Recovery)
Objective: Liquidate aged receivables and turn delayed claims into cash.
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Forensic Denial Appeals (92.6% Win Rate): Clinical denial appeal briefs citing payer LCD/NCD coverage determinations, medical necessity criteria, and CMS statutory policies.
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Aged A/R Liquidation: Systematic workdown of legacy 60+, 90+, and 120+ day balances through direct payer escalation, resolving claims instead of writing them off.
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EDI & Claim Transmission (Daily Scrub & Dispatch): High-speed clearinghouse validation running custom multi-payer edits prior to 837 claim transmission.
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ERA 835 Remittance Auto-Posting: Daily electronic reconciliation of payments, contract adjustment validations, and immediate secondary/tertiary billing rollover.
Compresses the collection cycle to 30-45 days and recovers up to 70% of legacy A/R written off as uncollectible.
Practice Operations (Practice Scale & Admin Support)
Objective: Eliminate administrative overhead and recapture contracted underpayments.
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Commercial & Government Enrollment: Comprehensive provider credentialing, CAQH management, hospital privileging, and Medicare/Medicaid re-validations.
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Fee Schedule & Underpayment Audits: Systematic line-by-line contract audits matching paid remittances against contracted payer fee schedules to reclaim silent underpayments.
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Virtual Medical Staffing: Dedicated, HIPAA-trained practice coordinators managing scheduling queues, inbound referral tracking, and pre-registration tasks.
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Clinical Scribing & Chart Support: Secure documentation assistance enabling clinicians to spend less time typing in EHRs and more time seeing patients.
Lowers back-office operating overhead by 30%–40% while safeguarding contracted payer margins.
Technical Delivery & Governance Framework
Enterprise operating standards engineered for transparency, continuous velocity, and bulletproof security.
Seamless Compatibility with 75+ Leading EHR & PM Platforms
No painful software migrations, no IT downtime, and no data re-entry. Our teams log directly into your existing EHR via secure, encrypted US-based remote connections.
Why Leading Practices Partner with MiraiCure
See how MiraiCure's enterprise RCM service outperforms expensive US in-house staffing and fragmented billing bureaus.
| Operational Dimension | In-House Billing Staff | Traditional Billing Bureau | MiraiCure Dedicated Partner |
|---|---|---|---|
| Clean Claims First-Pass Rate | 72% - 81% | 83% - 88% | 98.4% Guaranteed |
| Denial Overturn Win Rate | 35% (Written off to bad debt) | 58% (Basic resubmissions) | 92.6% Audited Win Rate |
| Average Days in AR | 55 - 70 Days | 45 - 60 Days | 30 - 45 Days SLA |
| Account Management Model | Staff turnover & sick leave risk | Call-center round-robin queue | Dedicated 1-on-1 Account Manager |
| EHR Disruption & Setup | Expensive licensing & training | Forces proprietary software swap | Zero IT Disruption (We log into your EHR) |
| Operational Cost Savings | High US wages, payroll taxes & benefits | Hidden software setup & module fees | Up to 75% Total Cost Reduction |
Frequently Asked Questions About Our Services
Everything you need to know about partnering with MiraiCure, our timeline, contract flexibility, and EHR connectivity.
Request a Full Revenue Cycle Health Audit
Identify margin leakage, coding gaps, and aged balance recovery potential. Delivered within 48 hours.
Submit Practice Profile
Share basic details on your specialty, EHR system, and monthly billing volume.
Confidential Root-Cause Audit
Our credentialed directors examine CARC/RARC patterns, aging A/R distribution, and fee schedule gaps.
Roadmap Delivered in 48 Hours
Receive an actionable blueprint outlining quantifiable revenue recovery and velocity uplift.
Request a Full Revenue Cycle Health Audit
Identify margin leakage, coding gaps, and aged balance recovery potential. Delivered within 48 hours.