Billing professional working at a laptop

Medical Billing Services

Medical professional in teal scrubs preparing billing paperwork

Claim Submission

Submitting clean claims to insurance payers electronically (EDI) or on paper using standardized forms like the CMS-1500.

Billing professional reviewing a claim and payment information

Denial & Appeals Management

Review and appeal denied or underpaid claims. Identify and categorize denials, correct and rebill, communicate with the provider, front desk, and coder, file an appeal if needed, and educate for denial prevention.

Professional reviewing account documents at a desk

Accounts Receivable A/R Follow-up

Investigating and appealing denied or underpaid claims. Work on current claims every week to prevent them from becoming old A/R.

Healthcare professional using video visit software at home

Provider Software

Use providers' cloud-based PMS, EMR, and ERA that support claims submission, payment posting, denial management, records, and reporting.

Hands reviewing healthcare paperwork and documentation

Compliance

Ensuring all billing practices adhere to HIPAA regulations and other relevant healthcare laws.

Billing professional working with records at a computer

Payment Posting/Collections

Recording payments received from insurance payers and patients.

Add-On / Micro-Services

Hands typing on a laptop used for coding work

Medical Coding

Translating medical procedures and diagnoses into universal codes, such as CPT, HCPCS, and ICD-10 codes.

Clinician reviewing a patient form on a clipboard

Patient Eligibility

Confirming and verifying patient demographic information and insurance details. Visit limits and prior authorization requirements.

Insurance Verification

Insurance verification confirms coverage is valid and active, and reviews deductibles, copays, coinsurance, and other requirements.

Professional signing payer enrollment documents

Payer Enrollment (EDI/ERA/EFT)

Registering a verified provider with insurance networks, including Medicare, Medicaid, and commercial plans, and setting up EDI, ERA/EFT, and clearinghouse connections.

Billing professional following up on claims over the phone

Accounts Receivable A/R Cleanup & Old Claims Recovery

Recover unpaid claims, correct errors, resubmit, and appeal. Reduce aging A/R and improve cash flow.

Credential and certificate displayed in an office

Provider Credentialing

Verifying a provider's qualifications, including education, training, licenses, and certifications. Includes CAQH setup, Medicare/Medicaid enrollment, and commercial payer credentialing.

Patient billing statements and paperwork on a desk

Patient Statement Letters

Provide mailing of patients' billing statement letters when needed by an office practice.

Appointment Reminder Cards

Provide mailing of patients' appointment reminder cards when needed by an office practice.

Small business owner reviewing figures with a calculator

Bookkeeping

Track money, organize financial records, and manage accounts for businesses.

Patient collection letter clearly marked past due

Patient Collection Letters

Provide mailing of patients' collection letters when needed by an office practice.