RCMMonks checks eligibility, benefits, and authorization requirements ahead of every visit. Your claims go out clean, your front desk collects the right amount, and your billers stop chasing denials that never needed to happen.
HIPAA-trained team · No long-term lock-in · Works inside your PM or EHR
Somewhere between 15 and 20 percent of claim denials trace back to eligibility. A policy that lapsed in March. A plan that changed at renewal. A member ID typed from last year's card. The claim was doomed the moment the patient checked in, and nobody knew.
Everything that follows is cleanup. The rework, the appeal, the phone queue, the write-off. Practices spend real money fixing problems that cost a few minutes to prevent.
We work at the other end of the pipeline. Verify properly before the visit, and most of those denials simply never exist. That is the entire business.
We are not trying to be your everything vendor. We handle the front end of the revenue cycle, the part that decides whether the rest of it goes smoothly.
We confirm active coverage directly with the payer: plan type, effective dates, group number, subscriber details. Portal, EDI 270/271, or a phone call when the portal is wrong.
Before every visitCopay, coinsurance, deductible met and remaining, out-of-pocket maximums, visit limits, exclusions. Documented by service line so the desk knows exactly what to collect.
By service lineWe flag procedures that need approval before they are scheduled, prepare the documentation, submit it, and follow up until there is an answer on record.
Flag · Submit · Follow upWhen a patient has more than one plan, we establish which one pays first, so the claim does not bounce between payers for a month while your A/R ages.
Primary vs secondaryWrong member IDs, misspelled names, and outdated plan data get corrected before verification starts, not discovered six weeks later on a denial report.
Clean data inVerified details go straight into your PM or EHR, with a daily log of what was checked, what changed since last time, and what needs your attention.
In your system, not oursThe workflow is deliberately boring. Boring is what makes it reliable at volume.
Send us your appointment list two to three days ahead, or give us read access to your scheduler and we pull it ourselves. Add-on patients go into a same-day lane.
Names, dates of birth, member IDs, and plan details get checked against what is on file. Bad data is fixed here, because a payer lookup on a wrong ID just returns a confident wrong answer.
Payer portals and EDI 270/271 transactions cover most of it. When a portal is stale or contradicts itself, we pick up the phone and get a reference number from a live representative.
Not just active or inactive. Copays and coinsurance by service, deductible progress, visit caps, exclusions, referral rules, and whether anything on the schedule needs prior authorization.
Everything is entered into your PM or EHR before the visit, in the fields your team already uses. Nobody on your staff re-keys anything from a spreadsheet.
Inactive coverage, missing authorizations, and COB conflicts come to you as a short flagged list, with enough lead time to reschedule, collect upfront, or fix the record.
Verification is not glamorous work. It is the same careful check, done correctly, hundreds of times a day. It rewards patience, routine, and attention span, and it punishes shortcuts about three weeks later, on a denial report.
Monks seemed like the right name for people who do that kind of work well. We did not chase the flashiest corner of the revenue cycle. We picked one discipline, the front end, and we practice it every single day.
We stay on hold with the payer so your staff never has to.
Every check follows the same written procedure, every time.
Every answer gets a reference number and a timestamp.
High visit volume, benefit-heavy plans, and frequent authorization rules are where front-end errors cost the most. That is where we spend our time.
No six-month implementation. No committee. You should be seeing verified schedules within a week.
We map your payer mix, agree on the checklist for each service line, set up secure access, and sign the BAA. One kickoff call, usually under an hour.
We verify alongside your current process and compare results daily. Discrepancies get discussed openly, whichever side got it wrong.
We take over the complete schedule. At day thirty you get the first accuracy report: what we checked, what we caught, and what it would have cost you.
Send us a week of appointments and we will run a sample verification batch, then walk you through what we found. No commitment attached to the sample.