Revenue Cycle Management Services Powered by AI, Backed by Expertise, Built for Predictable Revenue
Most revenue cycle partners tell you what happened last month. Neolytix tells you what’s coming — 30, 60, and 90 days out. InCredibly AI combines real-time claim intelligence with 14+ years of specialty expertise to deliver the one thing healthcare finance has always lacked: predictable revenue.
270+
14+
>96%
40%+
The Revenue That Never Arrives
First-pass clean rate
Avg. contract leakage identified
Typical collections lift
The leak is predictable. So is the fix.
Trusted by 270+ healthcare organizations nationwide
The Leaks Nobody Audits
Every RCM company will fix your front-end errors, undercoding, and reactive denials. That’s table stakes. The leaks that compound year after year are the ones buried inside your payer contracts — and almost no vendor looks at them.
One Operating Model. Four Pillars.
Most RCM vendors describe what they do. We publish how we do it — and the milestones we hold ourselves to. The Neolytix Operating Model is how we deliver 95%+ clean
Specialty-Specialized Delivery
Coding teams work in sub-specialty pods trained in modifier discipline, payer-specific policies, and the procedure-coding nuances of their assigned specialties — not generalist queues. AAPC- and AHIMA-certified coders are audited monthly against a 95% accuracy threshold for every provider on the account.
KPI-Bound Performance Standards
Outcomes are tracked against published thresholds, reviewed weekly with your account manager, and benchmarked monthly against HFMA MAP Keys. Performance targets include a clean claim rate of 95%+, denial rate under 5%, AR over 90 days under 10%, and a net collection rate of 97%+.
Diligence-Grade Compliance Posture
Operations run on a HIPAA-compliant, ISO 27001-certified security foundation built to withstand PE sponsor diligence, lender reporting, and Joint Commission scrutiny. Every control is designed for the audit environment your organization actually faces — not just the minimum to carry a compliance badge.
Dual-Shore Operating Model
US-based RCM leads own outcomes and report directly to your team, while offshore coding and AR-recovery teams supply the throughput that keeps unit economics competitive at mid-market collection volumes. The combination delivers a 95%+ clean claim rate without the cost structure of a fully domestic operation.
A 100-Day Roadmap to Predictable Revenue.
Day 30
Clean claim rate at 95%+; baseline diagnostic delivered to CFO.
Day 60
AR over 90 days held under 15%; payer-specific denial trends mapped.
Day 90
Denial rate reduced 40%+ from baseline.
Day 100
Full Incredibly AI dashboards live; first quarterly business review delivered.
Day 30
Clean claim rate at 95%+; baseline diagnostic delivered to CFO.
Day 60
AR over 90 days held under 15%; payer-specific denial trends mapped.
Day 90
Denial rate reduced 40%+ from baseline.
Day 100
Full Incredibly AI dashboards live; first quarterly business review delivered.
Choose Full-Service RCM or Select Targeted Solutions — On Your Terms
Select individual service offerings from within the revenue cycle to gain access to specific expertise to complement your non-clinical growth goals.
Patient Access
- Innovative data-driven solutions for hospitals, ambulatory care centers, clinics, etc.
- Reducing cost, minimizing errors, and improving patient experience
Credentialing And Enrollment Services
- For credentials verification, aligning with state compliance requirements, and delivering non-disruptive patient care.
- Medical Licensing, PSV, Credentialing & Enrollment & Privileging Management services
Medical Billing & Coding
- Insurance benefit verification, medical coding, claim submissions & follow-up, denial management, accounts receivable management, reporting & analytics.
- Reduction in AR, improved clean claims %, and process transparency.
Payor Contract Negotiation
- Optimizing reimbursement rates through contract negotiations and get paid what your healthcare organization deserves
- Fixed-Fee Structure & Incentive-Based Fee Structure available.
From First Appointment to Final Payment — Every Stage Covered
One integrated RCM model across six service areas — each stage staffed by specialists, tracked in real-time through InCredibly, and held to the same performance standard across every provider you operate.
Patient Access and Eligibility
25% of claim denials originate at the front end — eligibility errors, missed prior authorizations, and incomplete registration. Neolytix manages the full front end as a service: real-time eligibility verification before every visit, prior auth tracking across all payer types, and registration accuracy enforced at intake. Front-end denial rates, auth-to-service timelines, and no-show rates are reviewed weekly with your account manager — not buried in a monthly report.
- Real-time insurance eligibility verification before every visit
- Prior authorization management across all payer types
- Registration error identification and correction at intake
- CAQH profile setup and payer enrollment support
- Patient demographics and benefits capture
- Multi-channel patient intake (in-person, phone, digital)
>98%
Eligibility accuracy across managed practices
35%
Reduction in no-show rate post-engagement
Credentialing and Provider Enrollment
Every day a provider sits uncredentialed costs roughly $9,000 in unbilled revenue. Neolytix runs credentialing and payer enrollment as a managed service built around your provider start dates — not generic timelines. The InCredibly platform gives your team real-time visibility into every provider’s enrollment status, expected go-live date, and payer-side blockers across multi-entity groups and PE-backed platforms.
- Primary source verification (PSV) and credentials validation
- CAQH profile setup and ongoing maintenance
- Commercial and government payer enrollment
- Re-credentialing cycle management
- Privileging support for hospital-affiliated providers
- Multi-entity rollups for PE-backed platforms
99.2%
Approval rate across 8,000+ provider applications processed
< 90
days Target credentialing cycle vs. industry average of 120 days
Medical Coding
25–30% of denials trace back to coding errors, and CMS can recoup payments six years back. Neolytix coding runs in 31+ specialty pods staffed by AAPC- and AHIMA-certified coders, each audited monthly against a 95% accuracy threshold. HCC coding, modifier policing, and payer-specific audits are built into the workflow — not added after a denial.
- AAPC- and AHIMA-certified Certified Professional Coders
- 31+ specialty-focused coding pods
- E&M level validation against medical decision-making
- HCC coding for value-based care contracts
- Prospective (pre-submission) and retrospective audits
- Monthly coding accuracy audits per coder
60%
Reduction in coding error rate post-engagement
8-12%
Revenue recovery from undercoding identified through audit
Medical Billing and Claims Submission
30% of claims require manual rework before payment. Neolytix runs billing as a high-throughput operation tied to published KPI thresholds — rules-based scrubbing via integrated clearinghouse, payer-specific edits applied pre-submission, and same-day rejection flagging before claims age into denials. Clean claim rate by payer is reviewed weekly with your account manager.
- Rules-based claim scrubbing via integrated clearinghouse
- Electronic and paper submission across all payer types
- Payer-specific edit libraries and NCCI bundling logic
- Same-day rejection flagging and rework
- Timely filing management with payer-specific windows
- Claim-by-claim status tracking
>96%
Clean claim rate achieved across managed practices
<60
Days in AR vs. industry average of 45-60 at submission alone
Denial Management and Appeals
65% of denied claims are never reworked — turning $262 billion in annual denials into lost revenue. Neolytix runs denial management as a same-day discipline: root-cause coding, multi-level appeals with clinical documentation, payer escalation, and pattern detection to prevent the next denial. Pattern data feeds back into the front end so the underlying cause is fixed at the source.
- Same-day denial identification and root-cause coding
- Multi-level appeals with clinical documentation support
- Payer escalation pathways for complex denials
- Denial pattern detection and prevention feedback loop
- Specialty-specific appeals teams by payer type
- Weekly denial trend reporting to your account manager
40%+
Reduction in denial rates within 90 days of onboarding
70%
Claim denial reduction for Chicago BH client (in-house failure → Neolytix recovery)
Accounts Receivable Management and Collections
15–25% of the average practice’s AR sits over 90 days — and once it ages past 120, recovery probability drops below 30%. Neolytix runs AR management as an aging-bucket discipline targeting net AR days under 60, with payer-by-payer analysis, weekly account manager reviews, and full patient collections support. The InCredibly dashboard surfaces leakage before it becomes uncollectable.
- Aged AR analysis by payer and dollar value
- Payer-specific follow-up and recovery workflows
- Multi-channel patient statement delivery
- Payment plan setup and hardship screening
- AR over 120-day recovery campaigns
- Weekly aging-bucket review with account manager
<60
days Target net AR achieved across managed practices
<10%
Claims aging 90+ days, down from 40%+ pre-engagement (Chicago BH client)
Payer Contract Negotiation
82% of practices sign payer renewals without benchmarked rate intelligence — their payer knows what every competitor earns, and they don’t. Neolytix audits contracts for clawback provisions, silent PPO leakage, and below-market rates, then negotiates against Transparency in Coverage data. A recent Ohio behavioral health engagement surfaced $341K+ in annual revenue opportunity across a single payer mix.
- TiC rate benchmarking against market data
- Clawback and retroactive offset clause audit
- Timely filing window negotiation (vs. 90-day defaults)
- Silent PPO leakage identification
- Code-level rate gap analysis vs. 75th percentile
- 24-month gain-share partnership model available
$341k
Average opportunity identified per contract negotiation engagement
21%
Average rate gap below 75th percentile benchmark across major commercial payers
RCM Reporting and Revenue Intelligence
Most RCM platforms tell you what happened last month. Neolytix reporting tells you what’s coming — 30, 60, and 90-day revenue projections built from live claims data, payer behavior patterns, and AR aging trends. Real-time dashboards surface denial shifts and modifier errors at the claim level, so issues are caught at submission, not after the denial.
- 30/60/90-day revenue forecasting dashboards
- Denial pattern detection and root-cause attribution
- Modifier error and underpayment variance tracking
- TiC rate benchmarking by CPT code
- AR aging by payer, specialty, and provider
- Weekly KPI reporting against HFMA MAP Keys
30/60/90
day Forecasting delivered to all active clients
Weekly
Account manager review with published KPI reporting against HFMA MAP Keys
Revenue Cycle at Portfolio Scale
what that looks like across the Neolytix client portfolio.
Incredible RCM. Revenue That Doesn't Wait.
InCredibly™ is Neolytix’s purpose-built revenue intelligence platform — turning your billing cycle from an administrative holding pattern into a forecastable revenue pipeline.
Sankey Pipeline Visualization
Identifies revenue-blocking bottlenecks across all active payer workflows.
30/60/90-Day Revenue Forecasting
Projected collections by payer and provider, updated in real time.
Stakeholder Dashboards
COO, Finance, and Operations views with role-specific reporting.
Payer Intelligence Engine
Verified submission contacts, current requirements updated daily.
Case Studies
Real challenges. Measurable outcomes. Proven results across healthcare operations.
Prime Healthcare's Path to 98.5% First-Pass Enrollment
98.5%
First-Pass Approval
70%
Denial Reduction
40%
Faster Enrollment
50%
Revenue Increase
“Enrollment used to be a reactive, manual process that tied up significant resources. Neolytix gave us visibility and predictability. We can now flag problems early and prevent denials rather than chase them after they happen.”
— Operations Director, Prime Healthcare · 45+ hospitals · 300+ providers
Recovering 20% Lost Revenue After a Practice Merger
Breaking the Revenue Cycle Bottleneck — Behavioral Health AR reduced from 14% to 3.5% | $16K+ Medicare revenue recovered
Why Healthcare Leaders Choose Neolytix Over Conventional RCM
Not all revenue cycle partners are built the same. Here is how Neolytix compares to the typical billing company or in-house billing department.
| Neolytix | Typical Billing Company | |
|---|---|---|
| Specialty Coverage | 31 specialties with dedicated coding teams | Generalist billing, 5–10 specialties |
| Technology | InCredibly AI — live dashboards, TiC benchmarking | Monthly PDF or Excel reports |
| Revenue Forecasting | 30/60/90-day projected collections | Not available |
| AR Days Target | <60 days net AR | Often 75–120+ days |
| Clean Claim Rate | >96% first-pass acceptance | Industry average 85–92% |
| Denial Management | 40%+ reduction; root-cause analytics | Reactive appeals only |
| Certifications | ISO 27001, HIPAA, SOC 2, AAPC | HIPAA compliant (self-reported) |
| Onboarding Time | Go-live in 2–4 weeks | 4–12 weeks |
RCM Built for the Full Spectrum of Healthcare
From solo practitioners to 45-hospital networks — Neolytix scales to your complexity. Our model is built around your specialty mix, payer contracts, and operational structure.
40
US states
2x
languages
Three Steps. Thirty Days. Predictable Revenue From Day One
From solo practitioners to 45-hospital networks — Neolytix scales to your complexity. Our model is built around your specialty mix, payer contracts, and operational structure.
WEEK 1
Free Revenue Audit
We analyze your current billing data, denial trends, and payer mix — at no cost — and deliver a clear picture of where your revenue is leaking and how much is recoverable.
WEEK 1–2
Custom RCM Blueprint
Your dedicated account lead builds a tailored RCM workflow for your practice — mapping your specialties, payers, and operational requirements to the Neolytix delivery model.
WEEK 2–4
Go-Live & Optimization
We integrate with your existing EHR/PM system, train your staff, and go live. From day one you have InCredibly dashboards and a weekly performance cadence.
Security-First. At Every Step.
Built for Compliance. Designed for Confidence.
Every service we deliver is built on a foundation of strict data governance and regulatory compliance. HIPAA safeguards and ISO 27001-certified security practices are embedded into how we work, not added after the fact.
Get in Touch With Us
FAQs
Frequently Asked Questions About Neolytix RCM
What is a good clean claim rate for a medical practice?
A clean claim rate of 95% or higher is considered best practice per HFMA MAP Keys. The industry average is 85–92%. Rates below 90% signal systemic issues — incorrect coding, eligibility gaps, or payer-specific submission errors — that compound into higher denial rates and slower payment cycles.
How quickly can Neolytix take over our billing?
Most practices go live within 2–4 weeks. We handle system integration with your EHR/PM, staff onboarding, and data migration. Complex multi-location setups may take 4–6 weeks.
What should our claim denial rate be?
Best-in-class denial rates are below 5% per HFMA MAP Keys. The national average is 5–10%, with some specialties exceeding 15%. Rates above 10% indicate systemic front-end failures — eligibility errors, prior authorization gaps, or coding inconsistencies — not isolated claim issues that can be appealed away.
What is your fee structure — percentage of collections or flat fee?
Our standard model is a percentage of net collections, which aligns our incentives directly with yours. We also offer flat-fee arrangements for practices above a certain volume.
Which EHR and practice management systems do you integrate with?
Neolytix integrates with 20+ EHR and PM platforms including Epic, athenaOne, eClinicalWorks, Tebra, ModMed, Oracle Health, Greenway, and DrChrono. Integrations are completed during Week 1 of onboarding. If your system is not listed, contact us — we have connected with most major platforms in active use today.
Is Neolytix HIPAA compliant?
Yes. Neolytix is HIPAA compliant and ISO 27001 certified. All data is encrypted in transit and at rest. We sign a Business Associate Agreement (BAA) at the start of every engagement.
How do you handle denied claims?
Our denial management workflow begins with same-day identification and root-cause categorization. Appeals are worked by specialists assigned to the specific denial type — eligibility, coding, clinical documentation, or payer behavior. We track appeal outcomes by payer and use that data to reduce future denial rates proactively.
What does the free revenue audit include?
The free audit covers: a review of your last 90 days of claims data, denial rate and root-cause analysis, AR aging breakdown, clean claim rate assessment, and a benchmark comparison against specialty-specific TiC rates. You receive a written report with prioritized recommendations within 5 business days.
How do I know if my current RCM company is underperforming?
Key indicators: clean claim rate below 90%, denial rate above 10%, net AR days above 60, no weekly reporting, and no visibility into root-cause denial trends. If your RCM vendor delivers monthly PDFs instead of live dashboards, you are almost certainly leaving recoverable revenue uncollected.
How is Neolytix different from our current billing company?
Neolytix operates on published KPI thresholds — 95%+ clean claim rate, sub-5% denial rate, AR under 60 days — reviewed weekly with your account manager. Most billing companies report monthly. We also include payer contract benchmarking and 30/60/90-day revenue forecasting as standard, not add-ons.
Get Your Free Revenue Audit — No Cost, No Obligation
See exactly where your revenue is leaking and how much is recoverable — delivered in 5 business days.
Response within 1 business day · HIPAA-compliant onboarding · No long-term contracts required
