Eligibility verification and pre-authorization
Complete eligibility verification and pre-authorization for procedures and drugs, with co-pay and co-insurance estimation before the patient is seen.
Checked before the visit, not after the denial
Revenue cycle management for independent practices
Close the gap between what you bill and what you get paid.
CLINFI is a performance-driven medical billing and revenue cycle management (RCM) partner serving independent clinics, small medical groups, specialist providers, and ambulatory care facilities across the United States.
Our experienced RCM specialists take the complexity and administrative burden of medical billing off your hands, allowing you to focus on patient care while we work to maximize reimbursements, improve cash flow, reduce revenue leakage, and strengthen your bottom line — all while keeping costs under control.
HIPAA compliant
Works with any EHR
ICD-10 and CPT certified coders
Dedicated service manager
No switching cost to find out. The audit is a read-only review of your last 90 days of claims.
Built for
Primary care
Specialty clinics
Behavioral health
Physical therapy
Urgent care
DME
The problem, in numbers
Denials are no longer accidents.
Denials are no longer accidents.
They are a business model.
Payers have industrialized the first no. Most practices are not staffed to industrialize the second yes. Here is what the published benchmarks actually say.
7–8%
First-submission denial rate
Held steady across the past four years. Strong performers push it below 5 percent, and that difference is pure margin.
MGMA Stat poll, 28 July 2026, 203 responses
$25–$118
To rework one denied claim
Staff time per denial, rising toward the top of the range when a formal appeal with documentation is required.
MGMA and HFMA benchmark data
35–65%
Of denials are never reworked
Not delayed revenue. Written off. This is the single largest recoverable number in most practices we review.
Industry denial management benchmarks
54.3%
Of appealed denials get paid
Private-payer denials that were actually appealed were overturned and paid. The claims that go unappealed are the loss.
Premier national survey, 2024
Most of it starts before the claim is ever coded
Sixty-eight percent of providers say inaccurate or incomplete patient data captured at intake is what drives their denials, and 68 percent say submitting a clean claim is harder than it was a year ago. That is a front-office problem wearing a billing-office costume, which is why our work starts at eligibility rather than at submission.
Experian Health, The State of Claims 2025
Revenue leakage calculator
What is the gap worth,
What is the gap worth,
in your practice?
Move the four sliders. The model uses published benchmarks for recovery rates, not promises. It is a conversation starter, not a quote.
$50k$2M
60%Benchmark: 95%+
2%Benchmark: under 5%
18Benchmark: under 35
Not sure of your numbers? Most practice management systems report all four. We pull them for you during the audit.
Recoverable in year one
$0
Modeled against benchmark performance, phased over twelve months.
Annual charges$0
Collected today$0
Recovered from unworked denials$0
Recovered from collection-rate lift$0
Cash released from faster A/R, once$0
How the model works. Unworked denials are valued at the mid-point of the 35 to 65 percent never-reworked range, recovered at the 54.3 percent appeal-overturn rate observed by Premier in 2024. The collection-rate lift is capped at the 95 percent benchmark and phased at 60 percent in year one. Released cash is the working-capital effect of moving days in A/R toward 35, shown once rather than annually. No figure here is a guarantee, and none of it replaces a review of your own claims.
Where the money leaks
Eight stages. Money leaves
Eight stages. Money leaves
at every one of them.
A claim is not one event. It is a chain, and the weakest link decides what you are paid. Select a stage to see what goes wrong there and what we do about it.
Complete revenue cycle management
Everything between the visit
Everything between the visit
and the deposit.
Take the whole cycle or take the parts you are weakest at. Both work. Most practices start with denials and A/R because that is where the money already is.
Medical coding
Coders fluent in ICD-10 and CPT validate procedure codes and scrub against correct coding initiatives and payer-specific edits. Charge capture audits confirm nothing performed went unbilled.
Clean-claim rate is the measured output
Claim management
Timely submission through industry-standard clearing houses, with claim status tracked rather than assumed. Nothing sits in a queue waiting to be noticed.
Submission inside one business day
Payment posting and balance billing
Payments posted to patient accounts, claims identified for denial and underpayment recovery, and remaining balances billed to secondary payers or to the patient.
Underpayments flagged, not absorbed
Denials and underpayment recovery
We welcome the hard-to-collect and outstanding claims other people gave up on. Every claim is pursued to a logical conclusion, with a report on what happened to each one.
Aged A/R taken on as a standalone project
Patient balance collection
Technology-assisted collection paired with patient advocacy, so lead times shorten without the relationship souring. Daily visibility on balances and standard bad-debt reporting.
Patient-due is now a third of the money
RCM analytics
Claims, collections, receivables and denials in one view, with reports designed to track the finer detail rather than only the headline. Insight you can turn into an action this week.
Reported monthly, reviewed with you
Patient call center
Skilled agents take patient calls and collect the information that actually matters, so your front desk is not choosing between the phone and the person standing in front of them.
Calls answered in your practice's name
Dedicated client service manager
One named person who knows your account, your payers and your exceptions. You are their priority, not a ticket in a shared queue.
Same person, month after month
How we plug in
Nothing to install. Nothing to migrate.
The most common reason a practice delays changing biller is the fear of a systems project. There is not one. We work inside the software you already run, as named users, and your clinicians never see a change.
The second offering
Talk to us about front office cover
Virtual front office
Billing fails upstream more often than it fails downstream. The virtual front office puts trained people on the work that decides whether a claim is payable before the encounter even happens.
Scheduling and reminders
Appointments booked, confirmed and recovered when patients do not show.
Eligibility at booking
Coverage and benefits checked at the point the appointment is made.
Prior authorization
Chased through the payer portal and on the phone until a number comes back.
Patient calls
Inbound and outbound handled in your practice's name, with notes into your system.
Timely reports and a strong feedback loop
You should not have to ask
You should not have to ask
how the month is going.
Every client gets the same view we work from. Not a PDF at quarter end. The numbers that decide whether you are being paid, updated as they move.
Net collection rate
94.6%
from 83.1% at onboarding
Days in A/R
31
from 46 at onboarding
First-pass denial rate
4.2%
from 9.4% at onboarding
Claims over 90 days
6.8%
from 19.2% at onboarding
A/R ageing, before and after
Red is the position at onboarding. Blue is month nine. The work is moving money out of the right-hand buckets.
Top denial reasons this month
Missing or invalid prior authorization31%
Coverage terminated or not eligible24%
Coding specificity and modifiers18%
Duplicate or already adjudicated11%
Timely filing exceeded9%
Other7%
Each reason has an owner and a fix. The top two are front office problems, which is why the virtual front office exists.
Sample data shown to demonstrate the reporting layout. Client figures are not published.
Expected changes once we start together
Two numbers we are
Two numbers we are
measured against.
These are the averages CLINFI works to across its book. They are targets we accept accountability for, not a guarantee about your practice. What your numbers can do depends on your payer mix, your specialty and how much is already past timely filing.
Reviewed with you every month
No dollar left behind policy
35%
Average increase in revenue
Up to, across practices that hand over the full cycle
50%
Average cost reduction
Against the cost of running the same function in house
A note on how to read these. Any billing company can print a percentage. Ask us, and ask anyone else you are speaking to, for the denominator: how many practices, over what period, and what happened to the ones where it did not work. We will answer that in the first call.
The CLINFI way
Performance-driven is
Performance-driven is
an operating model,
not an adjective.
Four things decide whether a billing partner performs. None of them is software. All of them are how the work is organized and how people are treated while they do it.
Works with any EHR
EpicathenahealtheClinicalWorksNextGen
KareoAdvancedMDDrChronoPractice Fusion
CernerYours
Named systems are examples of the categories we work in, not partnerships or endorsements. If your system exports claims and remits, we can work in it.
01
Optimized workflow
We divide the work and put the right talent on each piece. Individual strengths complement each other rather than compete, which is what produces a throughput a generalist team cannot match.
02
Frequent quality audits
Audits keep the workflow honest. Our quality management does not punish people who make a mistake, because teams that hide errors produce more of them. We find errors before they reach a payer, and people learn from what we find.
03
Dedicated client service manager
Every ship needs a captain, and every account needs someone who knows everything about it. You get one named person whose job is to make sure you are satisfied. That is the difference between a partner and a vendor with a support inbox.
04
Strong work culture
People treated with respect and credited for their work do better work. It sounds soft until you look at attrition in this industry and what it does to a client's error rate. Our culture is a performance input.
Transition
Live in 30 days,
Live in 30 days,
without a gap in cash flow.
The fear with changing biller is a month of no deposits. We run the old and the new in parallel so that never happens, and we take your legacy A/R with us rather than leaving it to die.
01
Audit and baseline
Days 1 to 5
Read-only review of 90 days of claims and remits. We fix your baseline numbers before we touch anything, so improvement can be proved rather than claimed.
02
Access and mapping
Days 5 to 12
BAA signed, least-privilege access granted in your system, payer enrollments and clearing house routing confirmed, fee schedules loaded.
03
Parallel run
Days 12 to 24
New claims go out through us while your existing process keeps running. We reconcile daily and report the differences to you, not around you.
04
Full handover
Days 24 to 30
We take the whole cycle plus your aged A/R, and the monthly review cadence with your service manager begins.
Compliance and security
Your data is the most
Your data is the most
regulated thing we touch.
Keeping your practice compliant with HIPAA and with state and federal regulation is part of the service, not a disclaimer at the bottom of it. Here is what that means in practice, and where the honest boundaries are.
BAA signed before access
Least-privilege access
Audit logging
PHI handling
Protected health information is encrypted in transit and at rest, accessed only through named accounts tied to a role, and never moved onto personal devices or unmanaged storage.
Access and audit
Every account we hold in your system is least-privilege and individually named, so your own audit log shows exactly who did what. Access is revoked the day a person leaves the account.
Training and documentation
Annual HIPAA training for everyone who touches an account, documented policies on minimum necessary use, breach notification and retention, and a named privacy contact you can call.
What we do not claim
HIPAA has no certification body, so no one can hand you a HIPAA certificate. Ask us for our BAA, our policy set and our current independent assessment status, and we will send all three. Treat anyone who offers a certificate with caution.
Questions
The things practices
The things practices
actually ask us.
If the answer you need is not here, write to info@clinfi.com and you will get a real one.
How are you paid?
A percentage of net collections, so we are paid when you are paid. The percentage depends on volume, specialty and how much of the cycle you hand over. Aged A/R recovery is usually priced separately because the work per dollar is higher.
We will not quote a rate before seeing your claims, because a rate quoted blind is either padded or about to be renegotiated.
Do we have to change our EHR or practice management system?
No. We work inside whatever you already use. If your system exports claims and imports remittances, we can work in it. The transition adds user accounts, it does not add software.
What happens to our existing accounts receivable?
We take it. Most of the recoverable money in a practice on day one is sitting in claims between 60 and 180 days old that nobody has had time to work. We treat legacy A/R as its own project with its own reporting, so you can see exactly what was recovered from the old book rather than having it blended into current performance.
Will our staff lose their jobs?
That is your decision, not ours, and it is worth being straight about. Some practices move billing staff onto patient-facing and front-office work, which usually pays for itself. Others reduce headcount. We will tell you honestly which roles our scope overlaps with so you can plan rather than discover it.
How quickly do we see a difference?
Submission timeliness and denial working change in the first month because they are process changes. Days in A/R takes one full payer cycle to move, so expect a visible shift at 60 to 90 days. Net collection rate is the slowest of the three and is the one worth judging us on at six months.
Who do we talk to when something goes wrong?
Your client service manager, by name, by phone. Not a ticket queue and not a different person each time. If they cannot resolve it, they escalate it and stay on it. This is the single thing clients tell us matters most and the single thing the industry is worst at.
Do you handle patient calls and balances?
Yes, both. Patient responsibility is now a large share of practice revenue and it behaves nothing like payer revenue. Practices collect around 72 percent of copayments at the time of service but only about 27 percent of other patient-due balances, which is why we push estimates and collection to the front of the encounter rather than the back.
MGMA Stat, 28 July 2026
Are you HIPAA compliant?
We operate to HIPAA and sign a Business Associate Agreement before we are granted any access. There is no such thing as a HIPAA certificate issued by a regulator, so we do not claim one. What we will give you is the BAA, our written policy set, our training records and our current independent assessment status.
Free A/R audit
Send us 90 days of claims.
Send us 90 days of claims.
We will show you the gap.
A read-only review with no obligation and nothing to install. You get the findings whether or not you work with us, because a practice that knows its own numbers is a better client for everyone.
Request received
A client service manager will reply within one business day with the BAA and a short list of what we need.
CLF-000000
What happens next
- We send a BAA
Signed before anything containing patient data changes hands. Same day, usually within the hour.
- You export 90 days
Claims and remittance files from your existing system. We send the exact steps for your software, and we can do it on a screen share if that is easier.
- We read it
Five to seven business days. We look at denial reasons, underpayments against your fee schedule, A/R ageing and anything approaching timely filing.
- You get the findings
A written summary with the recoverable number and how we arrived at it, plus a call to walk through it. Yours to keep either way.
Prefer to just email?
General inquiries
info@clinfi.com
Careers hrsupport@clinfi.com
No dollar left behind.
We mean that literally.
Send us the claims everyone else stopped working. We will tell you what is still recoverable and what is genuinely gone, and we will be straight with you about which is which.