From annual wellness visits and chronic care management to multi-payer complexity and denial management — SCALE delivers revenue cycle intelligence purpose-built for primary care and multi-specialty groups, IPAs, and MSOs.
G0438/G0439 and preventive-vs-E/M separation
CCM/PCM/RPM enrollment, documentation & billing
HCC capture and documentation completeness
Real-time verification across diverse plans
Live dashboards via SCALE's analytics platform
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High-complexity care comes with high-complexity billing — and most generalist RCM vendors aren’t equipped to handle it. SCALE is.
AWV, preventive, and problem-based E/M services require clean separation and modifier-25 discipline to avoid denials.
CCM, PCM, and RPM programs represent significant recurring revenue most groups under-capture.
Diverse payer rules and HCC/risk-adjustment requirements create eligibility and documentation gaps across sites.
Core Service
We manage multi-payer verification and authorization across all of your sites.
AI-Powered
Automated review flags E/M level, modifier-25, and preventive-separation errors.
Denial Recovery
Payer-specific appeals across the full primary-care and multi-specialty claim mix.
Specialty Coding
We identify eligible CCM/RPM patients and close HCC documentation gaps your group is already earning.
Automation handles volume and velocity. Our experts handle exceptions, edge cases, and strategic optimization — creating a closed-loop system that continuously improves performance over time.
We analyze 90 days of claims data to identify coding gaps, denial patterns, and authorization bottlenecks specific to your practice.
Seamless connection to your EHR and practice-management system — no new software for your team to learn or manage.
SCALE’s dedicated team takes over day-to-day RCM operations with transparent reporting from day one.
Monthly performance reviews, payer-policy monitoring, and AI-driven recommendations keep revenue growing over time.
Representative results across SCALE Healthcare clients. Individual outcomes vary by organization size, payer mix, and baseline RCM maturity.
Reduction in average days to pay across SCALE-managed client portfolios
Reduction in cost-to-collect through AI automation and workflow optimization
Reduction in A/R aging beyond 90 days through proactive denial management
Reduction in overall denial rates powered by DenialShield predictive scoring
Book a free 30-minute strategy call with a SCALE Primary care specialist. We’ll review your current denial rates, authorization backlog, and coding performance — at no cost.
