Custom revenue cycle management built around payer rules—not guesswork. We help busy practices improve collections, reduce denials, and get their time back. Our model is simple and aligned: contingency-based collections with flat-fee add‑ons for credentialing/compliance, eligibility verification & prior and retro authorization request, and submission of patient invoices due to cost.

Why we exist

Doctors should focus on patients—not portals. After 20+ years across coding, billing, and A/R, Tailor Made was created to solve the problems we kept seeing: preventable denials, slow follow‑up, and fee schedules no one checks. We fix the workflow, work every claim per payer guidelines, and report with radical transparency.

What we do

• Claims & A/R Management – Front‑end edits, clean submissions, denial fixes, and persistent follow‑up until resolution.

• Credentialing & Contracts — CAQH management, payer enrollment, recredentialing, and contract review/renegotiation, with an optional monthly subscription for ongoing document tracking and upkeep.

• Audits & Compliance – Coding/documentation reviews, policy updates, training.

• Eligibility & Prior Authorizations – Real‑time benefits checks and auths to prevent front‑end denials. (extra add-on)

• A/R Clean-Up — We work aging inventory by payer rules—correct, resubmit, and appeal as needed—to recapture cash many providers assume is lost due to staffing constraints or outsourced EBO gaps. You get clear claim notes and weekly recovery summaries.

Outcomes

• Net collection rate: 92%

• Clean claim rate (first‑pass): 97%

• First‑pass resolution rate: 92%

• Denial rate improvement: from 36% to 4%

• A/R days: 17

• >120‑day A/R reduced by: 91%

• Aged A/R recovery (clean‑up projects): __ recovered on $__ starting inventory

• Credentialing cycle time: ~__ days average (varies by payer requirements)

Notes for your team:

• Overall A/R Aging on claims aging A/R days, >120‑day 72%.

• Denials reduced from 32% to 2%.

How we work

1. Assess – Discovery call and quick chart/claims review to ID bottlenecks.

2. Optimize – Fix coding, edits, and workflows; load payer fee schedules; set KPIs.

3. Perform – Daily claims + follow‑up, supported appeals, weekly reports.

4. Improve – Monthly review with action items and updated targets.

Pricing

• Primary model: percentage of cash collected or flat fee based on practice size and patient census.

• Add‑ons: flat fees for credentialing, recredentialing, compliance reviews, and project‑based A/R clean‑up.

Compliance & security

• HIPAA‑aware workflows and BAAs.

• Payer‑policy alignment on every resubmission and appeal.

Who we serve

Primary Care • Urgent Care • Pediatrics • Family Medicine • Women’s Health • Behavioral Health — plus facilities with elevated aged A/R needing compliant, by-payer recovery.

Leadership

LaDesha Whaley, Founder & CEO / Revenue Cycle Manager. A 20+-year RCM veteran, specializes in professional (HCFA-1500) and facility (UB-04) billing, coding and denial management, payer contracting support, and practice operations. Her expertise spans Medicaid, Medicare, and major commercial payers.

“Let us Tailor Our Superb Expertise, and attention to detail to Recover what you thought was LOST!!”

Ready to improve collections?

Tell us your goals and we’ll follow up within 72 hours (Mon–Fri). Please do not include PHI in messages.
Email: info@tailormademedicalbillingco.com • Billing: billing@tailormademedicalbillingco.com • Credentialing: contract@tailormademedicalbillingco.com