Hospital Billing That Holds Up From Admission to Final Payment
A hospital claim passes through registration, CDI, coding and the chargemaster, then lands with a payer that may deny it anyway. CureBytes manages every step, so the care your teams deliver gets paid in full.
$350M+
Processed Claim Value
21 Days Avg.
A/R Collection Time
24H
Turnaround Time
99% Client
Retention Rate
Pay Only On
Collections
Hospital Billing
Hospital Revenue Cycles Are Under More Pressure Than Ever
The AHA counts roughly 6,100 hospitals in the U.S., and 1,797 of them are rural community hospitals. Large or small, they're up against the same thing: payers that deny first and pay later. A Premier survey found private payers initially deny nearly 15% of claims. For Medicare Advantage plans, the figure is 15.7%. More than half of those denials eventually get paid. Getting there isn't cheap. Premier puts the average cost of fighting a denial at $43.84 per claim, and $47.77 for Medicare Advantage. Across the industry, that adds up to about $19.7 billion a year. The rules keep shifting, too. For 2026, CMS started a three-year phase-out of the inpatient-only list, began paying drug administration at off-campus departments at physician fee schedule rates, and added percentile-based allowed amounts to price transparency files. Each change touches coding, the charge master or both.
Provider
Where Hospitals Lose Revenue
Documentation that doesn't support the DRG.
One missed CC or MCC can drop an inpatient stay into a lower-paying MS-DRG. Without CDI queries before coding, the hospital gets paid for a simpler patient than the one it treated.
Inpatient versus observation status.
The two-midnight rule decides which applies, and Medicare Advantage plans have had to follow it since 2024. Get status wrong and the claim is denied or downgraded. Miss the MOON notice on an observation stay past 24 hours and you have a compliance gap as well.
A chargemaster that falls behind.
Quarterly HCPCS updates, revenue code mapping and pricing all live in the CDM. One stale line can underbill every claim that touches it, and it feeds your price transparency files too.
The 3-day payment window
Outpatient diagnostic and related services in the three days before a Medicare admission belong on the inpatient claim. Bill them separately and you’re looking at overpayments and recoupments.
Denials that never get appealed.
When the business office is stretched thin, low-dollar denials get written off and Medicare Advantage downgrades go unchallenged. That’s revenue the hospital already ear
How CureBytes Supports Hospital Revenue Cycles
Inpatient Coding and DRG Validation
Certified inpatient coders assign ICD-10-CM and PCS codes and validate every MS-DRG, with CDI queries sent before the claim is final.
Outpatient and Emergency Department Coding
APC-based outpatient coding, ED facility levels and professional fee coding for your hospitalists and hospital-based physicians.
Chargemaster Maintenance
Quarterly code updates, revenue code mapping and line-item reviews, so charges match the care delivered and the prices you publish.
Patient Access and Prior Authorization
Eligibility, benefits and authorizations confirmed before scheduled admissions and procedures, with patient status checked against the two-midnight rule.
UB-04 and 837I Claim Management
Every claim is scrubbed against NCCI edits, the 3-day window and payer-specific rules before it goes out the door.
Denial Management and Appeals
Clinical and technical denials worked by root cause and appealed through every level, Medicare Advantage downgrades included.
Reporting Your CFO Can Use
Days in A/R, denial rates, case mix index and cash collections by service line, available whenever you need them.
What Running Hospital Billing In-House Actually Costs
Factor
How We Start Billing for Your Hospital
Complimentary Revenue Cycle Assessment
We review claims, denials, DRG assignments and A/R to show you exactly where your hospital is losing revenue today.
Onboarding Built Around Your Systems
We work inside your current EHR and patient accounting system, whether that’s Epic, Oracle Health, MEDITECH or another platform. No new software for your staff.
Full Revenue Cycle Management Begins
Coding, claims, denials and A/R move to a dedicated team in planned phases, starting with the areas where you’re losing the most.
Continuous Performance Improvement
Ongoing reports on denial trends, case mix and cash flow keep leadership clear on where the hospital stands financially.
Hospital Billing
Ready to Find Out Where Your Hospital's Revenue Is Slipping?
Every downgraded DRG, missed charge and unappealed denial is revenue your hospital earned and never collected. A complimentary Revenue Cycle Assessment shows you exactly where it’s going.
Complimentary review of your current claims, denials, and A/R
Community, rural and critical access hospitals welcome
Clear findings delivered with no strings attached
No contracts, no setup fees, no upfront costs
Pay only a percentage of what CureBytes collects for you
Dedicated account manager assigned to your hospital from day one
Frequently Asked Questions
Everything You Need to Know Before You Decide
Can CureBytes work alongside our existing business office?
Yes. Many hospitals keep patient access in-house and send us coding, denials or A/R follow-up. Others outsource the full revenue cycle. We fit around the team you already have.
Do you code both inpatient and outpatient claims?
Yes. We cover inpatient ICD-10-PCS coding and DRG validation, outpatient and ED facility coding, and professional fee coding for hospital-based physicians.
Do you work with critical access hospitals?
Yes. We bill under CAH cost-based reimbursement rules, including Method II professional billing on the UB-04 where your hospital has elected it.
How do you handle Medicare Advantage denials?
We track them separately from traditional Medicare, appeal status and DRG downgrades, and hold plans to the two-midnight rule they’re required to follow.
How is pricing structured for a hospital?
CureBytes is paid a percentage of what we collect for you. There’s no setup fee and no minimum retainer, so the cost follows your collections.
Is our patient data secure with an outside billing partner?
Yes. CureBytes maintains HIPAA and SOC 2 compliance across every account, from small rural hospitals to multi-facility systems.