Charge entry, claim scrubbing, submission inside 48 hours, line-level payment posting and denial follow-up, all done inside the EHR you already use.
Certified coders assign CPT, ICD-10-CM and HCPCS from the signed note, with modifier and NCCI review before the claim goes out.
Eligibility before the visit, charge reconciliation after it, contract-level underpayment review and patient collections, reported on five KPIs every month.
Medicare PECOS, Medicaid and commercial enrollment, CAQH attestation every 120 days and revalidations tracked on one calendar so billing never stops.
Coverage, plan network status, copays and remaining deductible confirmed before each visit through 270/271 checks, portals and payer calls, with exceptions sent to your front desk.
Authorizations for imaging, injections, procedures, DME and therapy obtained before the visit, matched to the billed CPT and units, and renewed before they expire.
Every denial triaged by CARC and RARC code the day it posts, corrected or appealed inside the payer's deadline, and traced back to the step that caused it.
Insurance A/R worked by deadline and bucket, with payer calls, reference numbers and next actions recorded in your system. Also sold as a one-off cleanup of old A/R.
Claims scrubbed against payer edits and NCCI pairs and out inside one business day, with clearinghouse rejections reworked the same day.
Random chart samples read against the claims billed for them, reported in both directions with a written remediation plan.
ERA and paper EOB payments posted line by line with CARC and RARC codes intact, balanced to the bank deposit, underpayments flagged instead of adjusted away.
Statements that explain the balance in one line, payment plans patients keep, a phone answered by someone who can see the account, and your collections policy followed exactly.
Weekly collections, aging and denial figures pulled from your own system, compared with last week, explained by a named account manager.
Trained remote staff for scheduling, intake, insurance card capture and claim status calls, working inside your practice management system under a signed BAA with access you control.
We log into your practice management system rather than moving you onto ours. Your staff learns nothing new, and your data stays where it is if you ever decide to leave.
These are the states where the Medicaid program, its managed care plans and the local payer mix change the work enough to be worth writing down.
Yes. Each service can be scoped on its own. Practices often start with denial management or an old A/R cleanup project, then move the full cycle over once they have seen the reporting for a couple of months.
Within 24 to 48 hours of receiving the encounter. Charges are entered and scrubbed daily, and clearinghouse rejections are corrected and resent the same day they land.
Eligibility verification, charge entry, coding review, claim scrubbing and submission, payment posting, denial management and appeals, A/R follow-up, patient statements, credentialing maintenance and weekly reporting, with a named account manager.
No. Onboarding, system access setup and payer configuration are included. Pricing is a percentage of collections for full-service billing, or a per-claim or fixed project fee where that fits better.
