AI-Powered RCM Built for Primary Care & Multi-Specialty Groups
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.
AWV & Preventive Coding
G0438/G0439 and preventive-vs-E/M separation
Chronic Care & RPM
CCM/PCM/RPM enrollment, documentation & billing
Risk Adjustment & HCC
HCC capture and documentation completeness
Multi-Payer Eligibility
Real-time verification across diverse plans
Real-Time RCM Analytics
Live dashboards via SCALE's analytics platform
Primary care billing is uniquely complex. We know it cold.
High-complexity care comes with high-complexity billing — and most generalist RCM vendors aren’t equipped to handle it. SCALE is.
Preventive-vs-E/M Separation
AWV, preventive, and problem-based E/M services require clean separation and modifier-25 discipline to avoid denials.
Untapped Chronic-Care Revenue
CCM, PCM, and RPM programs represent significant recurring revenue most groups under-capture.
Multi-Payer & Risk Complexity
Diverse payer rules and HCC/risk-adjustment requirements create eligibility and documentation gaps across sites.
How SCALE solves it
Eligibility & Authorization Management
We manage multi-payer verification and authorization across all of your sites.
Primary Care Coding & Charge Capture
Automated review flags E/M level, modifier-25, and preventive-separation errors.
Multi-Specialty Denial Management
Payer-specific appeals across the full primary-care and multi-specialty claim mix.
Chronic Care & HCC Revenue Capture
We identify eligible CCM/RPM patients and close HCC documentation gaps your group is already earning.
End-to-end RCM for every Primary care encounter
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.
Discovery & Audit
We analyze 90 days of claims data to identify coding gaps, denial patterns, and authorization bottlenecks specific to your practice.
EHR Integration
Seamless connection to your EHR and practice-management system — no new software for your team to learn or manage.
Go-Live & Handoff
SCALE's dedicated team takes over day-to-day RCM operations with transparent reporting from day one.
Continuous Optimization
Monthly performance reviews, payer-policy monitoring, and AI-driven recommendations keep revenue growing over time.
Representative results across SCALE clients
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
Works inside the EHRs your team already uses
Let’s build your Primary Care & Multi-Specialty RCM roadmap together
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.