Claims Submission & Follow-up
We go beyond file and forget.
Every claim. Every day. Every dollar.
At RCAceSolutions, we don’t just send claims and hope for the best. Our RCM experts ensure every claim is coded, submitted, and followed up accurately, promptly, and compliantly — maximizing your reimbursements and eliminating unnecessary delays at every stage.
With built-in Root Cause Analysis and a proactive Consulting & Staffing model, we stop recurring issues before they cost you more money — turning your claims pipeline from a source of anxiety into a reliable, predictable revenue stream.
Client Benefits
What you gain when every claim
is actively worked to resolution.
Our Claims Process
From charge to collected —
every step actively managed.
Charge Capture & Pre-Submission Scrub
Every charge is captured accurately, coded with the correct ICD-10 and CPT codes, and run through a multi-layer scrub that catches errors, missing data, and payer-specific issues before the claim ever leaves our system.
Electronic Submission within 24–48 Hours
Clean claims are submitted electronically within 24–48 hours through the appropriate clearinghouse or direct payer portal. We monitor for real-time acknowledgements and flag any rejections immediately for same-day correction.
Daily A/R Follow-Up & Payer Contact
Our team works your A/R daily — checking claim status, contacting payers proactively, responding to requests for additional information, and escalating high-value or high-risk claims through our dedicated escalation system.
Denial Review, Appeal & Resubmission
Denied claims are not parked — they are worked immediately. We review the denial reason, prepare a targeted appeal with supporting documentation, resubmit promptly, and follow up until every recoverable dollar is collected.