Medical billing & RCM
Claim lifecycle, denial analysis, remittance and posting, patient financial workflows, and AR follow-up — with the upstream setup kept in view.
Explore medical billingAnimated visualization of healthcare operations: credentialing progressing, documents arriving, claims moving through submission and remittance, and follow-through completing. Decorative only — no live data or metrics.
OneSource RCM
Operational engineering for outpatient revenue
See the work between systems — not another billing brochure.
Credentialing, configuration, claims, remittance, and follow-through are one chain. This site is built to show how that chain actually behaves.
Credentialing lifecycle
From provider profile to the first payable claim.
Credentialing is more than an application. The payer path, participation record, billing connections, and early claim response all need an owner.- 01
Provider foundation
CAQH, identifiers, taxonomy, licenses, locations, and entity relationships begin the record.
- 02
Payer pathway
The correct state program, network, product, and provider role determine where the request belongs.
- 03
Participation details
Written payer responses, contract terms, dates, and location scope become the evidence the team follows.
- 04
Billing connections
Rendering relationships, EDI, ERA/EFT, clearinghouse, and EHR configuration connect enrollment to claims.
- 05
First-claim follow-through
The first transactions confirm whether payer records and billing configuration work together as expected.
Revenue workflow
Follow the work from enrollment through resolution.
Choose a stage to see the information and follow-through that support payment.
Revenue cycle
Enrollment
Panels, CAQH, contracting details, and ERA/EFT readiness all affect whether a submitted claim can be paid.
Open related pageWhy Choose OneSource RCM?
Connected setup and follow-through
The same posture as the live site: parallel enrollment and configuration, denial→prevention discipline, systems that fit how you work, and reporting you can act on — without invented scoreboard promises.
Fast, parallel go-live
Signed and stuck waiting? We run credentialing and billing setup together so active practices can move toward clean claims without a long handoff limbo.
Stop repeat denials
Tired of the same payer reasons? Each recurring denial can become a prevention rule for modifier/POS, authorization, or eligibility so the queue stays healthier.
System that works for you
Vendors that just “submit” keep you in rework. We reconfigure templates, POS/modifiers, taxonomy, and auth fields to eliminate avoidable edits before they happen.
Clarity you can act on
Denial shifts, recovery movement, and AR aging you can use — not noise dashboards. You should always know what to do next.
Three connected service paths
Clean Claim Flow
Still fixing the same edits? We rebuild charge templates, POS/modifier defaults, taxonomy mapping, and auth capture so more claims pay cleanly.
Configuration + denial follow-through as one job.
Medical billingIntegrated Credentialing
Panel gaps and missing EFT/ERA forms delay cash. We manage enrollments, CAQH, revalidations, taxonomy, and payer rules inside billing.
Enrollment tied to claim readiness
CredentialingPractice Optimization
Manual eligibility checks, auth confusion, and duplicate entry waste minutes per encounter. We embed prechecks, auth pathways, modifier rules, and targeted automation.
Fewer repeat denials and reclaimed staff time.
Practice operations
How we think about the work
Most billing problems involve more than the claim.
When CAQH is stale, a taxonomy is wrong, a charge template defaults to the wrong place of service, or an authorization pathway never makes it into the EHR, the claim queue inherits the failure. OneSource treats that chain as the work, with connected ownership rather than disconnected tickets.
How we work
Execution stays central
Claims, posting, denials, ERA/EFT, and enrollment work happen inside the systems you authorize, with direct accountability and clear ownership.
Atmosphere of the work
Revenue work stays visible from intake through follow-up.
The people, systems, and payer requirements behind a claim remain part of the same operating story.
Photo: Unsplash
Connected revenue cycle
Reimbursement is a chain. One weak link stalls cash.
Open any stage for the practical detail behind the overview.
- Payer enrollmentPanels, CAQH, contracting, ERA/EFT
- EHR & claim setupTemplates, taxonomy, plans, modifiers
- Auth & eligibilityPathways, capture, handoffs
- Claim lifecycleScrubbing, submission, clearinghouse
- Remittance & postingERA review, variances, patient billing
- AR & resolutionDenials, appeals, root cause
Connected support
The work is a chain — not a pile of tickets.
Billing, credentialing inside RCM, and practice-operations guidance stay linked so upstream enrollment or configuration failures do not quietly become next month’s aging.
Tailored solutions for practices of every shape and specialty.
Work directly with us—whether we’re upgrading forms after hours or walking you through a denial.
Solo / Emerging PMHNP
Wear every hat and losing time to auths + panel chases? We run credentialing and billing build together (CAQH, taxonomy, EFT/ERA, POS/modifier map).
Earlier clean claims; more patient hours.
Growing Psychiatry Group
Adding prescribers exposes repeat taxonomy + modifier denials and auth chaos. We centralize an auth matrix and tag every denial to root cause.
Denial recurrence drops; provider ramp speeds up.
Therapy + Med Management
New prescriber? Credentialing lag and telehealth modifier confusion stall payment. We align taxonomy, map CPT/POS/modifiers, and track panels inside billing.
Medication visits paid correctly from the start.
Selective Specialty
Prior vendor just “submitted” charges; aging bloated; underpayments slipped by. We rebuild templates and install root-cause denial tagging.
Faster cash and shrinking aging.
New Practice Startup
Still pulling pieces together? We sequence credentialing, system configuration, and first claim tests in parallel.
Earlier payer readiness and cleaner first cash.
Telehealth / Hybrid
Multiple POS codes and modifier confusion causing edits. We map payer-specific telehealth requirements into templates.
Clean telehealth reimbursement without manual overrides.
Physical Therapy
Auth, plan-of-care, and modifier (GP/59/KX) pitfalls driving repeat denials. We centralize auth/recert tracking and configure required modifiers.
Fewer repeat auth/modifier denials; steadier weekly cash.
Family Medicine / Primary Care
Broad payer mix, chronic care underutilized, lingering small-balance AR. We tune preventive vs problem visit rules and eligibility prechecks.
Better capture of covered services; cleaner aging buckets.
Your First Week With Us
Structured steps — discovery through clean live flow
A practical onboarding rhythm for active practices. Timing depends on access, payers, and inherited setup, and we explain those dependencies clearly.
Day 0–1
Action: Access & discovery (payer list, denial samples, top CPTs)
Why: Establish baseline + immediate rule planning
Day 1–2
Action: Credentialing & enrollment audit (CAQH, taxonomy, EFT/ERA, panel gaps)
Why: Removes early cash blockers
Day 2–3
Action: System reconfiguration (templates, POS/modifiers, auth fields)
Why: Stops avoidable edits at source
Day 3–4
Action: Denial pattern ingestion → prevention rules
Why: Converts history into forward guardrails
Day 4–5
Action: Test claims & ERA reconciliation
Why: Confirms clean flow before switch
Day 5–7
Action: Full switch + operational baseline snapshot
Why: Start measuring what is moving — without invented scoreboard claims
Where the expertise lives
Core areas of support — explained on their own pages.
Start with the overview that matches your question. Each page covers the operational detail — systems, enrollment mechanics, denial patterns, and how the work connects.
Credentialing & payer enrollment
CAQH, panels, contracting context, revalidation, and ERA/EFT — typically integrated into full RCM, not sold as a standalone commodity.
Learn about credentialingPractice operations
EHR configuration, workflow design, eligibility and auth capture, and operational advisory that keeps billing from repeating the same failure.
See practice operationsPractice fit
Deep behavioral health experience — broader outpatient capability.
Solo PMHNPs, growing psychiatry groups, therapy practices adding medication management, telehealth models, startups, and selective specialty cleanups are situations we discuss often. Browse specialties for the fuller picture.
PMHNP, psychiatry, therapy, telehealth, Medicaid ASO, and multi-state enrollment contexts show up often in the work — including the payer and configuration details those practices usually hit.
Broader outpatient experience includes dermatology, primary care, doula/perinatal support, physical therapy and chiropractic, plastic surgery, and podiatry when the operational fit is right — with dedicated specialty landings for the first four.
How engagements start
Start with the practice and the decision in front of you.
A concise description of services, locations, systems, payers, and the current obstacle gives us enough to assess the next step.
OneSource RCM and OneSource OS
Operational work, connected, with Luma as governed intelligence
OneSource RCM is the experienced human operation. OneSource OS is the platform built from that work — connecting credentialing, enrollment, documents, communications, and claims operations for authorized users.
Private access today, with updates available for organizations that want to follow OneSource OS.
Practical questions
Recent Insights from the work itself.
Education comes before a sales conversation. Start with these operational articles — then browse the full Insights hub.
- What no one tells you about credentialing (until it’s too late)Why “active” payer status alone does not establish billing readiness
- What your EHR isn’t telling you about your revenueHow template defaults, modifiers, and quiet configuration gaps become next quarter’s denial pattern.
- Why your billing vendor isn’t fixing denialsWhat changes when denials are owned as root-cause work instead of endless resubmits.