UCG SOLUTIONS
Billing operations that connect the encounter to the payment.
UCG supports billing workflows across hospital, physician, clinic, ASC, DME, laboratory, RPM/RTM and specialty-practice contexts, as applicable to the engagement.
Scope of support
- Charge entry and charge capture
- Claim creation and validation
- Claim scrubbing and submission
- Clearinghouse rejection management
- ERA/EOB payment posting
- Payment reconciliation
- Patient balance workflows where in scope
- Billing performance reporting
Common risks and triggers
- Missing or late charges
- Demographic and coverage errors
- Claim edits and rejections
- Documentation-to-claim mismatch
- Payment posting variances
- Inconsistent follow-up ownership
HOW THE WORK MOVES
Follow this capability through its operating steps.
Select each stage to inspect the task, the issue to watch, an example action and the accountable reviewer.
WORKFLOW EXPLORER
Encounter to adjudicated claim
Follow how documentation and charges become a submitted, posted and reconciled claim.
SELECTED STAGE
Charge entry
Documented services and charge details enter the billing workflow.
Illustrative operating sequence. Final responsibilities, payer rules and automation scope are confirmed for each engagement.
Organizations served
- Physician Groups
- Independent Practices & Clinics
- Hospitals & Health Systems
- Ambulatory Surgery Centers
INTELLIA relevance
UCG INTELLIA™ supports operational visibility, prioritization and workflow automation across revenue-cycle work, with review roles defined for each process.
- Denial Intelligence: Detect patterns, surface likely root causes, prioritize work and connect recovery findings back to prevention.
- A/R Intelligence: Segment accounts by age, value, payer, denial status and recovery potential.
- Coding Intelligence: Support documentation and coding review, QA prioritization and coding-risk visibility with human review.
- Eligibility Intelligence: Surface coverage and eligibility issues early in the revenue cycle.
- Revenue Analytics: Connect operational and financial KPIs into role-relevant views.
Related services
Discuss your workflow with UCG.
Share the revenue-cycle issue, operational priority or payer challenge you are working through.
Discuss Medical Billing