Eligibility verification and pre-authorization
Eligibility verification and pre-authorization for procedures and drugs, with co-pay and co-insurance estimated before the visit.
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.
Performance-driven medical billing and RCM for independent clinics, small medical groups, specialist providers and ambulatory care facilities across the United States.
Our RCM specialists take billing off your hands so you can focus on patient care, while we maximize reimbursements, improve cash flow and reduce revenue leakage at a controlled cost.
HIPAA compliant
Works with any EHR
ICD-10 and CPT certified coders
Dedicated service manager
A read-only review of your last 90 days of claims. No switching cost.
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 win the second yes.
7–8%
First-submission denial rate
Steady for four years. Strong performers stay below 5 percent, and the difference is margin.
MGMA Stat poll, 28 July 2026, 203 responses
$25–$118
To rework one denied claim
Staff time per denial, higher when a formal appeal is required.
MGMA and HFMA benchmark data
35–65%
Of denials are never reworked
Written off, not delayed. The largest recoverable number in most practices we review.
Industry denial management benchmarks
54.3%
Of appealed denials get paid
Share of appealed private-payer denials overturned and paid. Unappealed claims are the loss.
Premier national survey, 2024
Most of it starts before the claim is coded
Sixty-eight percent of providers say inaccurate or incomplete intake data drives their denials, and 68 percent say clean claims are harder to submit than a year ago. It is a front-office problem, so our work starts at eligibility, not 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. Recovery rates come from published benchmarks. This is an estimate, not a quote.
$50k$2M
60%Benchmark: 95%+
2%Benchmark: under 5%
18Benchmark: under 35
Most practice management systems report all four. We pull them during the audit.
Recoverable in year one
$0
Modeled against benchmarks, phased over twelve months.
Annual charges$0
Collected today$0
From unworked denials$0
From collection-rate lift$0
One-off cash from faster A/R$0
How the model works. Unworked denials use the mid-point of the 35 to 65 percent never-reworked range, recovered at the 54.3 percent appeal-overturn rate Premier observed in 2024. Collection-rate lift is capped at the 95 percent benchmark and phased at 60 percent in year one. Released cash reflects days in A/R moving toward 35, shown once. No figure is a guarantee or a substitute for a review of your claims.
Where the money leaks
Eight stages. Money
Eight stages. Money
leaks at each one.
A claim is a chain, and the weakest link decides what you are paid. Select a stage to see what goes wrong and what we do.
Complete revenue cycle management
Everything between the visit
Everything between the visit
and the deposit.
Take the whole cycle or only the parts you need. Most practices start with denials and A/R, where the money already is.
Medical coding
ICD-10 and CPT coders validate codes against correct coding initiatives and payer edits. Charge capture audits ensure nothing goes unbilled.
Clean-claim rate is the measured output
Claim management
Timely submission through industry-standard clearing houses, with every claim status tracked.
Submission inside one business day
Payment posting and balance billing
Payments posted, denials and underpayments identified for recovery, and balances billed to secondary payers or patients.
Underpayments flagged, not absorbed
Denials and underpayment recovery
We take on the hard-to-collect claims others gave up on, pursue each to a conclusion and report every outcome.
Aged A/R taken on as a standalone project
Patient balance collection
Technology-assisted collection with patient advocacy, for faster payment that protects the relationship. Daily balance visibility 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 detail beyond the headline and insight you can act on.
Reported monthly, reviewed with you
Patient call center
Skilled agents handle patient calls and capture what matters, so your front desk can focus on the patient in front of them.
Calls answered in your practice's name
Dedicated client service manager
One named person who knows your account, payers and exceptions. No shared ticket queue.
Same person, month after month
How we plug in
Nothing to install. Nothing to migrate.
There is no systems project. We work inside your existing software as named users, and your clinicians see no change.
The second offering
Ask about front office cover
Virtual front office
Billing usually fails upstream. The virtual front office puts trained people on the work that decides whether a claim is payable, before the encounter.
Scheduling and reminders
Appointments booked, confirmed and rebooked after no-shows.
Eligibility at booking
Coverage and benefits checked when the appointment is made.
Prior authorization
Chased by portal and phone until a number comes back.
Patient calls
Inbound and outbound, in your practice's name, noted in your system.
Timely reports, strong feedback loop
You should not have to ask
You should not have to ask
how the month is going.
Every client sees the view we work from, updated as the numbers move. Not a quarterly PDF.
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 onboarding, blue is month nine. The work moves 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 the virtual front office addresses.
Sample data showing the reporting layout. Client figures are not published.
Expected results
Two numbers we are
Two numbers we are
measured against.
The averages CLINFI works to across its book. They are targets we are accountable for, not a guarantee. Your results depend on payer mix, 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
Versus running the same function in house
Any billing company can print a percentage. Ask us, and anyone else, for the denominator: how many practices, over what period, and what happened where it did not work. We 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 is software. All concern how the work is organized and how people are treated.
Works with any EHR
EpicathenahealtheClinicalWorksNextGen
KareoAdvancedMDDrChronoPractice Fusion
CernerYours
Named systems are examples, 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, so strengths complement rather than compete. A generalist team cannot match that throughput.
02
Frequent quality audits
Audits keep the workflow honest. We do not punish mistakes, because teams that hide errors make more of them. We catch errors before they reach a payer, and the team learns from them.
03
Dedicated client service manager
Every account has one named person who knows it fully and is responsible for your satisfaction. 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. Industry attrition drives up client error rates, so our culture is a performance input.
Transition
Live in 30 days,
Live in 30 days,
without a gap in cash flow.
We run the old and new processes in parallel so deposits never stop, and we take on your legacy A/R.
01
Audit and baseline
Days 1 to 5
Read-only review of 90 days of claims and remits. We set your baseline first, so improvement is proven, not claimed.
02
Access and mapping
Days 5 to 12
BAA signed, least-privilege access granted, payer enrollments and clearing house routing confirmed, fee schedules loaded.
03
Parallel run
Days 12 to 24
New claims go through us while your existing process keeps running. We reconcile daily and report every difference to you.
04
Full handover
Days 24 to 30
We take the whole cycle plus your aged A/R, and monthly reviews with your service manager begin.
Compliance and security
Your data is the most
Your data is the most
regulated thing we touch.
Compliance with HIPAA and state and federal regulation is part of the service, not a disclaimer. Here is what that means, and where the boundaries are.
BAA signed before access
Least-privilege access
Audit logging
PHI handling
PHI is encrypted in transit and at rest, accessed only through named role-based accounts, and never moved to personal devices or unmanaged storage.
Access and audit
Every account we hold in your system is least-privilege and individually named, so your audit log shows who did what. Access is revoked the day a person leaves the account.
Training and documentation
Annual HIPAA training for everyone on your account, documented policies on minimum necessary use, breach notification and retention, and a named privacy contact.
What we do not claim
HIPAA has no certification body, so no HIPAA certificate exists. Ask for our BAA, policy set and current independent assessment status, and we will send all three.
How are you paid?
A percentage of net collections, so we are paid when you are paid. The rate depends on volume, specialty and scope. Aged A/R recovery is usually priced separately, as the work per dollar is higher.
We quote only after seeing your claims, because a blind quote is either padded or later renegotiated.
Do we have to change our EHR or practice management system?
No. If your system exports claims and imports remittances, we work inside it. We add user accounts, not software.
What happens to our existing accounts receivable?
We take it on. On day one, most recoverable money sits in unworked claims 60 to 180 days old. Legacy A/R runs as its own project with separate reporting, so old-book recoveries are not blended into current performance.
Will our staff lose their jobs?
That is your decision. Some practices move billing staff to patient-facing and front-office work, which usually pays for itself. Others reduce headcount. We will tell you which roles our scope overlaps so you can plan ahead.
How quickly do we see a difference?
Submission timeliness and denial work improve in the first month. Days in A/R needs a full payer cycle, so expect a visible shift at 60 to 90 days. Net collection rate moves slowest and is the one to judge us on at six months.
Who do we talk to when something goes wrong?
Your client service manager, by name and by phone, not a ticket queue. If they cannot resolve it, they escalate and stay on it. Clients tell us this matters most.
Do you handle patient calls and balances?
Yes, both. Practices collect around 72 percent of copayments at the time of service but only about 27 percent of other patient-due balances, so we move estimates and collection to the front of the encounter.
MGMA Stat, 28 July 2026
Are you HIPAA compliant?
We operate to HIPAA and sign a Business Associate Agreement before any access. No regulator issues HIPAA certificates, so we do not claim one. We provide the BAA, our written policies, training records and 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. The findings are yours whether or not you work with us.
Request received
We appreciate your interest in CLINFI. A member of our team will reach out at the earliest opportunity.
CLF-000000
What happens next
- We send a BAA
Signed before any patient data is shared. Same day, usually within the hour.
- You export 90 days
Claims and remittance files from your system. We send exact steps for your software, or do it with you on a screen share.
- We read it
Five to seven business days, covering denial reasons, underpayments against your fee schedule, A/R ageing and claims nearing timely filing.
- You get the findings
A written summary of the recoverable amount and our method, with a walkthrough call. Yours to keep either way.
Prefer email?
General inquiries
info@clinfi.com
Careers hrsupport@clinfi.com
No dollar
left behind.
Send us the claims others stopped working. We will tell you plainly what is recoverable and what is gone.