Over the past decade, hospital margins have continued to shrink. Rising operational costs, a shortage of skilled coders, and constantly changing regulations have made revenue management more challenging than ever. Credence acts as an extension of your team—helping healthcare systems collect more revenue, faster, while maintaining accuracy and compliance.
Credence delivers a comprehensive suite of customized medical billing and revenue cycle management solutions designed to meet the unique needs of hospitals and healthcare systems. Our services eliminate costly billing errors, streamline accounts receivable recovery, and accelerate reimbursements—ensuring smoother operations and improved financial outcomes.
A disorganized billing process can severely impact the financial health of a healthcare system. Outsourcing your billing and revenue cycle management to Credence provides a smart, cost-effective solution. We optimize your entire billing and AR recovery process at a fraction of the cost of maintaining in-house operations, while improving accuracy and cash flow.
Credence has quickly established itself as a trusted revenue cycle management partner by delivering tailored hospital billing services to leading healthcare systems. When you partner with Credence, you gain a team that understands your challenges and works collaboratively to resolve them.
With years of experience supporting hospitals and healthcare systems, Credence helps strengthen payment tracking, expense management, and reimbursement performance. Our clients experience reimbursement improvements of up to 20% or more through our comprehensive services, including full revenue cycle management, accounts receivable recovery, medical records review, inpatient DRG audits, provider credentialing, and prior authorization management.
Our Hospital & Healthcare System Billing Services
We provide end-to-end billing solutions along with fully customized services for healthcare systems, including:
Insurance Eligibility Verification Services
We verify patient eligibility, benefits coverage, referral requirements, and prior authorizations before services are rendered. Our team also calculates deductibles, co-payments, and patient responsibility to prevent billing errors. These proactive eligibility verification services significantly improve cash flow and reduce claim denials.
Demographics & Charge Entry Services
Accurate charge entry is the foundation of a successful billing process. Our specialists ensure precise entry of patient demographic data and charges from patient face sheets into billing systems. Credence’s experienced billing team delivers error-free demographics and charge entry to prevent downstream claim issues.
Billing & Coding Analysis
Our medical billing professionals review physician documentation, diagnostic reports, imaging results, and operative notes to validate services performed and assign accurate codes. Incorrect coding often leads to denials, underpayments, and workflow disruptions. Credence ensures compliant coding to reduce claim rejections and administrative burden.
Accounts Receivable (AR) Follow-Up Services
Managing accounts receivable can be time-consuming and resource-intensive. Our AR specialists aggressively follow up on unpaid and underpaid claims to minimize AR days. Denied claims are appealed promptly to ensure timely reimbursement and maximum revenue recovery.
Collections Services & Denial Analysis
Claim denials can cause significant financial losses if not addressed efficiently. Credence’s denial management team identifies denial root causes, corrects errors, and resubmits claims within timely filing limits. Our analysts track denial trends, improve billing workflows, and help reduce future denials.
Payment Posting
Payment posting is a critical step in identifying payer discrepancies. Our team reviews ERAs and scanned EOBs to ensure accurate posting of payments, adjustments, and denials. Any payer issues related to medical necessity, authorization, or non-covered services are routed to the appropriate team for immediate resolution.
Provider Credentialing
Provider credentialing is essential for timely reimbursements and payer participation. Credence manages the entire credentialing process, enabling patients to use their insurance benefits while ensuring providers are properly enrolled with payers. Our credentialing services support faster payments, increased referrals, reduced denials, and minimized revenue leakage.
Out-of-Network Negotiation
Our out-of-network negotiation team uses a multi-layered, data-driven strategy to maximize reimbursements. By leveraging proprietary algorithms and comprehensive payer databases, we identify underpayments and negotiate optimal reimbursement rates for each claim—helping healthcare systems recover the maximum allowable revenue.
