Revantix — Your Practice Navigator | RCM Guidance for Medical Practices

What We Do

Every service your practice needs — from setup to ongoing support

We guide. We advise. We help you navigate. We do not bill for you.

Billing Company Selection

We help you evaluate and choose the right billing company for your specialty, size, and budget — — free for your practice, funded by our partner network and always disclosed. We create a shortlist, help you ask the right questions, and review any contract before you sign.

New PracticesSwitchingContract Review

Credentialing & Enrollment

Full credentialing guidance — CAQH setup, Medicare & Medicaid applications, commercial payer enrollment, in-network & out-of-network applications. We track every application so nothing falls through the cracks.

MedicareMedicaidCAQH Setup

EFT & ERA Setup

We enroll you for Electronic Funds Transfer and Electronic Remittance Advice with every payer. No more paper checks. No more manual payment posting. This step alone saves your team hours every week.

All PayersDirect DepositAuto-Posting

Practice Health Reporting

Monthly reports covering AR aging, denial rates by reason and payer, net collection rate, and revenue cycle benchmarks. You see exactly how your billing is performing — in plain language, not billing jargon.

Monthly ReportsDenial AnalysisAR Aging

Billing Crisis Recovery

When billing companies shut down, we step in immediately. We deploy our pre-vetted backup billing network, triage the claim backlog by timely filing risk, notify payers, and restore your revenue flow as fast as possible.

EmergencyBackup NetworkClaim Backlog

Multi-Vendor Coordination

Some practices benefit from two billing companies — one for E&M codes, one for procedures or drugs. We coordinate the setup, manage both vendors, and keep them accountable to you at all times.

Multi-SpecialtySplit BillingCoordination

Not sure which service you need? Start with a free assessment — we will figure it out together.

Billing Guidance

What every practice owner should know before signing anything

Honest information about billing company rates, red flags, and the right questions to ask.

New Practice? Start Here.

Set up billing in the right order

Most practices get this sequence wrong and pay for it with delays and lost revenue.

01

Get your NPI numbers first

NPI Type 1 (individual) and NPI Type 2 (practice entity). Free at nppes.cms.hhs.gov. Nothing else moves without these.

02

Complete your CAQH profile

Most payers use CAQH to verify credentials. Incomplete CAQH is the #1 cause of credentialing delays by far.

03

Choose billing company, PMS & clearinghouse

Three systems that must work together. We help you choose the right combination for your specialty — free for your practice, partners disclosed.

04

Start credentialing immediately

90–120 day minimum. Start the day you decide to open — not when your office is ready. Every day of delay costs revenue.

05

Set up EFT & ERA with every payer

Direct deposit + electronic payment reports. Without these you are still getting paper checks in 2026.

06

Monitor practice health monthly

Denial rate, AR aging, and net collection rate reviewed every single month without exception.

Practice Health Benchmarks

Industry standards — healthy numbers

Net Collection Rate95%+

Overall Denial RateUnder 7%

AR Over 90 DaysUnder 15%

Days in ARUnder 40 days

First Pass Rate95%+

Credentialing Timeline90–120 days

Medicare Enrollment60–90 days

Billing Company Fee4–9% of collections

Not sure how your practice compares? Our free 30-minute assessment reviews your actual numbers.

Market Rates

What billing companies actually charge

Most practices sign contracts without knowing what is normal in the market.

Small Practice — Under $500K/year

6–9%

Of monthly collections. Higher because lower volume means more work per dollar collected by the billing company.

💡 1% less on $100K/month = $12,000 saved per year.

Mid-Size Practice — $500K–$2M/year

4–7%

Most common range. Real room to negotiate, especially if you bring multiple providers or a longer contract term.

💡 Offer a 2-year term in exchange for a lower percentage.

Large Practice — Over $2M/year

3–5%

High volume means significant leverage. Always get 3 competing quotes before sitting down to negotiate.

💡 Competition always brings rates down — get 3 quotes minimum.

Flat Fee Options

$3–$8

Per claim submitted. Also: $300–$800 per provider per month. Better for high-volume practices with straightforward claims.

💡 Calculate which model is cheaper for your volume first.

Before You Sign

6 questions every practice must ask

Most practices never ask these. The ones that do get better service and far fewer surprises.

01

What specialties do you have experience with — and can you share references?

A billing company handling 20 specialties often handles none well. Specialty knowledge matters enormously for coding and denial prevention.

02

What is your average denial rate — and can I see a sample denial report right now?

Target is under 5–7%. If they cannot show samples — that tells you everything about their reporting culture and accountability.

03

Are you HIPAA compliant and will you sign a BAA before we share any data?

Legally required under federal law. Any legitimate company signs immediately. Hesitation or resistance — walk away.

04

What happens to my data and patient records if I leave or if your company closes?

You own your data. Always. This must be in writing in the contract. Resistance to this clause is a serious red flag.

05

Who is my dedicated account manager and what is their response time?

You need one accountable contact who knows your practice inside and out — not a rotating support queue.

06

Is your fee based on billed charges or collected revenue?

Always negotiate percentage of collected — not billed. If billed, you pay fees even on denied, unpaid claims.

FAQ

Questions we get asked every single week

Honest answers to the most common questions from new practices and practice managers.

Getting Started

Setting up a new practice

Where do I start with billing when I open a new practice?

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Start with your NPI numbers — Type 1 for you as an individual, Type 2 for your practice entity. Both are free at nppes.cms.hhs.gov. Then set up your CAQH profile and start credentialing immediately. Do not wait until your office is ready — credentialing takes 90 to 120 days minimum and every day of delay is revenue you cannot collect.

What is credentialing and why does it take so long?

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Credentialing is the process where insurance companies verify your qualifications, license, malpractice history, and other credentials before agreeing to pay your claims. It takes 90 to 120 days because each payer independently verifies everything and most have committees that only meet monthly. The most common delays are incomplete CAQH profiles, wrong NPI information, and not following up with payers every two weeks.

What is the difference between a billing company, a PMS, and a clearinghouse?

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A billing company submits claims to insurance companies on your behalf and follows up on denials. A PMS (Practice Management System) is the software where you schedule patients, store billing data, and track claims. A clearinghouse is the electronic gateway between your billing company and the insurance companies — it validates claims before they are sent to payers. You need all three working correctly together.

What is EFT and ERA — and do I really need them?

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EFT (Electronic Funds Transfer) means insurance companies deposit payments directly into your bank account instead of mailing paper checks. ERA (Electronic Remittance Advice) means payment explanations come electronically and can be auto-posted to your billing system. Yes — you absolutely need both. Without them you are processing paper checks and manually posting payments in 2026, costing your team significant time every single week.

Billing Companies

Evaluating and working with billing companies

How much should I be paying my billing company?

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For small practices under $500K per year, the market rate is 6 to 9 percent of collections. Mid-size practices ($500K to $2M) typically pay 4 to 7 percent. Large practices over $2M can negotiate down to 3 to 5 percent. Always negotiate percentage of collected revenue — never percentage of billed charges. Getting a quote? We can review it for you free of charge before you sign anything.

How do I know if my billing company is performing well?

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Check these four numbers every month: your net collection rate (should be 95%+), overall denial rate (should be under 7%), percentage of AR over 90 days (should be under 15%), and days in AR (should be under 40). If your billing company is not sending you these numbers monthly — that is itself a red flag. A good billing company proactively reports performance without being asked.

Does my billing company need to sign a HIPAA BAA with me?

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Yes — absolutely and without exception. A Business Associate Agreement (BAA) is legally required under HIPAA before you share any patient data with any vendor, including your billing company. It is a written agreement where the billing company promises to protect your patient information according to federal law. Any legitimate billing company signs one immediately. If they hesitate, question it, or say it is not necessary — do not share any data with them and consider walking away.

What happens to my claims if my billing company shuts down?

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This is a real risk that practices almost never prepare for. If your billing company shuts down: immediately inventory all outstanding claims, contact your payers to flag the situation, and find a replacement billing company as fast as possible. Claims approaching timely filing deadlines (usually 90 to 180 days from date of service) must be prioritized first. Revantix maintains a pre-vetted backup billing network for exactly this scenario — contact us immediately if this happens to you.

About Revantix

Working with Revantix

Are you a billing company? Do you submit claims?

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No — we are not a billing company and we do not submit claims. We are a practice navigator and advisory firm. We help you choose the right billing company, guide you through credentialing, help you understand your billing reports, and advise on payer enrollment. Think of us as your expert guide who is entirely on your side — and whenever a recommendation involves one of our paid partners, we tell you up front.

Is the free assessment really free — no strings attached?

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Yes — completely free. No credit card. No obligation to hire us after. The 30-minute assessment is a genuine conversation where we review your situation and give you honest, useful guidance. If we cannot help you — we will tell you that clearly and point you in the right direction. We earn trust before we earn business. That is the only way we know how to operate.

Do you earn commission from the billing companies you recommend?

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Here is the honest answer: our services are free for practices. When you choose a billing company from our vetted partner network, that partner pays Revantix a referral fee. Three commitments keep this trustworthy: we disclose every partner relationship to you up front, your rate is never higher because of our fee, and if your best fit is outside our network we tell you so. You will never have to guess how we are paid.

Is my information safe if I fill out your assessment form?

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Yes. Your information is stored in a secure, HIPAA-compliant database (Google Workspace with a signed BAA). We never sell, share, or distribute your information to any third party. The website is protected by SSL encryption. Form submissions are spam-protected with honeypot detection and rate limiting. You can read our full Privacy Policy for complete details.

Did not find your answer? Ask us directly — we respond within 24 hours.

About Revantix

Why we built this — and who we are

A new company built on one simple belief: every doctor deserves to understand their own billing.

Our Story

Built from the inside of this industry

After years working inside Revenue Cycle Management — handling AR, managing denials, leading teams, and watching practices struggle with problems that should have been solved long before — one thing became very clear.

Most practices are navigating one of the most complex industries in the world completely alone. And every vendor they encounter — billing companies, software sellers, clearinghouses — has something to sell them.

Nobody was sitting entirely on the practice's side. That is the gap Revantix was built to fill.

The Insight

Practices are overwhelmed and underserved by an industry full of vendors with their own interests. Someone needed to be purely on the practice's side — with no agenda of their own.

The Foundation

Built on years of real inside experience working in RCM — AR management, denial workflows, team leadership, and credentialing. Not theoretical knowledge — lived, operational knowledge.

The Mission

Every practice deserves a trusted expert in their corner — one whose incentives are on the table in full view, every time. That is what Revantix exists to be.

Today — 2026

Helping new practices set up correctly, established practices perform better, and any practice navigate a billing crisis with confidence and a clear plan.

Our Values

What we stand for

🎯 Practice-First Always

Every recommendation is made purely in the interest of the practice. We never take sides with vendors.

📖 Radical Transparency

We tell you what we find — even when it is uncomfortable. We explain the market honestly, including our own limitations.

🔍 Disclosed Partnerships

Practices never pay us. Vetted partner billing companies fund our work through referral fees — disclosed openly, every single time.

💡 Teach Everything

We want practices to understand their billing so well they eventually need less guidance — not more.

Contact Revantix

info@revantixhealth.com linkedin.com/in/adityarajput

Free Assessment

30 minutes. Honest guidance. Zero obligation.

Tell us about your practice. We will give you a clear picture of where you stand and exactly what you need.

What to Expect

What happens after you submit

1

We receive your request within minutes

Your information is saved securely to our client database immediately.

2

Our team reviews your situation personally

Within 24 hours — not a template, not an auto-reply. A real member of our team who knows this industry reads your submission.

3

You receive a personal response

We reply to your email with initial thoughts and propose a time for your free 30-minute call.

4

The 30-minute assessment call

Video or phone — your choice. We ask questions, listen more than we talk, and give you honest guidance. No pitch.

5

You receive a written summary

After the call, we send a short written summary of what we discussed and what we recommend — at no charge.

Response within 24 hoursPersonal response from our team — not a template or chatbot.

HIPAA compliant & encryptedStored in our secure Google Workspace database. Never shared with third parties.

No sales pitch — guaranteedHonest review only. If we cannot help, we will say so directly.

HIPAA Compliant

SSL Encrypted

Data Never Sold

Or reach out directly

info@revantixhealth.com

Request Your Free Assessment

Your information goes securely to our client database. We respond within 24 hours.

Your Name *

Practice Name

Email Address *

Phone Number

Practice Specialty

Number of Providers

What do you need help with? *

Tell us more (the more detail, the better your assessment)

✅

Assessment Request Received!

Your information has been saved securely to our client database. Our team will review your details and reach out within 24 hours at .

while you wait.

Free Education

Medical billing, explained in plain language

No jargon. No gatekeeping. The knowledge every practice owner and office manager deserves to have — free.

The Big Picture

The revenue cycle — from appointment to payment

Every dollar your practice earns travels through these 8 steps. A breakdown at any step delays or loses revenue.

01

Patient registration & eligibility check

Collect demographics and insurance details, then verify coverage BEFORE the visit. Most "patient not covered" denials start with a skipped eligibility check.

02

The visit & documentation

The provider documents the encounter. Good documentation drives correct coding — and protects you in an audit.

03

Medical coding

The visit is translated into CPT codes (what was done), ICD-10 codes (why), and modifiers (special circumstances). Coding errors are a top denial cause.

04

Charge entry & claim creation

Codes and charges become a claim — the CMS-1500 form for most office visits, sent electronically as an 837 file.

05

Claim scrubbing & submission

The clearinghouse checks the claim for errors before it reaches the payer. A 95%+ first-pass acceptance rate is the benchmark.

06

Payer adjudication

The insurance company decides: pay, deny, or pay partially. The decision arrives as an ERA (electronic) or EOB (paper).

07

Payment posting & denial work

Payments are posted, denials are corrected and resubmitted or appealed. Unworked denials are the silent killer of practice revenue.

08

Patient billing & AR follow-up

Remaining balances are billed to patients via statements. Aging claims are followed up until paid — or written off if timely filing is missed.

Decode Your EOB

Common denial codes — and what they actually mean

These codes appear on your EOBs and ERAs. Knowing them tells you exactly where your billing is breaking down.

CO-45

Charge exceeds fee schedule

Not a true denial — it is the contractual write-off between your charge and the payer's allowed amount. Normal, but track it: if it is huge, your fee schedule may need updating.

CO-29

Timely filing limit expired

The claim was submitted too late — usually past 90–180 days from the date of service. This revenue is almost always lost. Prevention is the only cure.

CO-16

Claim lacks information

Something is missing or invalid — often an NPI, taxonomy code, or patient detail. Fixable: correct and resubmit quickly before timely filing runs out.

CO-97

Bundled / included in another service

The payer says this service is part of another procedure already paid. Sometimes correct — sometimes a missing modifier (like 59 or 25) is the real issue.

PR-204

Service not covered by plan

The patient's plan does not cover this service. PR means patient responsibility — but always verify eligibility was checked before billing the patient.

PR-1 / PR-2 / PR-3

Deductible, coinsurance, copay

Not denials — the patient's share of cost. These flow into patient statements. High PR amounts early in the year are normal as deductibles reset.

CO-22

Care may be covered by another payer

Coordination of benefits issue — the payer believes another insurance is primary. Fix the COB with the patient and payer, then resubmit.

CO-109

Claim sent to wrong payer

This payer says it is not responsible. Usually a payer ID mistake in your PMS or outdated insurance on file. Verify and redirect the claim fast.

Seeing a denial pattern you cannot crack? Send us a sample EOB — we will tell you what is happening.

Plain-Language Glossary

Billing terms, translated

The vocabulary every practice owner should know — without the jargon.

NPI — National Provider Identifier

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Your unique 10-digit ID. Type 1 identifies you as an individual provider; Type 2 identifies your practice as a business. Both are free at nppes.cms.hhs.gov and both are required for billing.

CAQH — Council for Affordable Quality Healthcare

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The central online database where you store your credentials once, and most insurance companies pull from it during credentialing. Must be re-attested every 120 days or applications stall.

EOB vs ERA — Explanation of Benefits vs Electronic Remittance Advice

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Both explain how a payer processed your claim — what was paid, denied, and why. The EOB is the paper/portal version; the ERA (835 file) is the electronic version that can auto-post into your billing system, saving hours of manual work.

EFT — Electronic Funds Transfer

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Direct deposit from insurance companies into your bank account, replacing mailed paper checks. Set up separately with each payer — usually alongside ERA enrollment.

Clean claim

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A claim with zero errors that gets accepted and processed on the first submission. Your first-pass clean claim rate should be 95% or higher — below that, basic errors are leaking revenue.

Timely filing limit

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The deadline to submit a claim after the date of service — commonly 90 days for commercial payers and 12 months for Medicare, but it varies by contract. Miss it and the revenue is gone permanently (CO-29).

AR — Accounts Receivable

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Money owed to your practice for services already delivered. Tracked in aging "buckets" (0–30, 31–60, 61–90, 90+ days). Healthy target: under 15% of total AR older than 90 days.

Modifier

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A 2-character code added to a CPT code to give the payer extra context — like modifier 25 (significant separate E/M service same day) or 59 (distinct procedure). Missing modifiers cause bundling denials; wrong ones trigger audits.

Prior authorization

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Payer approval required BEFORE certain services are performed. No auth = automatic denial, and these are among the hardest denials to overturn. Always verify auth requirements during eligibility checks.

Credentialing vs Contracting

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Credentialing is the payer verifying who you are. Contracting is negotiating and signing the agreement that sets your rates and makes you in-network. You need both completed before claims pay at in-network rates.

Superbill

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The encounter summary listing the diagnosis and procedure codes from a visit — the source document your biller uses to create the claim. In modern PMS systems it is digital, but the concept is the same.

Write-off vs Adjustment

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A contractual adjustment is the expected difference between your charge and the payer's allowed amount (normal). A write-off is revenue you abandon — bad debt, timely filing misses, uncollectable balances. Watch write-offs closely; they hide billing failures.

Want this knowledge applied to your own practice numbers?

Legal

Privacy Policy

How we collect, use, and protect your information.

Last updated: June 1, 2026 · Effective: June 1, 2026

1. Who We Are

Revantix ("we," "us," or "our") is an independent RCM advisory firm operating at revantixhealth.com. We are not a billing company, PMS vendor, or clearinghouse. Contact: info@revantixhealth.com.

2. Information We Collect

When you submit our assessment form, we collect: your name, email address, phone number (optional), practice specialty (optional), number of providers (optional), the challenge you need help with, and any additional details you provide. We also collect basic website analytics (page views, traffic sources) if analytics are enabled.

3. How We Use Your Information

To respond to your assessment request and provide the guidance you asked for
To send weekly billing tips if you subscribed to our newsletter
To improve our services and understand what practices need most
We do not use your information for advertising, profiling, or automated decision-making

4. How We Store Your Information

Your information is stored in Google Workspace (Google Sheets) under a HIPAA-compliant Business Associate Agreement (BAA). Google Workspace uses industry-standard encryption for data at rest and in transit. We retain your information for as long as you wish to receive our services. You may request deletion at any time.

5. HIPAA Compliance

As a business associate that may handle Protected Health Information (PHI), Revantix maintains HIPAA compliance including: a signed BAA with our data storage provider (Google Workspace), access controls limiting who can view your information, encryption of all data at rest and in transit, and a documented breach notification policy.

6. We Never Sell Your Information

We will never sell, rent, or trade your personal information to any third party. We do not share your information with billing companies, software vendors, clearinghouses, or any other third party — regardless of whether we recommend them to you.

7. Your Rights

Access: Request a copy of the information we hold about you
Correction: Request correction of any inaccurate information
Deletion: Request deletion of your information at any time
Opt-out: Unsubscribe from newsletter communications at any time

To exercise any of these rights, email info@revantixhealth.com. We respond within 5 business days.

8. Cookies

This website does not use tracking cookies. If Google Analytics is enabled, it may set a cookie to distinguish unique visitors. You can opt out of Google Analytics tracking at tools.google.com/dlpage/gaoptout.

9. Third-Party Services

We use Google Workspace (HIPAA BAA signed) for data storage and email. If Google Analytics is enabled, it is governed by Google's Privacy Policy. We do not use any other third-party data processors.

10. Contact

Privacy questions or requests: info@revantixhealth.com · revantixhealth.com

Legal

Terms of Service

The terms under which Revantix provides advisory services.

Last updated: June 1, 2026 · Effective: June 1, 2026

1. Services Provided

Revantix provides RCM advisory and consulting guidance to medical practices. Our services include: billing company evaluation guidance, credentialing process guidance, payer enrollment guidance, practice health reporting analysis, and general revenue cycle advisory. We are an advisory firm — we do not submit claims, own billing software, or operate a clearinghouse.

2. Not a Substitute for Professional Advice

Our guidance is advisory in nature and based on general industry knowledge and experience. It does not constitute legal, financial, medical, or regulatory advice. You should consult qualified professionals (attorneys, accountants, compliance officers) for legal, financial, or regulatory matters specific to your practice.

3. No Guarantee of Outcomes

While we provide our best professional guidance, we cannot guarantee specific outcomes including credentialing timelines, billing company performance, payer decisions, or revenue improvements. All billing, credentialing, and enrollment outcomes depend on third parties (payers, billing companies, regulatory bodies) outside our control.

4. Vendor Relationships & Disclosure

Revantix maintains referral partnerships with select billing companies, which pay Revantix a referral fee when a practice engages them through our guidance. Advisory services are provided to practices free of charge. We disclose partner relationships to practices, a practice's pricing is not increased on account of our fee, and our recommendations include non-partner options whenever they better serve the practice.

5. Confidentiality

We treat all information you share with us as confidential. We will not disclose your practice information to any third party without your explicit written consent, except as required by law. See our Privacy Policy for complete details on data handling.

6. HIPAA Compliance

We operate as a HIPAA Business Associate when handling any Protected Health Information. We maintain appropriate safeguards and will sign a Business Associate Agreement with any practice before handling PHI. We report any suspected breach within the timeframes required by law.

7. Limitation of Liability

Revantix's liability for any claim arising from our advisory services is limited to the fees paid to us for the specific service in question. We are not liable for decisions made based on our guidance, third-party vendor performance, or outcomes outside our direct control.

8. Governing Law

These terms are governed by the laws of the United States and applicable state laws. Any disputes will be resolved through good-faith negotiation first, followed by mediation if necessary.

9. Changes to These Terms

We may update these terms from time to time. Material changes will be communicated to active clients via email. Continued use of our services after changes constitutes acceptance of the updated terms.

10. Contact

Questions about these terms: info@revantixhealth.com · revantixhealth.com

Lost in thebilling world?We are your guide.

Every practice. Every stage.

The situations we help practices navigate

We are new. Here is why that works in your favor.

Every service your practice needs — from setup to ongoing support

What every practice owner should know before signing anything

Set up billing in the right order

What billing companies actually charge

6 questions every practice must ask

Questions we get asked every single week

Setting up a new practice

Evaluating and working with billing companies

Working with Revantix

Why we built this — and who we are

Built from the inside of this industry

What we stand for

30 minutes. Honest guidance. Zero obligation.

What happens after you submit

Medical billing, explained in plain language

The revenue cycle — from appointment to payment

Common denial codes — and what they actually mean

Billing terms, translated

Privacy Policy

1. Who We Are

2. Information We Collect

3. How We Use Your Information

4. How We Store Your Information

5. HIPAA Compliance

6. We Never Sell Your Information

7. Your Rights

8. Cookies

9. Third-Party Services

10. Contact

Terms of Service

1. Services Provided

2. Not a Substitute for Professional Advice

3. No Guarantee of Outcomes

4. Vendor Relationships & Disclosure

5. Confidentiality

6. HIPAA Compliance

7. Limitation of Liability

8. Governing Law

9. Changes to These Terms

10. Contact

Lost in the
billing world?
We are your guide.