What we do

Full middle and back office.
Plus specialist documentation work.

Six service lines spanning the operational heart of the revenue cycle — coding, billing, AR and denials, clinical documentation, and front-end eligibility and prior authorization — plus managed on-site teams for engagements that require an embedded cohort. Every line operates to the client's coding manual, QA scorecard, and reporting cadence, not to a methodology of our own.

01   Medical Coding

Specialty, multi-specialty, and risk adjustment.

Coding is the largest service at RevenueLink. AAPC- and AHIMA-credentialed coders work across professional-fee, facility, and risk-adjustment workflows — calibrated to each client's coding manual, quality scorecard, and audit methodology rather than to a standard of our own. The bulk of production runs in-house from our Bangalore facility; specialist engagements run on-site at the client's facility.

  • Specialty and multi-specialty coding   E&M, general surgery, anaesthesia, radiology, pathology, cardiology, orthopaedics, OB-GYN, behavioural health, ED, urgent care, and others — across professional-fee and facility settings.
  • HCC / risk adjustment   CMS-HCC capture under V24 and V28, MEAT-validated and audit-defensible. CRC-credentialed workforce with a minimum 24 months of HCC experience and continuous calibration to RADV defensibility.
  • Inpatient and outpatient facility   DRG and MS-DRG assignment with CC / MCC capture, APC coding for outpatient, and ICD-10-CM / PCS plus CPT / HCPCS fluency across the full code set.
  • Coding audit and quality review   Pre-bill and retrospective audits, sampling-based scoring against the client's QA rubric, structured feedback loops with the client's CDI and compliance teams, and root-cause analysis routed back to source.
  • Encoder & EHR fluency   Epic, Cerner / Oracle Health, MEDITECH, Allscripts, athenahealth, eClinicalWorks, and NextGen. Encoders including 3M 360 Encompass, Optum EncoderPro, and TruCode.
  • Productivity & QA reporting   Daily productivity, charts coded per resource, accuracy by service line, denial-trace-back metrics, and monthly governance reporting tied to the client's KPIs.
02   Medical Billing

Charge entry to clean-claim submission.

End-to-end billing operations delivered from our Bangalore facility — demographics and charge capture, claim preparation, payer-specific scrubbing, electronic and paper submission, payment posting, and patient billing. Integrated directly with the client's PM, EHR, and clearinghouse so the workflow runs inside the client's system of record, not a parallel one.

  • Charge entry & scrubbing   Demographics and insurance capture, charge entry, modifier review, NCCI and MUE edits, LCD / NCD validation, and front-end payer-specific scrubbing before submission.
  • Claims submission   837P and 837I electronic submission and paper UB-04 / CMS-1500 where required, via Availity, Waystar, Change Healthcare, Trizetto, and OfficeAlly.
  • Payment posting & reconciliation   835 ERA and EOB posting, contractual-adjustment validation against the fee schedule, underpayment flagging, and ledger reconciliation to the PM and bank deposits.
  • Patient billing & statements   Statement generation, patient-responsibility communication, payment-plan tracking, and coordinated handoff to the client's patient-services team — never a separate patient-facing brand.
  • Credit balances & refunds   Credit-balance research, refund-request preparation, and payer / patient overpayment resolution under the client's controls.
  • Compliance & reporting   Billing-audit support, denial-trend feedback into upstream coding, and reconciliation cadence with the client's compliance officer and finance team.
03   AR Calling & Denials Management

Working the AR. Recovering the revenue.

US-time-zone AR calling teams chase outstanding insurance claims, work denials to root cause, and clear aged AR — all delivered from our Bangalore facility on the client's PM and clearinghouse stack. Each engagement is reported against the client's defined AR-days, first-pass clean-claim, denial-rate, and recovery-percentage targets — never against a private scorecard of our own.

  • Insurance follow-up   Payer-side calling for claim status, payment confirmation, underpayment recovery, and refile coordination — conducted in US time zones using payer portals and IVRs where supported, calls where not.
  • Denials management   CARC / RARC categorisation, root-cause analysis, written and verbal appeals, peer-to-peer support, and structured feedback loops back into upstream coding, billing, and eligibility to reduce recurrence.
  • Aged AR cleanup   Structured projects against historical AR in 30 / 60 / 90 / 120+ day buckets, with defined work-lists, prioritisation logic, and reporting cadence. Suitable as a one-off recovery sprint or as ongoing operations.
  • Underpayment recovery   Contract-rate comparison, variance identification, and recovery against the client's fee schedule and payer contracts.
  • Reporting & analytics   Daily productivity and call-volume, weekly denial-trend analysis, payer-specific behaviour reports, and monthly governance reporting tied to the client's KPIs.
04   Clinical Documentation Improvement

Concurrent and retrospective CDI.

CDI specialists trained on the gap between a diagnosis on a problem list and a diagnosis supported by active clinical evidence. Concurrent and retrospective reviews, compliant AHIMA-aligned provider queries, and structured feedback into the client's clinician-education programme — never as a competing audit, always under the client's quality leadership.

  • Concurrent CDI   Real-time chart review during the encounter window, with structured query generation routed to the responsible provider through the client's query workflow tool.
  • Retrospective CDI   Post-encounter review for risk-adjustment, DRG accuracy, and audit-defensibility — with documented findings routed to the client's quality and compliance teams.
  • Provider query management   AHIMA / ACDIS-aligned, non-leading query construction. End-to-end query lifecycle tracking, response-rate monitoring, and physician-level coaching outputs.
  • DRG & risk-adjustment accuracy   CC / MCC capture, principal-diagnosis review, present-on-admission validation, and HCC documentation alignment for V24 / V28 capture.
  • Clinician education   Specialty-specific documentation-gap summaries, query trend analysis, and case-example libraries — packaged for the client's CME and clinician-education programmes.
  • Clinical credentials   CDI specialists drawn from clinical backgrounds (Nursing, MBBS, BDS, BPT, Pharmacy) with structured ramp into US documentation, coding linkage, and query writing.
05   Eligibility & Prior Authorization

Front-end accuracy that protects the back-end.

A specialist front-office service for providers and RCM partners. Eligibility verification, benefits checks, prior-authorization initiation and follow-up, referral coordination, and medical-necessity validation — delivered through payer portals, IVR, payer calls, and direct integration to the client's PM and EHR. Built around the principle that denials prevented at the front end never reach the back end.

  • Eligibility & benefits   Real-time (270 / 271) and batch verification, coverage discovery, COB validation, copay / deductible / out-of-pocket determination, plan-level visit and dollar limits flagged before service.
  • Prior authorization   Initiation, payer-specific submission, clinical-documentation packaging, status follow-up, expedited and retrospective handling, and denials triage at the auth stage so coding and billing inherit clean cases.
  • Referral & medical necessity   Referral capture and tracking, medical-necessity validation against LCD / NCD and payer policy, and CPT / ICD pairing checks before scheduling and submission.
  • Turnaround SLAs   Defined SLAs by procedure urgency — STAT, scheduled, and routine — with daily MIS on auth-pending volumes, aging buckets, and approval rates by payer and procedure.
  • Integration   Direct PM / EHR connectivity, payer-portal automation where supported (Availity, UHC, Aetna, BCBS plans), and structured handoff to coding and billing teams downstream.
  • Reporting   Auth approval / denial rates by payer and CPT, aging, time-to-decision, and avoided-denial trace-back into the back end.
06   Staff Augmentation

Managed on-site teams at the client's facility.

A specialist offering for clients who require a credentialed coding or RCM team to sit inside their own perimeter — driven by regulation, data residency, calibration depth, or audit posture. RevenueLink recruits, BGV-clears, deploys, supervises, and sustains the cohort under the client's quality framework, with one named on-site Account Manager owning every operational and HR thread.

  • Recruit   Credentialed specialists sourced through our network in major Indian metros, internally pre-screened on technical depth and English fluency, BGV-cleared before being put forward to the client's selection gateway.
  • Deploy   On-site at the client's facility, on the client's infrastructure, against the client's published quality framework. No data export, no parallel scorecard, no PHI leaving the client's perimeter.
  • Supervise   One named Account Manager plus Team Leads at a ratio of approximately one per twenty-five resources. Daily huddles, weekly MIS, monthly governance, quarterly executive review.
  • Sustain   Standing replacement bench, structured notice-period overlap, retention engine tied to market benchmarks and structured progression, and replacement SLAs published in the engagement contract.
  • Statutory & HR   PF, ESI, gratuity, professional tax, statutory leave, and POSH framework administered correctly and on time — the boring work, done right, is part of the deliverable.
How we deliver

In-house dominant. On-site where it counts.

In-house at Bangalore

Our HIPAA-compliant production facility.

The default delivery model for coding, billing, AR and denials, CDI, and eligibility / prior-auth. Badge-controlled access, clean-desk discipline, no personal devices on the production floor, multi-shift US-time-zone coverage, and secure integration to the client's PM, EHR, and clearinghouse via SFTP, site-to-site VPN, or REST API. Operates under RevenueLink's internal QA layer and the client's published quality framework.

On-site at the client's facility

For engagements that require a perimeter-fit.

Used when an engagement demands the team operate inside the client's own infrastructure — strict data residency, real-time clinical query, sovereign quality calibration, or regulatory posture. RevenueLink owns the workforce, the supervision, and the HR engine; the client owns the work product, the quality framework, and the perimeter.

What we do not do

Naming what we do not do is the cleanest way to describe what we do.

If one of these services fits the scope, that is where we start.

Tell us the scope. We will tell you whether we are the right fit.

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