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Medonix

Industry · Hospitals & Health Systems

Medical billing and RCM for hospitals & health systems.

Outpatient, ambulatory, and acute care networks above $50M. Medonix runs a dedicated hospitals & health systems playbook with AAPC- and AHIMA-credentialed coders, AI agents tuned to your payer mix, and engagement-specific service-level targets aligned to MGMA top-performer benchmarks (95%+ first-pass clean claims, sub-30-day A/R), written into your contract.

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95%+Clean-claim target (MGMA)
<30dA/R target (HFMA)
<5%Denial rate target
98%Net collection target

The challenge

Why hospitals & health systems need a dedicated billing playbook.

Hospital and health-system RCM is not just larger; it is structurally different. Institutional UB-04 billing, DRG validation, technical / professional component splits, outpatient APC management, charge-capture audits, and CDM maintenance run alongside professional-fee billing for employed providers. Medonix runs both sides on one contract, with hospital-experienced revenue-integrity analysts and the AI agents tuned for high-volume institutional claims.

What you get

Inside a Medonix hospitals & health systems engagement.

Every contract in this vertical includes the same four operational pieces, sized to your volume and complexity.

  • Piece 01

    Institutional and professional billing on one contract, one dashboard.

  • Piece 02

    Revenue-integrity analysts auditing UB-04 charges before submission.

  • Piece 03

    DRG and APC validation tied to clinical documentation review.

  • Piece 04

    CDM maintenance, fee-schedule analysis, and payer-mix reporting at the entity level.

Frequently asked

Hospitals & Health Systems medical billing, answered.

The questions decision-makers in hospitals & health systems ask before they switch. Book a 30-minute call if yours is not here.

Yes. Medonix runs both institutional UB-04 and professional CMS-1500 billing for hospital and health-system clients on a single contract. Our revenue-integrity team includes coders with prior hospital and outpatient-facility production experience.

Other industries we serve

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Related:Revenue cycle managementMedical codingDenial managementBrowse specialties

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  • 30-day parallel-run guarantee
  • Targets written into the contract
  • HIPAA · SOC 2 Type II · HITRUST
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