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Revenue Cycle

Get Paid Faster. Deny Less.

Every denied claim is revenue your facility already earned but cannot collect. Every delayed payment strains your cash flow. AssistedCare connects clinical documentation directly to billing so claims go out clean, go out fast, and come back paid.

Challenges in Revenue Cycle

Claim Denials Are Eating Your Margins

The average long-term care facility loses tens of thousands of dollars each month to preventable claim denials. Disconnected clinical and billing systems create documentation gaps that payers exploit to reject or down-code claims.

Manual Billing Introduces Errors at Every Step

When billing staff re-enter clinical data into a separate billing system, transcription errors multiply. Wrong diagnosis codes, missing modifiers, and incorrect dates of service generate rejections that take weeks to resolve.

California Medi-Cal Complexity

Medi-Cal billing in California requires treatment authorization requests, level-of-care certifications, managed care plan-specific rules, and documentation requirements that differ significantly from Medicare. Managing both payer types manually doubles the administrative burden.

PDPM Coding Confusion Leaves Money on the Table

The Patient-Driven Payment Model ties reimbursement to clinical documentation across five case-mix components. Facilities that do not capture accurate clinical detail in their documentation are systematically underpaid.

How AssistedCare Solves It

Automated Claim Generation

Clinical documentation flows directly into billing records. Diagnoses, procedures, therapy minutes, and payer information are captured at the point of care, eliminating manual re-entry and the transcription errors that come with it.

See Medicare Billing

Real-Time Eligibility Verification

Verify Medicare, Medi-Cal, and commercial insurance eligibility before services are rendered. Expired coverage, authorization gaps, and benefit exhaustion are caught before they become denials.

See Medi-Cal Billing

Denial Management Workflow

Denied claims are flagged with reason codes, suggested corrective actions, and links to the supporting clinical documentation. Your billing team tracks appeals from submission through resolution in one place.

PDPM-Optimized Documentation Capture

The system maps clinical documentation to PDPM case-mix components in real time. Clinicians see where documentation gaps affect reimbursement — and can address them during the current assessment, not after the claim is denied.

See PDPM Optimization

Revenue Cycle Dashboards

Days in accounts receivable, denial rates by payer and reason, collection trends, and aging reports give your billing team real-time visibility into financial performance. Revenue leaks are identified before they become cash flow problems.

98%

Clean Claim Rate

45%

Faster Payments

60%

Fewer Denials

12min

Per Claim Avg

Frequently Asked Questions

Yes. The system supports Medicare Part A and Part B, Medi-Cal fee-for-service and managed care plans, commercial insurance, and private pay. Each payer's specific billing rules, authorization requirements, and claim formats are built into the workflow.

Diagnoses, procedures, therapy minutes, and assessments documented at the point of care flow directly into billing records. Billing staff validate and submit rather than re-enter data, eliminating transcription errors and accelerating claim submission.

Yes. Denied claims are flagged with the payer's reason code and suggested corrective actions. Supporting clinical documentation is linked directly to the appeal. Your team tracks the appeal process from submission through resolution.

Both institutional and professional claim formats are supported. The system generates electronic submissions in the required X12 837I and 837P formats, and can produce printed UB-04 and CMS-1500 forms when needed.

We offer transparent per-bed pricing with no hidden fees, no long-term contracts, and no charges for updates or support. Contact our team for a customized quote based on your facility size and needs.

Ready to See It in Action?

Try AssistedCare free and see how it transforms your facility operations.