Our Services
Comprehensive medical billing and revenue cycle management services designed to maximize your reimbursements and minimize administrative burden.
Medical Billing & Coding
Accurate medical coding is the foundation of successful billing. Our certified coders ensure every procedure and diagnosis is coded correctly using current CPT, ICD-10, and HCPCS code sets.
We stay current with annual code updates, payer-specific requirements, and specialty-specific guidelines. Our coding accuracy reduces claim denials and ensures you receive appropriate reimbursement for services rendered.
Why it matters:
Incorrect coding leads to claim denials, delayed payments, and potential compliance issues. Professional coding reduces rejection rates and speeds up reimbursement.
- CPT procedure coding
- ICD-10 diagnosis coding
- HCPCS supply and equipment coding
- Modifier application
- Documentation review
- Coding compliance audits
Claims Submission & Follow-ups
We electronically submit claims to payers and track their status through every stage. When claims are delayed or missing, we follow up promptly to resolve issues and secure payment.
Our team monitors claim status daily, identifies issues before they become problems, and maintains detailed records of all communications with payers. We handle clearinghouse rejections immediately to prevent payment delays.
Why it matters:
Claims sitting in limbo hurt your cash flow. Proactive follow-up ensures payers process your claims quickly and you receive payment on time.
- Electronic claims submission
- Clearinghouse management
- Claim status tracking
- Payer follow-up calls
- Missing claim identification
- Resubmission of corrected claims
Denial Management
Denied claims don’t have to mean lost revenue. We analyze denial patterns, identify root causes, and appeal rejected claims with supporting documentation to overturn denials and recover payment.
Our denial management process includes categorizing denials, determining appeal viability, preparing comprehensive appeal letters, and tracking outcomes. We also implement process improvements to prevent future denials.
Why it matters:
Industry studies show that many providers write off denied claims rather than appealing them. Our denial management recovers revenue that would otherwise be lost.
- Denial analysis and categorization
- Root cause identification
- Appeal letter preparation
- Supporting documentation compilation
- Timely filing monitoring
- Process improvement recommendations
Eligibility & Benefits Verification
Before services are rendered, we verify patient insurance coverage, benefits, and authorization requirements. This prevents surprises and ensures you know what will be covered.
We check active coverage, confirm in-network status, verify copays and deductibles, and obtain necessary pre-authorizations. This upfront work prevents claim denials and reduces patient billing disputes.
Why it matters:
Treating patients without verifying coverage can lead to unpaid claims and difficult patient conversations about unexpected bills.
- Real-time eligibility verification
- Benefits and coverage confirmation
- Copay and deductible identification
- Prior authorization processing
- Referral verification
- Out-of-network status checks
Payment Posting & Reconciliation
We accurately post payments from insurance companies and patients to your accounts, reconcile discrepancies, and identify underpayments or contractual adjustments that need attention.
Our team posts electronic remittances (ERAs) and paper explanations of benefits (EOBs), applies payments to the correct patient accounts, identifies posting errors, and alerts you to underpayments that require investigation.
Why it matters:
Accurate payment posting gives you a clear picture of your revenue and helps identify when payers aren’t reimbursing according to contracted rates.
- ERA and EOB posting
- Payment application to accounts
- Contractual adjustment verification
- Underpayment identification
- Patient balance calculation
- Daily deposit reconciliation
Accounts Receivable Follow-up
We actively manage your accounts receivable by following up on outstanding claims, working unpaid balances, and contacting payers to resolve payment delays. Our goal is to keep your AR days low.
We prioritize follow-up based on claim age and dollar value, document all payer communications, escalate unresolved issues, and provide regular AR aging reports so you understand your collection status.
Why it matters:
Old unpaid claims become increasingly difficult to collect. Consistent AR follow-up improves cash flow and reduces write-offs.
- Systematic claim follow-up
- Aging report management
- Payer correspondence tracking
- Payment demand letters
- Small balance resolution
- Write-off recommendations
Reporting & Analytics
Regular reporting gives you visibility into your practice’s financial health. We provide detailed analytics on claim acceptance rates, denial trends, payer performance, and revenue metrics.
Our reports include key performance indicators, trend analysis, payer-specific metrics, and actionable recommendations. You receive monthly comprehensive reports and can request ad-hoc reports as needed.
Why it matters:
You can’t improve what you don’t measure. Clear reporting helps you understand your revenue cycle performance and identify opportunities for improvement.
- Monthly financial dashboards
- Key performance indicators
- Denial rate analysis
- Payer performance metrics
- Collection rate tracking
- Custom report generation
Ready to Optimize Your Billing?
Let’s discuss which services are right for your practice. Book a free consultation today.