End-to-End Medical Billing Solutions
From the moment a patient walks in to the day your payment posts, we manage every step of the revenue cycle so you don't have to.
Medical Billing & Coding
Accurate coding is the foundation of every dollar your practice earns. Our AAPC-certified coders specialize in ICD-10, CPT, and HCPCS coding across all major specialties — from primary care to complex surgical procedures. We review every encounter for coding completeness, medical necessity alignment, and payer-specific requirements before submission. The result: cleaner claims, fewer denials, and higher reimbursement rates. We don't just code for compliance — we code to maximize what you're owed. Our team stays current with annual code updates, LCD/NCD changes, and payer policy shifts so your practice never leaves reimbursement on the table. Average practices that switch to our coding service see a 22% increase in reimbursement within 90 days.
- ICD-10, CPT & HCPCS expertise
- Specialty-specific coding
- Annual coding updates included
- Modifier optimization
Claims Management
Getting claims paid the first time requires more than just submitting them — it requires a disciplined process. Our claims management team handles end-to-end submission to all commercial, Medicare, Medicaid, and managed care payers. We scrub every claim against 3,500+ edits before submission to catch errors that would trigger a denial. Once submitted, we track each claim in real time and follow up aggressively at 14, 30, and 45-day intervals. No claim falls through the cracks. We manage electronic remittance advice (ERA), secondary billing, and coordination of benefits automatically. You get a clean, organized AR and faster cash flow. Our 98.2% clean claim rate means your money arrives faster and your staff spends zero time on claim status calls.
- 3,500+ pre-submission claim edits
- Real-time claim tracking
- Electronic remittance posting
- Secondary billing automation
Denial Management
Denied claims are not dead claims — they're opportunities waiting to be recovered. Our denial management specialists analyze every rejection to understand why it happened, then build a recovery strategy specific to that payer and denial reason. We categorize denials by root cause: eligibility issues, authorization failures, coding errors, timely filing, or medical necessity — and address each category systematically. Beyond overturning individual denials, we track patterns across your payer mix to implement upstream prevention. Our appeal success rate exceeds 87%, and we file appeals at every level available — first-level, second-level, and external review when warranted. Practices that adopt our denial management see a 35% reduction in denial volume within six months.
- 87%+ appeal success rate
- Root cause denial analysis
- Multi-level appeal filing
- Pattern prevention reporting
Revenue Cycle Optimization
Medical billing is only one piece of your revenue cycle. True optimization requires examining every touchpoint — patient registration, eligibility verification, prior authorization, charge capture, billing, collections, and reporting — and eliminating inefficiency at each step. Our revenue cycle consultants perform a comprehensive assessment of your current workflows, identify revenue leakage points, and implement targeted improvements. We measure Days in AR, denial rates, net collection ratios, and cost-to-collect across your payer mix. Then we set benchmarks and track progress monthly. Practices that engage our RCO program reduce Days in AR from an average of 45 to under 22, improve net collection rates by 12-18%, and free clinical staff from administrative burden.
- End-to-end process assessment
- Days in AR reduction
- Charge capture improvement
- Monthly KPI reporting
Patient Billing & Collections
The shift to high-deductible health plans means patient balances are now a significant portion of your revenue — often 20-30% of total collections. Patients need clear, friendly communication about what they owe and multiple convenient ways to pay. Our patient billing service handles statement generation, payment plan setup, online payment portals, and soft-touch collection outreach. We use a compassionate, compliance-first approach that protects your practice's reputation while maximizing recoveries. Our team is trained in Fair Debt Collection Practices Act (FDCPA) compliance and patient communication best practices. We consistently recover 60-75% of patient balances compared to an industry average of 40%, without damaging the patient-provider relationship.
- Clear patient statements
- Flexible payment plans
- Online patient payment portal
- FDCPA-compliant collections
Compliance & Audits
Regulatory compliance in healthcare is not optional — and the penalties for violations can be severe. Our compliance program provides proactive protection through regular internal audits, staff training, and continuous monitoring of regulatory changes from CMS, OIG, and state agencies. We conduct prospective and retrospective claim audits to identify documentation gaps, overcoding, undercoding, and medical necessity concerns before they become OIG scrutiny or payer recoupment demands. We also provide HIPAA risk assessments and help you maintain a compliant Notice of Privacy Practices, Business Associate Agreements, and security policies. Our compliance team monitors OIG Work Plans, CMS transmittals, and MAC bulletins monthly to keep your practice ahead of regulatory changes.
- Regular internal claim audits
- HIPAA risk assessments
- OIG compliance monitoring
- Staff training programs
Not Sure Which Services You Need?
Schedule a free 30-minute consultation. We'll review your current billing workflow and recommend the services that will have the highest impact on your revenue.
Schedule Free Consultation