Who we fit
Back-office support for medical billing and RCM companies
Published · Last updated
Direct answer
Actigy BPO gives medical billing and revenue cycle management (RCM) companies managed capacity for charge entry, claims, denial work, AR follow-up and coding QA inside approved systems. The billing company retains client contracts, SOPs, coding policy, clinical attestation and final compliance decisions. A paid pilot starts with one defined queue.
Describe your workflow, volume and required coverage. You decide on a pilot after reviewing the written scope.
Scoped access · You own the SOPs · Pilot before you scale
What you’re accountable for
What medical billing and RCM companies deal with
Actigy BPO works with billing and RCM companies that grow through new provider clients. Each new client adds charge entry, claims, denials and AR work to the same team. Growth brings the same pressures to most of them:
- You win new provider clients faster than you can hire and certify coders
- Coding-related denials and aged AR are eating margin
- Seasonal and client-driven volume swings make staffing unpredictable
- You need measurable coding accuracy you can show clients and auditors
- You want to keep clinical attestation and compliance in-house
For in-house staffing context, use the 2026 biller and coder salary report. Match the occupation and source period; pay is not the full cost of a managed service.
Service fit
Which services support billing and RCM companies?
Actigy BPO runs three workstreams for billing and RCM companies, each with maker-checker QA. Scope coding support in ICD-10-CM, CPT and HCPCS against your payer rules, and verify any required operator credentials before assignment. Each card links to the full service page.
Actigy BPO separates denial management from payment posting, with written rules for each handoff. The old AR recovery scope covers assigned unpaid healthcare claims, not general trade receivables.
Which billing companies are a strong fit?
When the model is a strong fit
- You need coding and billing capacity with verified role requirements and an agreed staffing plan
- You need lower coding-related denials and faster cash
- You want QA-scored accuracy and audit-ready documentation
- You want to keep clinical attestation and final compliance sign-off
When the model may not fit
- You want a software-only RCM platform rather than an operations team
- You expect the provider to attest to clinical care or own compliance accountability
What stays with the billing company?
The delivery team runs the queue work, and your company keeps control of the client relationship. Client contracts, SOPs and billing systems stay yours. Clinical attestation, coding policy, write-offs, refunds and final compliance sign-off stay with your team. The team documents every action in your systems, so you can show clients and auditors how each claim moved.
Monthly reports show QA-scored accuracy, denial causes, AR aging and turnaround for each client queue. Review coding-related denial causes and measure whether agreed changes reduce repeat rejections. A new provider client's queue needs agreed scope, staffing, access and readiness checks before it is added. Specify the client and payer time zones, working hours and handovers; extended coverage depends on the agreed staffing plan.
FAQ
Questions from medical billing and RCM companies
When does managed support fit a billing company?
Actigy BPO can scope claim submission, denial follow-up, AR work and coding support for a billing or RCM company. Verify the credentials required for each assigned role and agree maker-checker QA against your payer rules. Your team keeps clinical attestation and final compliance sign-off. Select one queue, such as AR follow-up or denial work, for the pilot before considering more work types.
How should patient-data access be controlled?
Agree the permitted practice-management and clearinghouse access, logging, retention and segregation of duties before work starts. Confirm the protected health information (PHI) safeguards and any required business associate agreement (BAA) before access. The security page describes the approach; your review should confirm the proposed team's locations, permissions, controls and contractual duties. Geography or an alignment statement does not establish compliance, certification or an independent audit.
How can capacity change as new clients join?
Additional client queues or seasonal capacity require an agreed forecast, staffing availability and notice. Check operator credentials where required, specialty and payer training, and client approval before live chart access. The proposal should state readiness checks and capacity limits; it should not assume a fixed hiring or launch time.
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Scope support for your billing team
Tell us the process you want to outsource. Actigy BPO will assess scope, complexity, staffing, and delivery cost, then propose a pilot.
Describe your workflow, volume and required coverage. You decide on a pilot after reviewing the written scope.