- +1 (773) 985-1869
- info@stream-rcm.com
- 14430 Ocean Point, El Paso, TX 79938
Stream RCM supports physicians, clinics, and hospital groups across Oklahoma with accurate claims submission, denial management, and revenue recovery. Our experts have the knowledge about SoonerCare needs, payer mix issues, and financial stresses of rural providers. Practices work together with us to minimize the stress of paperwork, cash flow management, and patient care.
Claims Delayed Often
Oklahoma providers face a uniquely difficult billing environment. A majority of the state’s rural hospitals carry meaningful risk of closure, largely because Medicare and Medicaid reimbursement often falls below the true cost of care. The ongoing shift to SoonerSelect managed care has added new credentialing steps, payer specific rules, and documentation demands. Stream RCM absorbs that complexity so practices keep collecting what they are owed.
Rural Hospitals Vulnerable
Face Immediate Closure
State Population Covered
We have medical billing and coding services that cater specifically to the unique needs of every specialty in Oklahoma, adjusting processes according to the necessary requirements for documentation and coding. Our services include those in high patient-volume primary care physician groups, behavioral health physicians dealing with difficult Medicaid documentation requirements, orthopedics and surgery groups, rural critical access hospitals for proper cost reports and swing beds, as well as cardiology, pediatrics, and multispecialty groups.
Our medical billing specialists in Oklahoma have practical knowledge on credentialing through SoonerSelect, rural reimbursement and tribally-affiliated health services. We operate as an extension of your office team without incurring any additional cost of employing someone else.
Stream RCM manages every stage of the revenue cycle, from patient eligibility verification through final payment posting. Oklahoma practices gain one accountable partner instead of juggling multiple vendors, disconnected processes, and inconsistent reporting across departments.
Patient Eligibility Verification
Prior Authorization SupportCharge Entry Review
Accurate Medical Coding
Clean Claims Submission
Payment Posting Reconciliation
Denial Management Appeals
Patient Statement Processing
Reporting And InsightsWe start the revenue cycle by checking the demographics of the patient, their insurance coverage, their benefits, their eligibility, their effective date, their co-payment, their deductibles, coinsurance, and other payer’s policies prior to rendering the service. The reason why this is important is that eligibility, registration, and demographic problems are consistently one of the top reasons for claims denials. Studies within the industry indicate that about four out of five revenue cycle professionals link claims denials with a front-end process.
Prior authorization needs are met by determining what requirements to be authorized, gathering the necessary documentation, making the request, monitoring the payer’s response, and tracking the authorization numbers and authorized services. There is a great need for proper management of authorizations because from the year 2025 data shows that regular authorization requests have been denied at rates of 12% for Medicare Advantage, 14% for Medicaid Managed Care, and 18% in Marketplace Plans. We work towards preventing revenue leakage due to authorization problems.
Charge entry reviews are done to make sure that services are captured in a consistent and accurate manner prior to billing. This process involves reviewing the following criteria: patient information, date of service, provider information, procedure codes, units, modifiers, relationships between diagnoses, and payer requirements. The importance of accurate charge capture cannot be overstated since incomplete or inaccurate claim information is still one of the biggest causes of reimbursement delays and denials. Research by industry analysts reveals that 35% of physicians list incomplete or inaccurate claim data as one of their biggest denial causes.
We use the process of medical coding to accurately assign diagnoses and procedure codes from information provided in the clinical documentation. Coders review clinical documentation, code specificity, modifiers, sequencing, medical necessity, and other factors for the payer's requirements in order to avoid mistakes. Errors in the coding process can be considered one of the biggest preventable reasons for claims issues, as the recent statistics have shown that about 24% of denials have been made due to coding mistakes.
Claims preparation and submission occur only after the completion of front-end, charging, coding, documentation, and payer-specific validations. The aim is to achieve first-pass acceptance as much as possible to avoid any preventable rejections by the payers. Statistics prove the significance of this process for the industry: medical groups had the rate of denial on their first submission of claims at about 8%, and the wider hospital statistics for the year 2024 showed an initial rate of denial of 11.81%.
Payment from the payers and patients is reconciled with the expected payment from insurance based on contracts, adjustments, deductibles, coinsurance, co-pay, denial, and balance. Correct posting will ensure that each payment is posted accurately and discrepancies are detected promptly. This is especially crucial for the providers since they stand to lose between 2% to 5% of their net patient revenue due to inefficiencies in the revenue cycle and underpayment. We compare the remittance data with what was expected and detect any underpayment or discrepancy in the process.
Denials are treated as revenue recovery by organizing denial codes, finding out their causes, collecting documents, preparing appeal letters, submitting them before the deadline for the payer, and monitoring results. Denial impact on finances is high; industry estimates put the annual cost of denials to hospitals at approximately $262 billion, while more than 50% of the denials made in one national survey were actually reversed. Hence, our approach to handling denials consists of both preventing them and recovering from them, focusing on valuable clients and recurring issues.
Our treatment of patient statements is done under the focus of being accurate, clear, prompt, and balanced. Statements contain information concerning the payments by the insurance company, deductions to be made according to agreements, deductibles left, copayments, coinsurance, and the responsibility of the patient. Management of patient balance is becoming essential because of poor collection results. According to statistics, the providers collected 34.5 percent of money from the patients having health care insurance compared to the previous collection of 37.6 percent.
Revenue cycle performance analysis involves turning revenue cycle activities into useful performance information through reports on claim status, denied claims, payments received, aging, results of authorization process, collections, adjustments and reimbursements trends. Dashboards for management will enable identification of payer specific issues, repeated coding errors, late payments, underpayments and problematic accounts that need attention. The importance of having this information cannot be underestimated since recent statistics have shown a denial rate of 11.81% and an increase in account receivable days by 5.2%.
Many Oklahoma practices still manage billing internally, often with small teams stretched across scheduling, coding, and collections. Outsourcing medical billing services in Oklahoma gives practices access to dedicated specialists, established payer relationships, and consistent follow up on aging claims, without the overhead of hiring and training an internal billing department year-round.
| Factor | In House Billing | Outsourced with Stream RCM |
|---|---|---|
| Staffing Cost | Salaries, benefits, ongoing training | Fixed cost, no added overhead |
| Denial Follow Up | Often delayed due to workload | Tracked daily until resolved |
| Payer Expertise | Limited to one office's experience | Statewide SoonerCare and payer knowledge |
| Claim Turnaround | Varies with staff availability | Consistent submission within 24 to 48 hours |
| Reporting Visibility | Manual, inconsistent updates | Regular performance and revenue reports |
We offer complete revenue cycle management services in Oklahoma which cover coding, claims, denial management, credentialing, and reporting for practices of every size.
We handle end to end claims processing for Oklahoma providers, minimize manual work and ensure every submission meets current SoonerSelect and Medicare needs.
Our team appeals denied claims promptly, identifying root causes and correcting recurring issues so Oklahoma practices recover revenue that would otherwise go uncollected.
We manage OHCA enrollment and SoonerSelect plan credentialing simultaneously, helping new and existing providers reach billable status without unnecessary delays.
Practices receive clear monthly reports covering collections, denial trends, and outstanding balances, giving Oklahoma providers real visibility into their financial performance.
We manage patient statements and payment inquiries professionally, reducing administrative burden on front office staff at Oklahoma practices of every size.
Our team supports billing needs across every single region of the state from downtown Oklahoma City to small towns near the Kansas and Texas borders.
Home to OU Health and several large specialty groups, the metro's dense payer mix demands billing teams fluent in all contracts daily.
Anchored by Ascension St. John and Saint Francis Health System, Tulsa practices need coordinated coding across large multi-specialty.
Home to Norman Regional Health System, this Cleveland County city requires billing support suited to hospital based and outpatient practices.
A fast-growing Oklahoma County suburb, Edmond practices increasingly compete for specialists, and fast reimbursement competition.
Near Fort Sill, Comanche County practices manage a distinct payer blend of TRICARE, Medicaid, and coverage require claims handling.
One of Tulsa County's largest suburbs, Broken Arrow's growing outpatient clinics need scalable billing support to match rising patient volume.
Home to Oklahoma State University, Payne County practices serve a mixed, and resident population with varied insurance coverage patterns.
A regional hub for Garfield County, Enid providers depend on efficient rural billing support given limited specialist alternatives for patients.
Home to a VA medical center, Muskogee County practices often coordinate billing between veteran, Medicaid, and commercial populations.
Anchored by Mercy Hospital, Carter County practices need dependable billing support given the area's role as a regional referral center.
Served by Ascension St. John Jane Phillips, Washington County practices require consistent claims follow up given limited staff availability.
Home to AllianceHealth Seminole and area clinics, Pottawatomie County practices benefit from billing support matched to a largely rural patient.
A Pittsburg County regional hospital hub, McAlester practices need dependable revenue cycle support given the area's limited specialist density.
Home to Cherokee Nation health facilities, Cherokee County providers manage a unique tribal, Medicaid, and commercial billing requirements.
Anchored by Chickasaw Nation Medical Center, Pontotoc County practices require billing expertise across tribal health, Medicare, and SoonerCare.
We consistently track performance closely, giving Oklahoma practices clear visibility into monthly collections, denial rates, and days in accounts receivable, quarter after quarter.
We combine Oklahoma specific payer knowledge, including SoonerCare and SoonerSelect requirements, with dedicated account management, consistent denial follow up, and transparent reporting that helps practices recover revenue faster.
Yes. We understand cost based reimbursement rules, swing bed billing, and the financial pressures facing Oklahoma’s rural hospitals, and we tailor our processes to support their unique reporting and reimbursement needs.
Our group is aware of the current requirements for OHCA enrollment and SoonerSelect health plan credentialing, which ensures that our claims are compliant and not affected by any delays due to the current managed care conversion process.
Oklahoma implementations typically get their onboarding done in just a few weeks, and this includes assessment, secure system access, claim testing, and full implementation with little disruption to normal business operations.
We support practices throughout Oklahoma, from Oklahoma City and Tulsa to smaller rural communities, adapting our services to each practice’s location, specialty, and payer mix.
Our experts constantly keep track of SoonerCare announcements, Medicare contractor notifications, and commercial payer policies so that any changes can be quickly accounted for to prevent unnecessary denials of claims by our clients.
Partner with a dedicated billing company in Oklahoma and start recovering revenue with faster reimbursement.
