For rural and critical access hospitals, every earned dollar has to arrive.
Twenty-five beds, a 24/7 emergency department, swing beds, a rural health clinic, and a business office you can count on one hand. Revenue here follows different rules: cost-based Medicare reimbursement, Method II billing, and payer mixes where one bad month shows up in days cash on hand. We bring certified access, coding, and billing specialists fluent in those rules, backed by RevAmp intelligence and connected governance, joining your team at the share of work you choose.
7 of top 20
U.S. health systems served
32M+
Coding charts processed annually
28M+
A/R claims managed annually
Cost-based, swing bed, RHC: billing that knows the difference.
Revenue cycle management for rural and critical access hospitals is its own discipline. Cost-based Medicare payment, swing-bed billing, the 96-hour certification, provider-based rural health clinic claims, and Medicare Advantage plans that pay by their own rules all rest on a staff of two or three. We deliver front, mid, and back-office services using certified practitioners and the RevAmp AI platform, carrying the specialized work so the dollars your hospital earns actually arrive.
Coverage that protects daily cash flow
Workflows aligned to rural reimbursement realities
Clear ownership without added operating burden
Front-office, mid-office, back-office, and technology support sized to your hospital.
Start with the queue, role, payer, or workflow creating the most pressure. Services can support one function or a broader scope across hospital and clinic billing. Work is configured around your existing systems, policies, reimbursement model, and staffing plan, with clear ownership for the portion you engage.
Front-office
Clear coverage, authorization, demographic, and financial information before care becomes downstream rework.
- Scheduling and Registration
- Patient Access Management
- Eligibility and Benefits Verification
- Registration QA and Demographic Accuracy
- Prior Authorization
- Financial Clearance and Counseling
- Self-Pay, Charity Care and Medicaid Screening
Mid-office
Turn emergency, inpatient, outpatient, clinic, ancillary, and swing-bed documentation into accurate billable work.
- Medical Coding
- Coding Audits and Quality Assurance
- Clinical Documentation Integrity (CDI)
- Charge Capture Optimization
- Revenue Integrity and Leakage Prevention
- Billing Compliance and Audit Defense
- Health Information Management Support
Back-office
Move claims and cash while addressing denials, payment variance, and aging before they strain limited capacity.
- Claims Editing and Clean-Claim Validation
- Claim Submission and Clearinghouse Support
- Payment Posting and Reconciliation
- Accounts Receivable Follow-Up
- Denials Management and Appeals
- Underpayment Recovery and Payer Variance Resolution
- Extended Business Office and Co-Managed Operations
Technology
Add practical workflow intelligence and reporting without forcing a new core system.
- RevAmp
- EHR Integrations
Specialized billing done right. Earned dollars defended. A revenue cycle that keeps care local.
Bill the rural rules correctly the first time
Swing-bed, rural health clinic, and observation claims worked by certified specialists, so billing follows the rules of the setting where care happened.
Hold every payer to your real rates
Payments reconciled against cost-based and contracted terms, with Medicare Advantage shortfalls and posting errors appealed and tracked to resolution.
Turn uninsured visits into covered care
Self-pay balances screened for Medicaid and charity eligibility, converting write-offs into coverage and keeping bad debt true to your policy.
See every function's numbers in one place
One consolidated view across the work we support, from charge lag to denials to aged A/R, refreshed for your monthly review.
One operating model. Three pillars. Every engagement.
Expertise-led
Experienced teams aligned to the work type, reimbursement context, and systems in your scope.
- Patient access, coding, billing, denial, and A/R roles matched to the selected work
- A named engagement lead for decisions, escalation, and follow-through
- Coverage plans sized for steady work, vacancies, backlogs, or volume changes
Technology-powered
Low-burden workflow support that prioritizes work and makes exceptions visible.
- Queue prioritization based on aging, value, timely filing, and operational risk
- Rules and quality checks applied to the supported workflow
- Dashboards that show inventory, cash timing, payer response, and unresolved issues
Operationally-governed
Practical governance built for leaders who already carry multiple responsibilities.
- Agreed KPI definitions, data sources, and review cadence at kickoff
- Quality review and escalation tied to the selected scope
- Corrective action that returns repeat findings to access, coding, billing, and follow-up
Our Vision
Open Accountability: Taking responsibility without taking control.
Small hospitals get asked to trade control for help more than anyone, and can afford it less. This model works the other way: you keep every metric, your data, and the right to size the engagement up or down, on your systems or through RevAmp, while we sign our name to committed outcomes and report them straight, good month or bad.
Days in A/R
Cash-conversion speed across hospital and clinic receivables
Clean Claim Rate
Claims accepted without avoidable edits or rework
Denial Rate and Yield
Denial incidence, overturns, and recovered value by cause
Coding Accuracy
Coding quality against the agreed audit method
Time to Bill
Elapsed time from documentation completion to claim release
Why Us
Why first-pass accuracy matters most at 25 beds.
A denied claim a large system shrugs off can be a payroll question at a rural hospital. Our first-pass performance was built for that margin: get the account right the first time, because the rework comes out of days cash.
Rework-Powered Cleanup Machine
Our First-Pass Performance
Role Coverage
One vacancy leaves queues waiting or shifts work to another role.
Documented coverage keeps the supported queue moving with clear escalation.
Claim Readiness
Errors surface after billing, when correction takes more touches.
Checks focus on the inputs and handoffs that determine first-pass claim quality.
Rural Workflows
Generic procedures overlook CAH, clinic, payer, or swing-bed differences.
Work instructions reflect the reimbursement and workflow rules in scope.
Performance Visibility
Leaders assemble inventory and cash views from separate reports.
Agreed measures show the work, aging, quality, and dependencies we support.
Accountability
Issues move between a vendor, a system, and a lean internal team.
A named lead owns follow-through for the scope and escalates what needs your decision.
Extend performance across connected outcomes.
Revenue cycle thinking for leaders who need fewer surprises.
Explore Vee Healthtek perspectives on the forces reshaping revenue cycle performance, healthcare operations, technology adoption, and financial resilience.
Find the earned dollars that never reached your bank account.
Send a remittance file, your A/R aging, and one month of denials ahead of a 30-minute call with our rural hospital practice lead. We'll show where payments fall short, what is still collectible, and what support sized for your hospital looks like. No commitment expected.
Frequently Asked Questions
Have you worked under cost-based reimbursement and critical access billing rules?

Yes, and it shapes how we work. Under cost-based payment, accuracy in charges, documentation, and settlement data matters as much as speed. Our teams treat allowable-cost detail, swing-bed rules, and the 96-hour certification as core requirements, with billing compliance support behind them. Where a question belongs to the cost report itself, we flag it for your reimbursement consultant rather than guess.
Can you bill for our rural health clinic and swing beds as well as the hospital?

Yes. Coding and billing support covers the settings rural hospitals actually operate: acute and swing-bed stays, the emergency department, outpatient and ancillary services, and provider-based rural health clinic claims. One team, one quality standard, and one report across all of them, so nothing falls between entity lines.
We run TruBridge. Do your teams actually work in it?

Yes, alongside Meditech, athenaOne, Oracle Health (Cerner), Epic, and comparable systems. Our staff work inside your environment under your security controls; claims, notes, and worklists stay in your system of record. RevAmp reads from it to prioritize and report, and where definitions differ, we reconcile to yours.
How do you handle Medicare Advantage plans that pay less than traditional Medicare?

We treat the gap as a workable balance, and document it. Payments post against expected amounts, shortfalls and downgrades get appealed with the records each plan requires, and RevAmp tracks behavior by plan and reason code. You get a running picture of what each plan costs you, which is also useful the next time that contract is discussed.
How much of my team's time will implementation take?

Less than a project plan implies, because nothing gets replaced. We start with access and a data check, calibrate on one defined slice of work with whoever owns it today, and pilot before anything expands. Expect short, scheduled working sessions with one point person during startup, then the monthly review.
Can this flex if our volumes swing or a grant or levy changes our budget?

Yes. Engagements are scoped in shares of work rather than fixed seats, so coverage can widen for a backlog or narrow when your own staffing recovers. Changes are agreed in governance, documented, and priced to match, and the quality standard does not move when the scope does.
What happens if the results aren't there?

You will see it in the same report we do, because KPIs are defined at kickoff and reported from your data whether they flatter us or not. Misses get a corrective action with an owner and a date in the monthly review, and the engagement is sized so you can scale it down if we have not earned more. That is Open Accountability in practice.