How CareMedox works

Transparency matters most when the numbers need explaining.

CareMedox combines revenue-cycle operations with explicit accountability, detailed reporting, aging control and technology flexibility so providers can understand the work rather than simply receive a monthly total.

Core operating values

Six principles that define the CareMedox approach.

The emphasis changes by service, but these principles guide how CareMedox handles responsibility, reporting and provider coordination.

TFL accountability

If CareMedox negligence causes an eligible claim to become unrecoverable because the timely filing limit was missed, we accept responsibility under the service agreement and applicable Medicare fee schedule.

Reporting with context

Weekly and monthly payment reporting can include claim-level, CPT-level and full RCM views—plus explanations of material collection changes.

60–120+ aging focus

We actively work aging instead of allowing older receivables to become a permanent part of the practice balance.

Transparent corrections

When a previously counted payment is corrected, reversed or removed, we carry the correction transparently into the next reporting cycle rather than hiding it.

PM / EHR friendly

We work within the practice technology environment whenever feasible and do not require an unnecessary software or clearinghouse change just to work with CareMedox.

Provider visibility

Our reporting model—and planned client portal—are designed to keep providers and authorized practice teams informed and coordinated with CareMedox.

01 · Timely filing accountability

When our negligence creates the TFL loss, we accept responsibility.

If an eligible claim becomes unrecoverable because CareMedox team negligence caused the applicable timely filing limit to be missed, CareMedox accepts responsibility under the governing service agreement and applicable Medicare fee schedule.

The commitment applies to a documented CareMedox-caused failure. Delayed or incomplete practice information, payer processing, missing documentation, authorization requirements, system outages and other circumstances outside CareMedox control are handled according to the service agreement and the actual claim history.

Why this matters

Timely filing is deadline-driven. Clear ownership, escalation and action history should exist before the deadline—not be reconstructed after the claim becomes unrecoverable.

02 · Performance context

Metrics are useful only when the dependencies are visible.

CareMedox publishes real operating ranges and a workflow benchmark rather than presenting the numbers as universal guarantees.

92–96%First-Pass Claim AcceptanceObserved CareMedox operating range; results vary by documentation, payer rules, coding, eligibility and claim readiness.
4–8%Denial RatioCareMedox operating range; actual denial performance varies by specialty, payer mix and upstream practice workflow.
90%Billing RatioCareMedox workflow benchmark for billing received versus billing moved through submission; dependent on complete, timely and claim-ready information from the practice.
Measured, not marketedOperational ranges, not blanket guarantees.Practice results depend on payer mix, specialty, documentation, coding and the timeliness/completeness of information supplied.
03 · Reporting

Know which claim, CPT, check or correction changed the picture.

Depending on service scope, CareMedox reporting can include weekly and monthly payment views, claim-level detail, CPT-level analysis, aging, denial trends and broader RCM indicators.

The objective is to explain material movement. If collections change, the practice should be able to see which payments, corrections or claim events contributed to that change.

Correction rule

We do not hide the reduction.

If a duplicate or incorrect payment was counted in an earlier period and must later be reversed or corrected, the reducing adjustment is carried transparently into the next reporting cycle with the reason documented.

04 · Aging control

60–120+ day receivables receive deliberate attention.

CareMedox places strong operational focus on 60-, 90-, 120- and 120+ day AR. Work is prioritized using age, balance, payer status, remaining deadlines and collectability rather than allowing old claims to sit in an undifferentiated queue.

Recovery and prevention belong together

Old claims need action, but cleanup is incomplete if the same eligibility, authorization, claim, denial or posting problem keeps creating new aged balances.

05 · Provider visibility

Reporting should be accessible when the practice needs it.

CareMedox is developing a client portal intended to give authorized providers and practice teams access to practice analysis, reporting and coordinated work with the CareMedox team.

View the Client Portal direction
Client Portal

Analysis + reporting + coordination.

The goal is a shared operating picture that helps both teams understand status, priorities and next actions.

06 · Technology flexibility

Changing your billing partner should not automatically mean changing your systems.

CareMedox is PM and EHR friendly. The team works within the practice’s existing billing software and clearinghouse environment when the payer, security, technical and workflow requirements allow it.

If a system change is genuinely required, the reason should be operational or technical—not simply a condition imposed for convenience.

See how it applies

Bring us the part of the revenue cycle you want more visibility into.

CareMedox can discuss the current workflow and show which operating principles matter most for that service.

Talk with CareMedox