Comprehensive Medical Billing Services

End-to-end revenue cycle management solutions tailored specifically to your clinical specialty and practice scale

Medical Billing & Coding

Our certified medical coders ensure every medical encounter is accurately translated into standardized ICD-10-CM, CPT, and HCPCS Level II codes. We eliminate under-coding and reduce audit risk while maximizing rightful reimbursement.

Key Capabilities:

  • AAPC & AHIMA certified professional coders (CPC, CCS)
  • Specialty-specific clinical documentation improvement (CDI)
  • Double-tier quality assurance reviews & charge scrubbing
  • Continuous compliance monitoring against OIG & CMS benchmarks
Get Started with Coding

Revenue Cycle Management (RCM)

A holistic, closed-loop financial solution for modern practices. We manage every touchpoint from demographic intake and pre-authorization to electronic submission, denial appeals, and secondary insurance coordination.

Key Capabilities:

  • Front-end patient registration & insurance eligibility verification
  • Electronic charge capture and instant pre-submission validation
  • Automated multi-payer clearinghouse claims submission (EDI 837)
  • Daily payment posting, EFT reconciliation, and executive KPI reporting
Explore Complete RCM

Claims Management & Submission

Accelerate cash flow with 99.5% first-pass clean claim rates. We partner with premier healthcare clearinghouses to submit electronic claims rapidly while conducting automated edits for NCD/LCD coverage policies.

Key Capabilities:

  • Electronic claims submission (EDI 837) to 2,000+ commercial and government payers
  • Real-time clearinghouse status tracking with instant rejections alerts
  • Automated rule-based claim scrubbing prior to carrier transmission
  • Batch processing and daily transmission verification logs
Optimize Claims Submission

Denial Management & Appeals

Turn denied claims into cash. Our denial specialists conduct root-cause analysis on every rejection (CO, PR, OA codes), compile comprehensive clinical appeal packets, and aggressively pursue overturning wrongful payer decisions.

Key Capabilities:

  • Root cause categorization by payer, provider, CPT, and denial code
  • Specialized appeal letters backed by medical necessity documentation
  • Timely filing tracking and systematic secondary appeals Escalation
  • Trend reporting to fix front-end operational vulnerabilities
Recover Denied Claims

Credentialing Services

Avoid revenue interruptions and patient out-of-network complaints. We manage your primary source verifications, CAQH updates, state licensing renewals, and payer contract negotiations from start to finish.

Key Capabilities:

  • Initial provider enrollment and hospital privilege applications
  • Ongoing re-credentialing and CAQH profile maintenance
  • Payer contract fee schedule reviews and re-negotiation assistance
  • Expirable tracking (DEA, malpractice insurance, state licenses)
Start Provider Enrollment

Insurance Verification

Eliminate front-desk surprises and eligibility-related denials. We verify coverage, copays, deductibles, coinsurance, and pre-authorization requirements 48 to 72 hours before every scheduled appointment.

Key Capabilities:

  • Pre-visit electronic eligibility checks and coverage verification
  • Comprehensive benefits investigation (in-network vs. out-of-network)
  • Prior authorization identification, submission, and status monitoring
  • Upfront patient liability calculation for point-of-service collections
Verify Patient Eligibility

Accounts Receivable Management

We don’t let your hard-earned money sit in 90+ day aging buckets. Our dedicated AR recovery team systematically audits unpaid balances, contacts payer reps, and ensures every eligible dollar is collected.

Key Capabilities:

  • Detailed AR aging analysis stratified by 30, 60, 90, and 120+ days
  • Systematic payer follow-up via phone, portal, and written appeals
  • Patient balance statement generation with online payment integration
  • Bad debt mitigation and customized ethical collections protocols
Accelerate AR Recovery

Payment Posting & Reconciliation

Maintain crystal-clear financial books. We post electronic remittance advices (ERA/835), manual EOBs, patient credit cards, and copays within 24 hours of deposit, ensuring zero unallocated cash.

Key Capabilities:

  • Automated ERA/835 electronic posting and line-item adjustment tracking
  • Manual paper EOB entry with contractual allowance verification
  • Bank deposit cross-reconciliation against PMS ledger reports
  • Denial routing to appeals specialists on the exact day of posting
Automate Payment Posting

Practice Management Consulting

Transform your medical practice into a high-performing enterprise. Our senior healthcare consultants audit your workflows, benchmark your fee schedules against regional medians, and implement KPI scorecards.

Key Capabilities:

  • Clinical workflow and front-desk operational optimization
  • Fee schedule benchmarking against regional CMS and commercial medians
  • Executive KPI dashboards (Days in AR, Clean Claim Rate, Net Collections)
  • Staff cross-training on HIPAA compliance and EHR utilization
Schedule Practice Audit

Service Package Comparison

Choose the level of revenue cycle support that aligns with your practice goals and internal staffing.

Feature / Service Basic Billing Complete RCM (Recommended) Enterprise Care
Target Practice Type Solo practitioners Independent practices (1-5 providers) Multi-specialty clinics & groups
Fee Structure 4.5% of net collections 5.5% of net collections Custom tiered percentage
ICD-10 & CPT Medical Coding Certified CPCs Dual-tier audits
Electronic Claims Submission (EDI)
Payment Posting & Reconciliation 24h turnaround Real-time ledger sync
Proactive Denial Appeals Management Basic re-submissions only Full clinical appeals Full clinical appeals + peer review
Insurance Eligibility Verification 48h pre-visit check Real-time API verification
Provider Credentialing & CAQH Add-on fee Add-on fee Included turnkey
Dedicated Account Manager Shared team Dedicated specialist Dedicated team squad

Specialties We Serve

Every clinical discipline has unique documentation nuances, modifier requirements, and payer carve-outs. We tailor our workflows to your field.

Family Medicine

Preventive care, annual wellness, chronic care management (CCM).

Internal Medicine

Complex multi-condition diagnostics and medication reconciliation.

Pediatrics

Vaccine coding, developmental screenings, and EPSDT billing.

Cardiology

EKG, echo, nuclear stress tests, and catheterization coding.

Orthopedics

Surgical bundles, fracture care, and DME billing.

Mental & Behavioral Health

Psychotherapy, psychiatric evaluations, and telehealth billing.

Physical Therapy

Timed modality CPT codes and functional limitation reporting.

Urgent Care

High-volume point-of-care encounters and rapid insurer turnaround.

Multi-Specialty Groups

Consolidated reporting across departments and varied fee schedules.

Find the Right Solution for Your Practice

Contact our medical billing advisors to review your practice volume, fee schedules, and current denial rates.

Request Custom Quote
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