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Why Use Optimal RCMS?

The answer is simple. We are different.

We may not be the biggest billing

company in the industry, but we stand above the rest.

We understand that entrusting a billing company to handle your revenue management can be scary. We get it, and we are dedicated to maintaining the highest levels of quality, professionalism, and customer satisfaction to make sure our clients are not just happy with our service, but they enjoy working with us. We want every experience in this sometimes-stressful world of billing and revenue management to be a positive one. We want to take the burden and stress off you. We are, after all, an extension of your office. We are not an automated robot or tough to reach. We are here for you, working for you, dedicated to you.

“We have spent a lifetime working with or for other billing companies until we took the time to step back, take note of everything that was wrong, and create a company that was right.”

We thoughtfully built Optimal to be

everything the other companies are not.

Everyone can say they are efficient, timely, heavy on customer service – most are not. We can guarantee you this… you will not find a more positive team to work with than Optimal. At Optimal you will find people that have been in your shoes and want to do everything possible to get you paid. We have years of practical experience as well as claims processing and we understand the issues of “medical necessity” and clinical documentation from the inside out.

Most of all…we are affordable. Rates are based on a % of what we collect. If we don’t collect, we don’t get paid. We work with our clients to achieve their financial goals. And we work hard. If you don’t get paid, we don’t get paid.

It’s during tight financial times when you truly need a dedicated partner and Optimal will work the hardest for you. Our services pay for themselves in the form of first pass claims payments, and a low percentage of resubmissions and appeals which contributes quickly and positively to your cash flow. We find ways to get you money, faster payments, more money, and we can even assist you with negotiating rates with the Payors.

We are different. We care.

Value of adding Optimal RCMS to your healthcare team?

99% Average collection rate = More reliable outcome and more revenue

(Clearing House and Payor)
Claims rejects are reviewed and modified promptly, ensuring accurate submissions.

“Out of Network” insurance billing specialist = Better outcomes / pay rates

We know how to work with Payors on the ‘out of network’ provider billing and get claims paid.

Electronic claims filing = Faster processing

Claims are submitted within 72 hours of receipt to get payments to you as quickly as possible.

Follow-up on all delinquent claims = Revenue that would have previously been delayed or written off

We employ a professional claims appeal process.

Reduction of expenses associated to your billing process = Increased revenue

Salaries, Vacation, Sick Pay, Medical & Dental Benefits, Workers Comp, Payroll Taxes.

Reduction in time allocated to time intensive tedious tasks = More opportunity to utilize staff on higher level tasks and patient care

Minimize the time your staff spends on the phone with insurance companies, resubmitting claims, or chasing receivables.

Provider enrollment = Faster onboarding with Payors = Faster revenue generation

We work with all Government and Commercial payors.  As well as the CAQH, PECOS, & NPPES