Eligibility Problems Found After the Visit
Coverage changes, especially for Nevada Medicaid and managed care patients, get missed at check-in. The claim denies weeks later and the patient has moved on.
Revenue cycle management by Nevada Medical Billing
Revenue Cycle Management Services for Nevada Medical Practices
Every visit your providers see should turn into a paid claim. Nevada Med Billing runs your entire revenue cycle from inside the EHR you already use, from eligibility and coding to denials, AR and patient balances. We're a Las Vegas company, we've billed Nevada payers for more than a decade, and we only get paid when you do.
We review 90 days of your claims, denials and AR at no cost.
- Las Vegas based since 2014
- From 3.9% of net collections
- HIPAA compliant with a signed BAA
- No EHR switch
- Month-to-month
What is RCMWhat Is Revenue
What Is Revenue
Cycle Management?
Revenue cycle management is how a medical practice gets paid. It starts the moment a patient books an appointment and ends when the last dollar of that visit is collected, whether it comes from Medicare, a commercial plan or the patient.
In between, a lot has to go right. Coverage has to be verified before the visit. The encounter has to be coded correctly with CPT, ICD-10-CM and HCPCS codes. The claim has to pass the payer's edits, get paid at the contracted rate, and get chased if it doesn't. Any balance the patient owes has to be billed and collected. Miss one step and the money slows down or disappears.
After more than a decade of working Nevada claims, here's the pattern we see most: practices rarely lose revenue in one big mistake. They lose it in dozens of small ones that nobody has time to catch. Good RCM is the discipline of catching them, every day.
See what our free revenue cycle audit coversRevenue leaksWhere Nevada Practices Lose
Where Nevada Practices Lose
Revenue in the Revenue Cycle
When we audit a new practice, the same leaks show up across specialties and EHRs. Most practices have more than one.
Prior Authorizations That Slow Down or Stall
Nevada Medicaid and commercial plans each have their own authorization rules. A missing or expired auth turns a covered service into a write-off.
Coding That Leaves Money on the Table
Undercoded E/M visits, missing modifiers and unbilled add-on codes cost practices money on claims that do get paid.
Denials That Never Get Appealed
Busy teams fix a denial once or adjust it off. Many denials are recoverable with the right correction or appeal.
AR That Ages Past the Point of No Return
New claims always feel more urgent, so older balances slide past 90 days and past timely filing.
Patient Balances Nobody Follows Up
High-deductible plans have shifted more of every bill to patients. Without a steady statement cycle, those balances quietly become bad debt.
Services by stageOur End-to-End RCM Services,
Our End-to-End RCM Services,
Stage by Stage
A healthy revenue cycle has three stages and a support layer underneath them. Nevada Med Billing covers all of it with one team, so nothing falls between two vendors.
Front end
Front-End RCM: Registration, Eligibility and Prior Authorization
Most denials start at the front desk, which is why we start there too.
Patient registration review
We check demographics and insurance details so claims aren't rejected for a wrong member ID or date of birth.
Patient cost estimates
We help your team give accurate estimates, including good faith estimates for self-pay patients under the No Surprises Act.
Eligibility verification and prior authorization are included in Group and Enterprise plans.
Mid-cycle
Mid-Cycle RCM: Charge Capture, Coding and Claim Scrubbing
This is where a visit becomes a claim, and where small errors multiply. We offer complete mid-cycle RCM services for providers in Nevada, from charge capture to claim scrubbing.
Charge capture
A daily check for completed visits with no charges or unsigned notes, sent back to providers as a short list.
Claim scrubbing
Every claim is checked against your EHR's edits and each payer's own rules before it goes out.
Back end
Back-End RCM: Claims, Payment Posting, Denials and AR
The back end is where most practices are understaffed, and where the biggest recoveries usually are.
Payment posting
835 ERAs, EFTs and paper EOBs posted within 48 hours and matched to your contracted rates, so underpayments are caught.
Patient billing
Statements on a 30-day cycle, online payment options and a team that answers your patients' billing questions.
Support layer
Credentialing, Payer Contracts and Compliance
Payer contract analysis
We compare what payers actually pay against your contracts and flag rates worth renegotiating.
Quarterly compliance audit
A coding and documentation review to keep you on the right side of CMS and OIG guidance.
Reporting
A monthly KPI report and review call, so you always know where your revenue stands.
Credentialing and enrollment, payer contract analysis and quarterly compliance audits are included in Enterprise plans.
Want a price built around your practice?
Get a Custom RCM Quote →Nevada payersRCM Built
RCM Built
for Nevada Payers
National billing companies treat Nevada like any other state. It isn't. Our payer mix is heavy on Medicaid managed care and Medicare Advantage, rules differ from plan to plan, and a claim set up for one payer can deny at the next. Nevada Med Billing has worked these payers every day for more than ten years.
Noridian Medicare JE and Nevada Medicaid (DHCFP)
Nevada Medicare Part B claims go to Noridian Healthcare Solutions, the Medicare Administrative Contractor for Jurisdiction E. Nevada Medicaid is run by the Division of Health Care Financing and Policy (DHCFP), which covers fee-for-service Medicaid and Nevada Check Up, the state's children's health program. We keep provider enrollment current with each, set up their billing rules in your system, and track their timely filing limits so claims don't age out.
Anthem BCBS, Health Plan of Nevada, Molina and SilverSummit
Most Nevada Medicaid members are enrolled in a managed care plan, and each plan runs its own authorization and claims process. We bill Anthem Blue Cross Blue Shield, Health Plan of Nevada, Molina Healthcare and SilverSummit Healthplan daily, along with Medicare Advantage and commercial plans. We know where each one tends to deny and how to get those claims paid.
EHRWe Run Your Revenue
We Run Your Revenue
Cycle Inside Your EHR
Switching software to fix billing is expensive, slow and hard on your staff. You don't have to. Our billers log in to your existing EHR and practice management system with their own named accounts and work your revenue cycle right there, where your team can see everything we do.
We run dedicated teams for DrChrono and eClinicalWorks, and work daily in athenaOne, Tebra (formerly Kareo), AdvancedMD and NextGen. Using something else? Ask us. If your system supports named user accounts and electronic claims, we can almost always work in it.
See all EHR integrationsOnboardingHow We Take Over Your Revenue
How We Take Over Your Revenue
Cycle in 2 to 4 Weeks
There's no data migration and no downtime. Moving your RCM to Nevada Med Billing is mostly access, setup and cleanup.
Step 1: Free 90-Day Revenue Cycle Audit
We review 90 days of claims, denials, payments and AR aging and show you where revenue is leaking and what it's worth.
Step 2: BAA and Secure System Access
We sign a Business Associate Agreement, and your admin creates named, role-based user accounts for our team.
Step 3: Payer, Fee Schedule and Workflow Setup
We review fee schedules, payer settings, clearinghouse and ERA/EFT enrollment, and fix what's causing denials.
Step 4: Go-Live and Backlog Recovery
Daily RCM work starts. Aged AR from your previous biller is ranked by value and filing deadline and worked alongside new claims.
Step 5: Monthly Performance Review
You get a KPI report and a call with your account manager every month.
ComparisonOutsourced RCM vs. In-House
Outsourced RCM vs. In-House
Billing: What It Really Costs
An in-house biller looks cheaper on paper until you add up salary, benefits, training, software seats, and the claims that sit untouched when that person is out sick or quits. Here's how the options compare.
| What matters | Nevada Med Billing | In-house billing team | National billing company |
|---|---|---|---|
| Cost model | 3.9% to 4.9% of net collections | Salaries, benefits, training, turnover | Usually % of collections, often not published |
| You pay when | You get paid | Every payroll, regardless of results | Varies |
| Coverage during PTO or turnover | Full team backup | Work stops | Team backup |
| Nevada payer experience | Daily since 2014 | Depends on the hire | Often limited |
| Works inside your EHR | Yes | Yes | Sometimes requires their software |
| Aged AR recovery | From day one | Often pushed aside | Varies |
| Monthly KPI reporting | Included | Depends on the team | Varies |
| Contract | Month-to-month, 30 days' notice | Employment | Often 12 months or more |
PricingRevenue Cycle
Revenue Cycle
Management Pricing
Our pricing is simple and published. You pay a percentage of what we actually collect for you, so our incentive is the same as yours: get every claim paid.
Solo
4.9%
of net collections
Best for: 1 provider, single location
Coding and claim submission, denial rework, patient statements, monthly reporting
Group
3.9%
of net collections
Best for: 2 to 10 providers, multi-site
Everything in Solo, plus prior authorization and eligibility, a named RCM lead with a monthly call, and provider-level benchmarking
Enterprise
Custom
volume-based
Best for: 10+ providers or MSOs
Everything in Group, plus credentialing and enrollment, payer contract analysis and a quarterly compliance audit
There's no setup fee and no long-term contract. Every plan is month-to-month with 30 days' notice. After your free audit, we confirm your plan and rate in writing.
SpecialtiesRCM Services
RCM Services
for Your Specialty
Every specialty has its own codes, modifiers and authorization rules. We match your practice with billers and coders who know yours.
Nevada locationsRevenue Cycle Management
Revenue Cycle Management
Across Nevada
Nevada Med Billing is based in Las Vegas. We support practices throughout Clark County and Washoe County, in Carson City, and in rural communities across the state. Because we work inside your EHR, a clinic in Elko gets the same team and turnaround as a practice down the street from our office.
We also serve practices outside Nevada. Your location doesn't change the service.
KPIsThe RCM KPIs We Track
The RCM KPIs We Track
and Report Monthly
You shouldn't have to guess whether your billing company is doing its job. These are the numbers we hold ourselves to, and you'll see every one of them in your monthly report.
Clean claim rate
Claims accepted on first submission
95% or higher
Denial rate
Share of claims denied
Under 5%
Days in AR
Average time to get paid
Under 40 days
AR over 90 days
Balances at risk of write-off
Under 15% of total AR
Net collection rate
What you collected vs. what you could collect
95% or higher
Charge lag
Visit date to claim submission
Under 3 days
Targets are based on widely used medical practice benchmarks. Results depend on specialty, payer mix and the condition of your existing AR.
Why usWhy Nevada Practices
Why Nevada Practices
Choose Nevada Med Billing
A Local Company, Not a Call Center
We're in Las Vegas and have billed Nevada payers since 2014. You can reach a real person who knows your account.
One Team for the Whole Revenue Cycle
Eligibility, coding, claims, denials, AR and patient billing handled by one accountable team.
Published, Pay-for-Performance Pricing
From 3.9% of net collections, no setup fee, month-to-month.
You Keep Your EHR
No migration, no retraining, no downtime.
Reporting You Can Actually Read
A plain-English monthly report and a call to walk through it.
SecurityHIPAA-Compliant Revenue
HIPAA-Compliant Revenue
Cycle Management
We sign a Business Associate Agreement before anyone on our team touches your system. Every biller works under a named, role-based account, never a shared login. Your data stays in your EHR, every action is recorded in its audit trail, and your admin can remove our access at any time. Our team completes HIPAA training as part of onboarding and on a regular schedule after that.
RCMRevenue Cycle
Revenue Cycle
Management FAQs
Can't find what you need? Our Nevada team answers every question before you commit.
An RCM company manages every financial step of a patient visit for your practice: eligibility checks, prior authorization, coding, claim submission, payment posting, denial management, AR follow-up and patient billing. Nevada Med Billing does all of this inside your existing EHR.
Most RCM companies charge a percentage of collections. Nevada Med Billing charges 4.9% of net collections for solo providers and 3.9% for groups of 2 to 10 providers, with custom pricing for larger groups and MSOs. There's no setup fee and no long-term contract.
For most small and mid-size practices, yes. You avoid salaries, benefits, training and turnover, you get a full team instead of one person, and you only pay when claims are collected. In-house can work well for large practices with an experienced billing department.
No. Our team works inside the EHR and practice management system you already use, including DrChrono, eClinicalWorks, athenaOne, Tebra, AdvancedMD and NextGen.
Most practices are fully live with Nevada Med Billing in 2 to 4 weeks. There's no data migration, so onboarding covers system access, payer and fee schedule setup, and a plan for your existing AR.
Yes. We bill Noridian Medicare under Jurisdiction E, Nevada Medicaid through DHCFP, and Nevada managed care plans including Anthem Blue Cross Blue Shield, Health Plan of Nevada, Molina Healthcare and SilverSummit Healthplan.
At a minimum: clean claim rate, denial rate, days in AR, AR over 90 days, net collection rate and charge lag. We report all six every month against clear targets.
Yes. Our Solo plan is built for single-provider practices, and our Group plan covers practices with 2 to 10 providers across one or more locations.
Yes. We sign a Business Associate Agreement before accessing your system, use named role-based accounts, and keep your data inside your EHR, where every action is logged.
Yes. We support practices across Nevada, including Henderson, Reno, North Las Vegas, Carson City and rural areas, as well as practices in other states.
Still have questions? Talk to our team.
Free RCM audit
Get a Free Revenue Cycle Audit
You can't fix what you can't see. Nevada Med Billing will review 90 days of your claims, denials, payments and AR aging inside your own system, then show you your clean claim rate, your top denial reasons, how much of your AR is at risk, and which plan fits your practice. It's free, there's no obligation, and nothing changes in your EHR.
Prefer to talk to a person? Call (631) 652-3106.