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End-to-End RCM
One team owns the complete revenue cycle—from the first patient touchpoint to final payment, reporting, and improvement.
15RCM services
30+Specialties supported
75+Systems expertise
600+RCM professionals
THE CASE FOR END-TO-END
Claims rarely fail inside a step. They fail between them.
A missed eligibility detail becomes an authorization issue. A documentation gap becomes a coding error. A weak denial workflow repeats the same preventable mistake.
Connecting the entire cycle gives every team the context and feedback to stop revenue leakage earlier.
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WHY OUTSOURCE THE FULL CYCLE
Outsource to reduce errors, not to move them.
Sunshine RCM creates one operating system across people, processes, payers, and technology. Issues are owned through resolution and fed back to the stage that caused them.
- One team accountable for the result
- Shared workflows across every billing function
- Root-cause reporting, not just task counts
WHAT END-TO-END RCM INCLUDES
Fifteen connected services.
01
Before the patient is seen
◎Patient RegistrationAccurate demographics and insurance details captured at the first touchpoint.→✓Eligibility VerificationBenefits, coverage, and patient responsibility confirmed before care.→↗Referral ManagementEvery inbound and outbound referral tracked through completion.→◇Prior AuthorizationPayer requirements identified and approvals followed to a decision.→
02
Turning care into a claim
⌘Medical CodingCertified coding aligned with documentation, payer policy, and specialty rules.→＋Charge EntryComplete, timely charge capture with daily reconciliation.→➜Claim SubmissionClaims scrubbed, formatted, submitted, and tracked to acceptance.→↻Rejection ManagementFront-end rejections corrected quickly before they become denials.→
03
Getting paid, and paid correctly
$Payment PostingERA, EOB, and patient payments posted line by line with precision.→!Denial ManagementDenials categorized, corrected, appealed, and prevented at the source.→↑Appeal ManagementEvidence-based appeals prepared for the payer and reason at hand.→◷A/R Follow-UpEvery aging bucket prioritized and worked through resolution.→
WHAT MEDICAL BILLING NORMALLY COSTS
A fee should be measured against what it improves.
Billing arrangements commonly use a percentage of collections, a per-claim rate, or dedicated staffing. The right model depends on volume, specialty, scope, and current performance.
TYPICAL INDUSTRY RANGE4–8%of monthly collections
Final pricing reflects service scope, claim volume, payer complexity, and technology requirements.
Get a tailored estimate →IN-HOUSE BILLING VS OUTSOURCING
Compare the total operating cost.
One accountable model
✓ Dedicated specialists✓ Built-in leadership✓ Workflow documentation✓ Quality assurance✓ Payer follow-up✓ Actionable reportingEXPECTED FINANCIAL IMPACT
What better execution can change.
CONTROL & VISIBILITY
Outsourcing does not mean losing control.
01Named owners
Know exactly who leads each workflow.
02Daily visibility
Queues, exceptions, and trends remain transparent.
03Monthly governance
Review performance, causes, and corrective actions.
04Your systems
The work stays connected to your operating environment.
COMMON QUESTIONS
What practices ask us.
Can we start with one service? ＋
Yes. Begin with the stage creating the greatest friction and expand when it makes sense.
How do you transition work? ＋
Through documented discovery, access validation, testing, parallel workflows, and controlled launch.
Will you work in our current platforms? ＋
Yes. Our teams are trained across leading EMR, PMS, LIS, clearinghouse, and payer systems.
How is performance measured? ＋
Against an agreed baseline, service-level targets, financial outcomes, quality, and recurring root causes.
START WITH THE LEAKS
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