RIK Healthcare Solution

Comprehensive RCM & Staffing Solutions Designed for Healthcare Excellence

At RIK Healthcare Solution, we deliver a full spectrum of healthcare support services that empower practices to operate with precision, efficiency, and confidence. From end-to-end Revenue Cycle Management (RCM) to certified healthcare staffing, we integrate advanced technology and expert teams to streamline every stage of your revenue process. Our services are built to maximize reimbursements, reduce administrative burden, and maintain full HIPAA compliance — enabling providers to focus on what matters most: patient care.

With 15+ years of combined experience, we ensure measurable outcomes — faster claim resolutions, higher First Pass Acceptance Rates, and transparent reporting that keeps your financial health strong and secure.

Our Services and specialities

1. Our End-to-End RCM Workflow: Precision and Transparency

RIK Healthcare Solution manages the entire Revenue Cycle to maximize the probability of a “clean claim” and ensure timely payment. This comprehensive, 9-step workflow minimizes revenue leakage points:

Patient Data Intake – Accurate Information from the Start
- Elaboration: This critical front-end step involves gathering and verifying all patient demographic, insurance, and guarantor information. Errors here are the #1 cause of claim denials. Our staff ensures that data is entered precisely into the EMR/PMS, validating spelling, addresses, and date formats to establish a clean financial record before service delivery.
Insurance Verification & Pre-Authorization – Securing Coverage Early
- Elaboration: Before a patient is seen, we confirm eligibility, benefits, and financial responsibility. Crucially, we proactively obtain prior authorization (pre-auth) for services that require it (e.g., specific surgical procedures, high-cost therapy). This process streamlines insurance checks and approvals, preventing delays and claim denials before they happen, saving 20–45 minutes per claim.
Medical Scribing – Capturing the Right Information
- Elaboration: While primarily a clinical support function, accurate scribing directly impacts billing. Our expert scribes ensure that the provider’s documentation fully supports the services rendered, including time, location, and medical necessity. This results in complete and error-free clinical records, which are essential for correct coding and avoiding payer audits.
Coding – Translating Care into Billable Claims
- Elaboration: This is where clinical documentation is translated into standardized codes, specifically CPT (procedures), ICD-10 (diagnoses), and HCPCS (supplies). Our certified coders ensure that all codes are accurate and compliant with the latest regulations and payer-specific rules. Accurate coding (saving 15–30 minutes per claim) is the backbone of our high First-Pass Acceptance Rate (FPAR) of 95–98%.
Requisition Creation – Preparing Claims for Submission
- Elaboration: This step involves auditing the coded encounter data and assembling the final claim package. Our automated and manual workflows ensure all necessary attachments, modifiers, and documents are reviewed and submitted correctly. This guarantees that the claim is “submission-ready” and meets all payer formatting requirements the first time.
Medical Billing & Payment Posting – Efficient and Transparent
- Elaboration: Claims are submitted electronically (EDI) to payers, and payments (Electronic Remittance Advices/ERAs or Explanation of Benefits/EOBs) are efficiently posted back to the patient ledger. We ensure accurate reconciliation of payments and identify any underpayments immediately, flagging them for subsequent action.
Accounts Receivable (AR) & Denial Management – Maximizing Revenue
- Elaboration: This is a core focus area. We track unpaid or partially paid claims in real-time. Denial management involves analyzing the root cause of the denial (e.g., coding, eligibility, medical necessity) and correcting the claim. This is an aggressive effort to track unpaid claims in real-time and intervene early, ensuring faster resolution and protecting your revenue.
Following up with Appeal Process
- Elaboration: For complex or high-value denials, we initiate a formal appeal process. Our specialists draft payer-specific appeal letters, compile supportive documentation, and persistently follow up through all necessary stages (administrative, medical review, etc.) to overturn the denial and recover the payment. Our denial resolution rate is typically 90–95% on appeals.
Patient Billing – Clear, Supportive, and Trustworthy
- Elaboration: Once the insurance portion is resolved, we handle the patient’s remaining balance. Statements are clear, easy to understand, and compliant with federal and state surprise billing laws. We provide friendly, supportive contact center services to answer patient questions, set up payment plans, and collect outstanding balances, improving patient financial satisfaction and self-pay revenue.

2. Comprehensive Staffing Services

Rapidly deploy certified billers, coders, and AR specialists who plug into your workflows, scale with demand, and maintain productivity standards without long-term hiring risk

3. Cost-Effective Flexible Business Models:

In-House Level – Our Team on Your System
1. We work directly on your EMR/RCM software
2. Functions like your in-house billing team, but at lower cost
3. You keep control, we deliver efficiency
Hourly / Project Basis – Short Term or Clean-Up Work
1. Best for backlog clean-ups or temporary projects
2. Pay only for what you use
3. Scale support without long-term contracts
Flat Rate per FTE – Dedicated Resource
1. Dedicated billers, coders, or AR specialists
2. Fixed monthly fee → predictable costs
3. Team trained exclusively for your workflows
% of Collections – Pay As You Earn
1. No upfront cost
2. We only get paid when you get paid
3. Our success is directly tied to yours

4. Admin & Back-Office and IT Support

We provide comprehensive Administrative and Back-Office Support tailored for U.S. healthcare providers, medical billing companies, and healthcare networks. Our specialized team ensures seamless coordination and accuracy across all operational workflows.
For Application and Software Development
We also provide end-to-end IT Support, Application Development, and Software Solutions customized for healthcare and other business domains
Cybersecurity & Compliance: Protecting sensitive data and ensuring HIPAA/PHI security standards.

We Serve

RCM and staffing solutions cater to a wide spectrum of healthcare providers, each with unique needs and billing complexities.

Physicians (Individual & Group Practices)
We manage every aspect of the billing cycle—from patient registration to payment posting—ensuring accurate charge capture, clean claims, and timely reimbursements. Our certified coders and AR experts help reduce denials and maintain compliance with payer guidelines.

Laboratories (Diagnostic & Pathology Labs) Lab billing requires precision due to complex CPT coding and frequent payer updates. We handle claims for high-volume tests efficiently, ensure accurate modifier use, and track payments across multiple payers to maximize revenue and minimize write-offs.
Nursing Homes & Skilled Nursing Facilities (SNFs) We specialize in managing both Medicare and Medicaid claims, handling complex documentation, and maintaining compliance with state and federal regulations. Our AR follow-up ensures timely payments and reduced bad debt.
Rehabilitation Centers (Inpatient & Outpatient) Rehab centers face frequent claim denials due to documentation or coding errors. Our RCM team ensures clean claim submissions, accurate therapy coding (PT/OT/ST), and proper authorization tracking to improve cash flow.
Elder Care & Assisted Living Facilities We provide end-to-end billing and staffing solutions tailored to elder care environments—streamlining the administrative process, managing recurring claims, and ensuring accurate reporting for both private and insurance-based care.
Psychologists & Mental Health Providers Behavioral health billing involves complex rules for session lengths, telehealth codes, and modifiers. We handle claims for individual and group sessions, manage credentialing, and ensure compliance with parity and telehealth billing regulations.
Chiropractors Our team understands chiropractic-specific codes, documentation standards, and payer limitations. We streamline claim submissions, verify coverage for chiropractic services, and manage appeals to reduce underpayments or denials.
Physical Therapists & Occupational Therapists We help therapy providers with correct CPT coding, authorization tracking, and therapy cap management. Our experts handle daily billing, claim follow-ups, and patient balance management to maintain healthy revenue flow.
Telehealth Providers We support modern healthcare models with specialized telehealth billing, ensuring accurate coding for virtual visits, remote monitoring, and digital consultations. Our RCM experts stay up-to-date with evolving telemedicine billing regulations and payer requirements.
Ambulatory Surgical Centers (ASCs) Surgical billing demands strict compliance, correct use of CPT/HCPCS codes, and coordination between surgeons, anesthetists, and facilities. Our ASC billing team ensures optimized reimbursement by managing pre-authorizations, charge entry, and EOB reconciliation.
Hospice Care Providers We manage hospice billing complexities including per diem rates, levels of care, and multiple payers. Our team ensures proper documentation, eligibility verification, and accurate claim submission for compassionate end-of-life care services.
Tailored Solutions for Every Practice Size
Whether you are a small private clinic or a multi-location healthcare network, we understand that your challenges are unique.