End-to-end RCM and coding services and solutions for high-performing MSOs, provider practices, ASCs and hospital systems.

About

SCALE RCM

SCALE RCM’s mission is to help high-performing practices thrive in today’s highly complex SCALE Healthcare marketplace. We offer a portfolio of services designed to achieve RCM and coding performance transparency, efficiency, and results optimization. 

Our unbiased suite of RCM solutions was developed in response to the prevailing one-size-fits-all approach of the industry. To best meet our client’s precise needs and objectives, SCALE RCM provides flexible service offerings ranging from consulting solutions to interim RCM leadership to fully managed (outsourced) services.

SCALE RCM is headquartered in New York.

The SCALE Difference

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years - operating a successful revenue cycle business
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years - average client tenure
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client retention

CASE STUDY:

Full-Service RCM

Client Profile

Our Client’s former outsourced RCM company was underperforming with a lack of denial and AR management resulting in high Days in AR and %AR > 90 days. Over 800 UnitedHealthcare claims were pending medical records review, up to 1 year old.

The Owner has noticed a significant increase in number and frequency of payments and we are expected to see a 10% increase in practice revenue. We estimated $250,000 in recovered collections from aged claims (2/3 of 1-month).

SCALE was able to bring the Client immediately up to date on ongoing Medical Records Requests and all claims and payments are current and up to date.

CASE STUDY:

Full-Service RCM

Client Profile

Location:
NYC
Specialty:
Endocrinology

Our Client’s former outsourced RCM company was underperforming with a lack of denial and AR management resulting in high Days in AR and %AR > 90 days. Over 800 UnitedHealthcare claims were pending medical records review, up to 1 year old.

SCALE was able to bring the Client immediately up to date on ongoing Medical Records Requests and all claims and payments are current and up to date. The Owner has noticed a significant increase in number and frequency of payments and we are expected to see a 10% increase in practice revenue. We estimated $250,000 in recovered collections from aged claims (2/3 of 1-month).

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instances where SCALE RCM achieved material performance improvement in key RCM results across collection rates, collection days, denials, reporting transparency, etc.

SCALE RCM Consulting Services

More than an outsourced RCM solution.​

"SCALE RCM has been a true partner to us as we scale our physician-centric MSO. They not only helped define and implement a successful billing integration program across our business units, they also sourced permanent in-house leadership to continue the work they started. We feel confident that we have a best-practice system in place now, and with dedicated leadership at the helm."

SCALE RCM Fully Managed Services

Improve your RCM performance and results.

Why SCALE RCM?

We Systematize RCM

We take the guesswork out of RCM performance. Our team has decades of experience in RCM for high-performing physician practices.

We Leverage SCALE Healthcare

We leverage SCALE’s multi-disciplinary operational service lines to create a differentiated and more holistic value-add experience for each engagement.

How We Work

Every engagement is unique since every practice is unique. We follow a standardized analysis to qualify and measure all areas of your revenue cycle management processes, from patient intake to insurance billing to patient billing and collections. Regardless of whether you engage us for consulting or fully managed services, we offer the same level of dedication, transparency and execution support to help your billing department succeed.

Dedicated, seasoned account leadership

We bring a highly experienced team of managers trained in our proprietary approach to holistic RCM performance management. Our team has a low ratio of account managers to accounts, ensuring high-touchpoint client communications and quality controls.

Regular performance update meetings

We review historical results across a broad range of workflows and results, identify areas for performance improvement, and provide regular analytics-driven updates, including predictive analytics and credentialing status reports.

Integration with numerous SCALE Healthcare MSO services and solutions

  • Finance - accrual revenue management
  • Payer contracting - payer project escalation, in-network negotiations
  • Coding - provider auditing, training, and education
  • IT - business intelligence performance analytics, systems and site-of-service integration

Multilayered, analytics-driven internal quality controls and oversight

SCALE RCM's proprietary, analytics-driven performance dashboards and benchmarking show real-time progress.

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