One stop solution for medical providers. From our Maryland office, Edge RCM runs your medical billing and revenue cycle, clears your credentialing and payer enrollment, secures your state licenses, and builds the healthcare IT that brings new patients through your door, for practices in all 50 states, all under one roof, with one accountable team.
Most practices juggle a billing vendor, a credentialing consultant, a licensing service and a marketing agency: four contracts, four invoices and nobody owning the outcome. We replace all four.
End-to-end revenue cycle management that turns documented care into deposited cash, faster, cleaner and fully transparent.
Get on payer panels and stay on them. We own every application, every follow-up call and every revalidation deadline.
Practice where your patients are. We manage new licenses, renewals and multi-state expansion in every jurisdiction.
Websites, patient portals, mobile apps, CRM, AI assistants and digital marketing engineered for regulated healthcare.
When billing, credentialing, licensing and technology live in four different companies, the gaps between them cost you money. A provider sits idle waiting on enrollment. A license lapses and claims deny. Your website generates leads your front desk never sees. Edge RCM closes those gaps by design.
Clean claims out the door in 24 hours, denials worked in 48, and a dashboard that shows exactly where every dollar sits.
Payer panels opened, revalidations calendared, and rosters kept current so a new hire starts billing on day one.
New states, renewals, DEA registrations and compact privileges handled end to end so expansion never stalls.
A site that ranks, a portal patients actually use, and automation that fills tomorrow's schedule.
A single discovery call captures everything four vendors would ask for separately. Your staff answers once, and we take it from there.
A named senior contact who knows your payers, your providers and your systems, reachable by phone, not a ticket queue.
Collections, denials, enrollment status, license expirations and marketing leads on one monthly report your leadership can act on.
These are the operating benchmarks our teams are held to across the practices we support.
We are not a call center that learned healthcare from a script. Our billers, credentialing specialists and licensing analysts come from practice operations, and it shows in the questions we ask before we touch your revenue.
Typical improvement across the first two quarters of an Edge RCM engagement.
Send us three months of remittance data and we will return a written revenue opportunity analysis: denial patterns, underpayments, coding gaps and enrollment issues, at no cost and with no obligation.
Staying out of network is a legitimate strategy, but only if someone is fighting for every claim. Out-of-network reimbursement is negotiated, not posted, and payers count on practices accepting the first offer. Our out-of-network desk does not.
When a patient needs you and no in-network option exists, we build the clinical and financial justification, open the case with the payer and negotiate a written single case agreement before the service is rendered, so the rate is locked, not hoped for.
We benchmark your billed charges against usual and customary data for your ZIP code and specialty, then negotiate case by case with documented comparables instead of accepting an arbitrary allowed amount.
Old out-of-network balances written off as uncollectable are our favorite place to start. We re-open timely-filing-eligible claims, pursue underpayments and recover money your prior biller had already given up on.
Structured, deadline-tracked appeals with medical necessity letters, records and policy citations attached, escalated through first level, second level and independent external review when the payer will not move.
Pre-service benefit checks, gap exception requests and prior authorization filed with the clinical documentation payers actually require, plus peer-to-peer scheduling when a medical director review is needed.
Good faith estimates, clear patient responsibility letters and compassionate balance conversations that protect your reputation while still collecting what is owed.
From a solo behavioral health practice to a multi-site ambulatory surgery group, our teams already speak the language of your specialty: its codes, its payers and its denial patterns.
Family medicine, internal medicine, pediatrics, geriatrics, urgent care and concierge practices.
Psychiatry, psychology, counseling, substance use treatment, ABA therapy and IOP/PHP programs.
Orthopedics, general surgery, ENT, ophthalmology, plastics, pain management and ambulatory surgery centers.
Cardiology, pulmonology, nephrology, gastroenterology, endocrinology, rheumatology and oncology.
Physical therapy, occupational therapy, speech language pathology, chiropractic and sports medicine.
Clinical labs, toxicology, pathology, radiology, imaging centers and mobile diagnostic services.
Home health, hospice, skilled nursing, DME suppliers, wound care and mobile provider groups.
Virtual-first clinics, multi-state telemedicine groups, weight management and men's and women's health platforms.
A transition should never cost you a week of cash flow. Here is exactly how onboarding runs.
A 30-minute call to understand your specialty, payer mix, systems and where revenue is leaking. You leave with findings whether or not you hire us.
We review remittances, denial reasons, fee schedules, enrollment status and license expirations, then present a written scope with pricing.
Access, credentials and workflows are set up in parallel with your current process, so claims keep flowing while we take over.
Weekly working sessions, monthly performance reporting and quarterly strategy reviews that keep pushing collections up and AR down.
The outcomes our clients care about most: cash in the door, providers billing sooner, and fewer administrative fires.
Our aged AR had crossed 140 days and two prior billers had told us it was uncollectable. Edge RCM worked the backlog claim by claim and recovered a meaningful share of it in the first quarter. The weekly call is what changed things. Nothing sits.
We were expanding telehealth into six new states and drowning in license applications and CAQH updates. Handing licensing and credentialing to one team that also understood our billing meant our new providers started seeing patients weeks earlier than planned.
The new website and patient portal paid for themselves. Online scheduling cut our phone volume noticeably, and local SEO put us in the map results for our main procedures. Having the same partner handle marketing and billing means the numbers actually tie out.
Still unsure about something? Call +1 (855) 307-4535 and speak to a specialist directly.
We provide four connected service lines: medical billing and revenue cycle management, provider credentialing and payer enrollment, state medical licensing, and healthcare IT including websites, patient portals, mobile apps, CRM and digital marketing. Practices can engage a single line or run all four under one agreement with one account team.
We support providers in all 50 states and the District of Columbia, with working experience in more than 75 medical specialties: primary care, behavioral health, therapy and rehabilitation, orthopedics, cardiology, anesthesia, ambulatory surgery, laboratory and diagnostics, home health and telehealth among them. If your specialty is not listed on this site, ask us; the odds are strong that we already bill it.
A standard transition runs 10 to 15 business days. Week one covers discovery, clearinghouse and EHR access, fee schedule loading and an audit of your open accounts receivable. Week two runs parallel claim submission so nothing is dropped. By day 15 we are submitting your full claim volume while simultaneously working the legacy AR you hand over.
Yes. Our out-of-network desk handles single case agreements, insurance negotiation support, usual and customary reimbursement analysis, appeals on underpaid claims, authorization assistance and recovery of aged out-of-network balances. Many practices come to us specifically because their previous biller only worked in-network claims.
Billing and revenue cycle work is quoted as a percentage of collections, so we are paid when you are paid. Credentialing and licensing are quoted per provider per application. Healthcare IT projects are quoted as a fixed project fee with an optional monthly care plan. Every quote is written after your free consultation, and there are no long-term lock-in penalties.
We operate HIPAA-focused workflows: role-based access, least-privilege permissions, encrypted transmission and storage, signed business associate agreements, ongoing workforce training, audit logging and documented breach response procedures. Access to your systems is limited to the named team members assigned to your account, and access is revoked the day someone rolls off it.
No. We work inside the systems you already own and you keep the licenses in your name. That is deliberate, because it means your data stays yours. Our teams work daily in the major cloud EHR and practice management platforms as well as most clearinghouses. If you are unhappy with your current system we will give you an honest opinion, but switching is never a condition of working with us.
Practical guidance on billing, credentialing, licensing and healthcare technology, written by the specialists who do this work for practices every day.
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