A revenue intelligence platform,
not an outsourcing desk.
Exact Core Group helps healthcare organisations maximise practice revenue efficiency and optimise operations through technology-enabled revenue cycle management.
One cycle,
not eight services.
Exact Core Group manages the revenue cycle for healthcare organisations — the whole of it, from confirming a patient’s coverage before the visit through to the last balance on the ledger. The eight disciplines are billing, coding, denial management, AR management, credentialing and eligibility verification.
Most revenue leakage does not happen inside those disciplines. It happens between them. A coverage check that was never run becomes a denial that coding cannot explain, which ages into a receivable nobody can collect. Managing the stages as separate services is precisely what allows the gaps to persist.
So the work is run as one cycle, with one view of it. Findings are traced back to the stage that produced them, and causes that recur are removed rather than reworked every month.
Four principles.
Evidence before opinion
Findings are traced to the claim, the denial or the balance that produced them.
One cycle, not eight services
Coding, denials and AR are stages of the same process. Treating them separately is what creates the gaps.
Prevention over rework
Reworking a denial recovers one claim. Removing its cause recovers every future one.
Transparency by default
You should be able to see what is being worked, what it is worth and why it is prioritised that way.
How an engagement runs.
Assessment
A revenue assessment reviews all eight disciplines against your current data. It produces a picture of where reimbursement is being lost and what is causing it — before anything is committed on either side.
Scope
What Exact Core runs, what stays in house, and how the two hand off is agreed in writing. Ambiguity at this stage is the single most reliable way to make outsourced billing fail.
Transition
Work moves across in a defined sequence rather than all at once, inside your existing practice management system, so nothing is ever in flight without a named owner.
Run and report
The cycle runs, and reporting shows what is being worked, what it is worth and which causes are recurring — the same view Exact Core works from.
What we will
and will not say.
Most of what makes this decision hard is that the claims are unfalsifiable until you have already signed. These are checkable.
What you will get
Commitments that can be verified against your own system while the work is running.
- A written scope naming what is ours and what is yours
- Work performed inside your PM or EHR, on your audit trail
- Findings traced to the claim or balance that produced them
- Denials reported by root cause, not just by payer
- Write-offs recorded with a reason
What you will not get
Things Exact Core will not tell you, because nobody honestly can at this stage.
- A promised uplift figure before anyone has seen your ledger
- Upcoding — coding reflects the documentation, in both directions
- A turnaround time quoted before payer mix is known
- Scope accepted beyond what can actually be staffed
- Client names or logos used without their written consent
Recommended H1
Exact Core Group specializes in the management of healthcare medical billing, medical coding, and revenue cycle management using a connected and technologically-driven approach. We strive to help healthcare practices become more operational efficient by offering them insights into the billing processes and addressing ongoing billing issues.
In addition to managing specific billing processes, we analyze the impact of each stage of the revenue cycle process on overall performance, which allows our clients to be more transparent about their revenue cycle management and make better decisions regarding it.
Who We Are and What We Do
As Exact Core Group, we are well aware that a good management of healthcare revenue cycle requires coordination of many different administrative and financial processes from patient registration to claim submission and collection management.
Through the analysis of your workflow and recurring issues, we aim to give you more insight into your billing processes and outstanding revenue.
Our Medical Billing and Revenue Cycle Management Services
We offer a variety of services for any stage of your healthcare revenue cycle management.
Medical Billing & Coding
The medical billing and coding process we offer helps you prepare, submit and process medical claims. Our focus lies in correct coding, documentation and spotting any potential problems which might impact the billing.
Denial & Accounts Receivable Management
Denial management includes recognition of rejection patterns and review of claim issues to help with proper actions that need to be taken. The focus of our accounts receivable strategy lies in tracking unpaid balances and taking necessary actions.
Eligibility Verification and Credentialing
Insurance eligibility verification assists practices in recognizing any possible insurance problems before delivering their services. Provider credentialing and enrollment assistance helps healthcare organization to comply with payer requirements.
Patient & Front Office Support
Administrative procedures such as communication, patient registration and front office processes help create an orderly revenue cycle process. We could assist you with the processes depending on your scope of work.
Learn more about our medical billing services.
Our Approach to Revenue Cycle Management
A Process That Is Connected & Transparent
Billing, coding, denial management, and accounts receivable need to be highly interrelated processes rather than separate processes.
Making Decisions Through Data
The review of claims, payment information, denials, and open balances will help create clear priorities for operational management. We put an emphasis on the informative reporting so that healthcare facilities could better understand the revenue cycle activities of their organization.
Clear Communication and Accountability
It is good for us to have clearly laid-out responsibilities, transparency in processes, and proper communication. Our process is designed to assist our customers understand what processes they should concentrate on.
Why Choose Exact Core Group?
Selecting a medical billing and revenue cycle management company means that you will trust its processes and approach. Exact Core Group is focused on the coordination of services, openness of processes, and identification of the reasons for repeated billing issues.
We realize that each healthcare practice has its unique needs, systems in place, and administration processes. These aspects are taken into account by us while determining the service responsibilities and managing revenue cycle.
We also realize that it is important to protect healthcare information. The security process, access control, confidentiality, and compliance should remain the focus of our services.
Frequently Asked Questions
What kind of services do you offer through Exact Core Group?
Services we offer are medical billing, medical coding, denial management, account receivable management, eligibility verification, credentialing and administration support.
Revenue cycle management definition
Revenue cycle management refers to the administrative and financial processes involving patient registration, verification of patient insurance, claim filing, billing and collection of payments from the insurer.
How can I start working with Exact Core Group?
Healthcare organizations can ask us for revenue assessment to talk about their existing workflows and potential challenges and possible service solutions for them.
Let’s improve your revenue cycle
Properly managed revenue cycle begins with assessing the existing processes and recognizing possibilities for improvements. Exact Core Group assists healthcare organizations in analyzing their billing processes and finding the way how to manage revenue cycle process better.
Do you want to make next step? Ask us for revenue assessment!
What clients say.
Exact Core doesn’t feel like a typical outsourced service provider. Their team takes the time to understand our priorities, communicates with us regularly, and operates much more like an extension of our own organization.
Melissa Turner
Practice Administrator
Exact Core has brought greater accountability and structure to an area of our business that is critical to our financial performance. Their team understands the details while keeping sight of the bigger picture.
William Harris
Healthcare Operations Executive
Exact Core brought much more visibility to our revenue cycle. Instead of looking at billing, denials, and AR as separate problems, their team helped us understand how they were connected and where we were actually losing revenue.
Dr. Michael Reynolds
Medical Director
Start with the numbers.
A revenue assessment is the fastest way to see whether any of this applies to you.