Question 1

What is Revenue Cycle Management (RCM) and why is it important?

Accepted Answer

Revenue Cycle Management (RCM) is the financial process that healthcare facilities use to track patient care episodes from registration and appointment scheduling to the final payment of a balance. It is critical because it ensures that practices are compensated fully and promptly for their services, minimizing administrative burdens and maximizing cash flow.

Question 2

How does WE-PRO RCM Solutions differ from other billing companies?

Accepted Answer

WE-PRO RCM Solutions stands out by offering a 100% US-based team, advanced predictive AI for denial prevention, and a zero-tolerance policy for unpaid claims. We operate as an extension of your practice rather than a third-party vendor, providing specialized expertise in complex fields like Cardiology and Mental Health.

Question 3

Do you offer full practice management or just medical billing?

Accepted Answer

We offer end-to-end full practice management. This includes credentialing, eligibility verification, prior authorizations, coding, claim submission, payment posting, and aggressive AR follow-up.

Question 4

How fast can you transition our billing to your system?

Accepted Answer

Our onboarding process is highly streamlined. Depending on the size of your practice and your current EHR system, a full transition typically takes between 2 to 4 weeks, with zero disruption to your daily cash flow.

Question 5

What EHR/EMR systems do you work with?

Accepted Answer

We are software-agnostic. Our experts are proficient in all major EHR/EMR platforms including Epic, Cerner, eClinicalWorks, AdvancedMD, AthenaHealth, NextGen, SimplePractice, and many more.

Question 6

Why is Mental Health billing considered so complex?

Accepted Answer

Mental Health billing involves strict pre-authorization requirements, variable session-time billing codes, and complex payer-specific guidelines regarding telehealth vs. in-person care. Our specialized team understands these nuances to prevent common denials.

Question 7

Do you handle Cardiology billing and its specific coding requirements?

Accepted Answer

Yes. Cardiology is one of our core specialties. We handle complex procedural coding (like catheterizations and echocardiograms), ensuring all modifiers are applied correctly to maximize reimbursement under CMS guidelines.

Question 8

Can you manage Wound Care billing under the new 2025 LCD guidelines?

Accepted Answer

Absolutely. Our certified coders stay ahead of all CMS updates. We ensure strict compliance with Local Coverage Determinations (LCDs) and National Coverage Determinations (NCDs) for advanced wound care and hyperbaric oxygen therapy.

Question 9

Do you provide credentialing services for new providers?

Accepted Answer

Yes, we offer comprehensive credentialing and contracting services. We manage the entire enrollment process with Medicare, Medicaid, and commercial payers, ensuring your providers are fully in-network and eligible for maximum reimbursement.

Question 10

How do you handle telehealth and virtual care billing?

Accepted Answer

We stay up-to-date with the constantly changing telehealth regulations, applying the correct POS (Place of Service) codes and modifiers (like 95 or GT) to ensure telehealth visits are reimbursed at the highest possible rate.

Question 11

What is your approach to denial management?

Accepted Answer

We use a proactive, AI-driven approach to catch errors before claims are submitted. For existing denials, our dedicated AR team investigates the root cause, submits multi-tiered appeals, and follows up aggressively until the claim is paid.

Question 12

How do you handle old Accounts Receivable (AR)?

Accepted Answer

We deploy a specialized AR recovery team that systematically analyzes aging reports (30, 60, 90, 120+ days). We identify unworked claims, appeal wrongful denials, and recover 'lost' revenue that other billing companies write off.

Question 13

What is your typical First-Pass Clean Claim rate?

Accepted Answer

Our rigorous claim scrubbing and automated auditing processes result in a first-pass clean claim rate of over 98%, significantly reducing the time it takes for your practice to get paid.

Question 14

Do you charge fees on denied claims?

Accepted Answer

No. We only get paid when you get paid. Our fee is a percentage of the collected revenue, meaning our success is 100% aligned with your financial success.

Question 15

How often do you follow up on unpaid claims?

Accepted Answer

Our system flags unpaid claims the moment they exceed the standard payer processing window (usually 14-21 days). Our team follows up continuously until a resolution is reached.

Question 16

How much do your medical billing services cost?

Accepted Answer

Our pricing is highly competitive and is typically based on a small percentage of net collections. We do not charge hidden fees, setup fees, or minimum monthly minimums for standard accounts. Contact us for a customized practice assessment.

Question 17

Are there any long-term contracts required?

Accepted Answer

We believe in earning your business every single month through exceptional performance. We offer flexible, month-to-month agreements without locking you into rigid, long-term contracts.

Question 18

Is your team based in the US or outsourced?

Accepted Answer

WE-PRO RCM Solutions operates with a 100% US-based team of certified coders, billing specialists, and account managers. We never offshore your practice's sensitive financial operations.

Question 19

Will I have a dedicated account manager?

Accepted Answer

Yes. Every client is assigned a dedicated, US-based Account Manager who serves as your single point of contact. They hold regular financial review meetings with your team to discuss performance.

Question 20

Do I lose control of my billing if I outsource to WE-PRO?

Accepted Answer

Not at all. You maintain 100% transparency. You will have 24/7 access to our proprietary analytics dashboard where you can see real-time data on collections, claim statuses, and AI insights.

Question 21

Are your services HIPAA compliant?

Accepted Answer

Yes, our entire infrastructure, from our software to our office protocols, is strictly HIPAA compliant. We utilize enterprise-grade encryption and conduct regular security audits to protect PHI.

Question 22

How do you protect patient data?

Accepted Answer

We use end-to-end AES-256 encryption for all data in transit and at rest. Access to patient data is strictly controlled through role-based access protocols (RBAC) and multi-factor authentication (MFA).

Question 23

Do you provide compliance auditing for our practice?

Accepted Answer

Yes, we offer preventative compliance audits to ensure your practice adheres to CMS coding guidelines, minimizing your risk of audits or recoupments from insurance payers.

Question 24

What happens if there is a payer audit?

Accepted Answer

In the event of a payer audit (like a RAC audit), our team acts as your primary defense. We gather all necessary documentation, construct the appeal letters, and represent your practice throughout the audit process.

Question 25

How do you stay updated on changing healthcare regulations?

Accepted Answer

Our certified compliance officers and billing experts participate in continuous education and monitor daily updates from CMS, the AMA, and commercial payers to ensure our clients are always ahead of regulatory changes.

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