Revenue Cycle Management FAQs

ABOUT THIS PAGE

Common questions about Advantum and the work we do.

The questions below cover revenue cycle management and how we approach it. For questions about a specific service or our technology platform, see the FAQ section on each of those pages.

UNDERSTANDING RCM

What Is Revenue Cycle Management

  • Revenue cycle management is the end-to-end process healthcare organizations use to get paid for the care they deliver. It begins with provider enrollment and continues through patient access, prior authorization, medical coding and billing, claims submission, accounts receivable follow-up, denial management, and audits. When the cycle works, providers are paid quickly and predictably. When it breaks, revenue leaks at every stage, often quietly.

  • Healthcare margins are tight. Payer rules change constantly. The administrative cost of getting paid is one of the largest controllable line items in a practice. A well-managed revenue cycle turns getting paid from a recurring problem into a predictable system.

  • Medical billing is one part of revenue cycle management. Billing focuses on submitting claims and collecting payment. Revenue cycle management covers the full pipeline that makes billing possible, including everything that happens before and after a claim is filed.

  • Most denials are not coding problems. They are workflow problems that show up as denials. Eligibility verification fails at the front desk. Authorizations stall and go untracked. Credentialing gaps suppress revenue for months before anyone notices. By the time a denial lands, the cause is usually three steps back in the process.

WORKING WITH ADVANTUM

How Advantum Health's Revenue Cycle Management Works

  • Advantum is a technology-enabled revenue cycle management company. Our specialists run the revenue cycle for healthcare organizations of every size, supported by our proprietary Advantum One platform. We cover the full cycle, including provider enrollment, patient access, prior authorization, coding and billing, accounts receivable follow-up, coding audits, contract negotiations, denial management, and RCM consulting.

  • Advantum supports healthcare organizations across the full spectrum of care. Solo practitioners, group practices, multi-specialty groups, ambulatory surgical centers, skilled nursing facilities, IPAs, PHOs, hospitals, and health systems. Our specialists work across more than 30 clinical specialties.

  • Almost certainly. If your specialty is not listed on our Who We Serve page, contact us. We have likely served it.

  • You can engage Advantum for the full cycle or for one specific service. Many engagements start with a focused service and expand over time as the working relationship develops.

  • The first conversation is with our sales team. They will ask a few questions about your current performance and give you a straight answer on whether we are a fit. If we are not the right partner for what you need, we will tell you.

GETTING STARTED

How to Switch Revenue Cycle Management Companies

  • Typical onboarding inputs include accounts receivable aging reports, denial summaries, payer mix data, historical collection performance, current workflows, and access to your EHR or practice management system. Our implementation team walks you through exactly what we need and when.

  • A well-planned transition is structured so it does not. We coordinate with your outgoing vendor or in-house team to ensure aged accounts receivable continues to be worked while we take over new claims. The goal is no claim left behind.

  • We work with you to determine the best approach for your situation. In many engagements, Advantum takes over aged AR alongside new claims, with separate workflows for each. The right approach depends on your existing vendor relationship and the state of your aged AR.

PRICING AND CONTRACTS

Revenue Cycle Management Pricing and Contracts

  • Pricing depends on the scope of the engagement, the services involved, your specialty and payer mix, and the volume of work. Our sales team provides a clear, written proposal after the first conversation. We do not publish standard pricing because every engagement is structured differently.

  • Engagement agreements define the scope of services, the pricing model, performance expectations, communication cadence, and data handling. Standard agreements include a Business Associate Agreement covering HIPAA compliance.

  • Yes. Our platform is modular and engagements are structured to allow scope changes as your needs evolve. Many clients begin with one service and expand over time.

OUR TEAM AND LOCATIONS

Where Advantum Health's Revenue Cycle Teams Are Located

  • Advantum operates from our Louisville, Kentucky headquarters, a nearshore team in Tijuana, Mexico, and our operations centers in Hyderabad, Noida, and Chennai, India. More than 650 revenue cycle professionals work across these locations under one set of standards.

  • The mix of onshore, nearshore, and offshore coverage gives clients flexibility on time zones, engagement model, and cost structure without giving up accountability or consistency. The work is allocated based on what makes sense for your account.

  • Yes. All Advantum employees, regardless of location, operate under the same security controls, training requirements, and Business Associate Agreement obligations as our US-based team. Our compliance program does not change with geography.

  • Yes. Our credentialing subsidiary, Med Advantage, holds NCQA certification across all 11 credentials verification categories.

STILL HAVE QUESTIONS

Talk to our team.

We will give you a straight answer on whether we are the right partner for the revenue cycle work in front of you.

Phone: 502-861-5629

Schedule a Consultation