Stop losing money to denials — and stop exhausting your staff.
Provider Prime runs your billing and back-office workflows with documented SOPs, QA checks, and weekly KPI reporting — so cashflow becomes predictable and your team gets time back.
Outsourcing fails when it becomes a black box
Clinics don’t need “another vendor.” They need visibility, accountability, and measurable improvement. That’s why our delivery is built around SOPs, QA, and reporting — the mechanisms that create trust.
Get a free denial snapshot (quick win)
Send us a de‑identified list of recent denials (or denial categories). We’ll return a short summary: top 3 root causes, the fixes, and the KPI we’ll track. It’s a fast way to see if we’re a fit.
Request the snapshot See our workflowWhat you get in the first 14 days
- Access + setup plan (roles, queues, checklist)
- Baseline KPI dashboard (denials/AR/volume)
- Clean-claim checklist customized to your clinic
- Daily execution + QA checkpoints
- Weekly report with next actions + blockers
Services (built around outcomes)
We don’t sell “tasks.” We sell consistent execution that protects revenue and saves staff time. Start with billing, then add other workflows as needed.
Medical Billing
Charge entry, claims, payment posting, denials, AR follow-up, patient statements and reporting.
Pre‑Authorization
Eligibility checks, auth submissions, status follow-up, documentation requirements, escalation.
Documentation Support
Note QA support, templates, missing-info checklists, provider feedback loops.
Front Desk & Calls
Scheduling, confirmations, insurance capture, inbound call handling, patient communication.
Coding Support
CPT/ICD support, coding QA, denial trend insights, coordination with billing for clean claims.
Credentialing Support
Enrollment assistance, tracking, documentation management, and payer follow-up support.
What a billing stabilization typically looks like
An anonymized, illustrative example based on common clinic patterns. Actual results vary, but the sequence is consistent.
In‑house vs. Provider Prime
This is why clinics prefer a structured partner instead of “trying harder” internally.
| Typical pain | Provider Prime approach |
|---|---|
| No standard workflow → avoidable errors | SOPs + checklists + QA sampling |
| Denials repeat because causes aren’t tracked | Root-cause + fixes + KPI tracking |
| AR follow-up is inconsistent | Queues with ownership + escalation |
| You “hope” it’s improving | Weekly report with measurable movement |
What you see every week
Confidence comes from visibility. Our weekly report is intentionally simple and decision-ready.
Weekly KPI report includes:
- Volume processed (claims/posting/follow-ups)
- Denials by category + top root causes
- AR movement and priority queues
- Open blockers + escalation items
- Next actions for the week
Why this matters:
- Removes anxiety: you know what’s happening
- Prevents “vendor drift”: accountability stays high
- Creates momentum: issues get fixed once, not repeatedly
What clinics say when outsourcing feels “safe”
These are example statements that reflect common feedback when SOPs + reporting are in place.
“For the first time, we could see what was happening in AR every week. That visibility changed everything.”
Clinic manager — illustrative“Denials stopped repeating because the root cause was tracked and fixed. It felt like a real system.”
Operations lead — illustrative“Our staff stopped getting interrupted all day. Work queues and reporting made the week calmer.”
Office admin — illustrativeSimple 4‑step onboarding
You get a dedicated point of contact, SOPs, QA, and weekly reporting — so you always know what’s happening.
Your systems, payers, volumes, pain points, KPIs.
Access, workflows, templates, SOPs, security controls.
Daily execution + QA checkpoints + escalation rules.
Weekly reporting and continuous improvements.
Start with a pilot — keep only if it works
We recommend a 30–45 day pilot focused on billing stabilization and KPI baselines. If delivery isn’t clear (execution + weekly reporting), we extend the pilot at no cost until you have clarity.
- Clear scope + responsibilities
- Weekly KPIs + action plan
- Escalation rules for blockers
FAQ
The questions clinics usually ask before choosing an outsourcing partner.
Can we start with billing only?
Yes — that’s the recommended starting point. Once billing is stable, you can add pre-auth, documentation, front desk, and coding support.
How do you keep things from slipping?
We use documented SOPs, QA sampling, work queues, and a weekly KPI report. Each workflow has an owner and an escalation path.
How do you handle PHI and security?
We follow minimum-necessary access, role permissions, and documented handling steps. We align to your clinic’s requirements during onboarding and can sign a BAA when required.
What do you need from us to start?
Access (or supervised access), current workflows, payer list, and your priority KPIs. We provide a setup checklist on day one.
Want a calm, consistent operations partner?
Get Free Snapshot. We’ll map your workflow, propose a pilot scope, and share what we’ll report weekly.
Get Free Snapshot