Most billing problems begin at charge capture — encounters posted late, modifiers applied from habit, and NCCI edit pairs discovered by the payer instead of by your team. EntireRCM reconciles every encounter to the schedule, applies AAPC-standard coding and modifier logic, scrubs against CMS NCCI Procedure-to-Procedure edits and Medically Unlikely Edits, then submits clean claims within 24–48 hours.
The workflow is deliberately boring, which is the point. Charges post the day they are documented; every code combination is checked against the NCCI Policy Manual and payer-specific edits before submission; place-of-service and provider attribution are validated; and any claim that cannot be made clean the same day goes to a documented work queue with an owner and a deadline — never into a month-end pile.
Modifier logic is where most internal teams quietly lose money: modifier 25 for a significant, separately identifiable E/M on the same day as a procedure; modifier 59 (or the X-modifier family) for genuinely distinct services; 26/TC splits for diagnostics when the professional and technical components are performed by different entities. We apply them from documentation, never as defaults.
After submission, the same desk owns the claim through adjudication: rejected claims are corrected and resubmitted the day the rejection lands, and every rejection reason is classified so the upstream cause — a template error, a referral gap, a fee schedule mismatch — gets fixed at the source.