Comprehensive Medical Billing Services
End-to-end revenue cycle management and billing solutions for healthcare providers.
Our Services Overview
Our Services
- End-to-end medical billing services to maximize revenue
- Reduce administrative burden and ensure compliance
- Patient eligibility verification
- Accurate medical coding
- Charge entry and claim submission
- Payment posting and denial management
- AR follow-up and analysis
- AI-powered tools for fast, error-free processing
- In-house claims settlement software
- Real-time visibility into billing workflows
- Tailored services for clinics, diagnostic centers, and specialty practices
- Seamless integration with any EHR or practice management system
- Trusted partner handling revenue cycle from start to finish
Patient Access & Registration
- Patient demographic entry
- Insurance verification
- Coverage limits verification
- Prior authorization
Charge Capture & Entry
- Encounter form review
- CPT/ICD code mapping
- Service validation
- Specialty charge review
Claims Management
- Clean claim creation
- Code validation
- Electronic submission
- Error resolution
Payment Posting
- ERA/Manual EOB entry
- Insurance and patient payment posting
- Secondary claim submission
- Refund processing
Accounts Receivable (A/R) Management
- Insurance A/R aging analysis
- Follow-up for unpaid and underpaid claims
- Denial root cause identification
- Appeals with medical necessity documentation
- Patient follow-up and payment plans
Denial Management
- Automated and manual denial capture
- Categorization by denial type
- Root cause trend analysis
- Appeal letter generation and submission
- Payer follow-ups and escalation
Patient Billing & Collections
- Patient statements and invoices
- Phone/email reminders
- Payment portals and card-on-file systems
- Collection agency coordination
Medical Coding & Complaince Services
Comprehensive Coding Solutions
- ICD-10, CPT, and HCPCS coding
- Specialty-specific coding (e.g., cardiology, orthopedics, radiology)
- EHR/EMR-based chart abstraction
- Real-time and batch coding
- Code validation and optimization
- DRG and HCC coding (for hospitals and risk adjustment)
- Auditing and feedback for physician documentation
- Compliance with CMS/OIG/NCCI guidelines
Compliance & Quality Assurance
- HIPAA compliance (data security & access control)
- CMS/OIG regulation alignment
- Internal audits (billing and coding accuracy)
- Coding quality checks and scorecards
- Periodic compliance training for staff
- Support for RAC, MAC, and private payer audits
- SOP documentation and version control
- Auditing services
Credentialing & Enrollment
Credentialing Services
Ensure that healthcare providers are qualified and verified by third-party authorities to offer services.
- Complete setup of NPI, CAQH, and licensing requirements for healthcare providers.
- Initial credentialing (NPI, CAQH setup, licensing)
- Re-credentialing and revalidation tracking
- Group/facility NPI and TIN enrollment
- EFT/ERA setup and maintenance
- Hospital privileges and insurance paneling
- Follow-up on application status and escalations
- Document management and expiration tracking
Payer Enrollment Services
Get providers enrolled with insurance companies to allow billing and reimbursement.
- Payer Applications & Submissions
- Payer enrollment (Medicare, Medicaid, BCBS, Aetna, Cigna, etc.)
- Individual and group TIN/NPI linking
- Online portal setup and submission handling
- Follow-up & Escalation
- Resolution of rejections or missing information
- EFT & ERA Setup
- Insurance Paneling & Contracts
- Reviewing and negotiating contract terms
Additional Services
Analytics & Reporting
- Monthly financial reports (charges, collections, adjustments)
- A/R aging by payer, provider, or location
- Denial rates, trends, and resolution metrics
- Clean claim rate, first-pass resolution rate
- Provider productivity analysis
- Payer performance benchmarking
- Custom dashboard creation (Excel, BI tools, PDFs)
- On-demand and scheduled reporting
EMR Integration
- EMR setup and configuration for billing
- Data extraction for coding and charge entry
- Integration with clearinghouses (Availity, Office Ally, Change Healthcare, etc.)
- Custom template creation for encounters
- Automation of charge posting and payment processing
- Technical support for updates and error resolution
Client Support & Account Management
- Dedicated account manager per client
- Weekly/monthly review calls and performance check-ins
- Escalation management and SLA tracking
- Client onboarding and workflow documentation
- Billing SOP alignment with client operations
- Training for clinic/office staff on best practices
Value-Added Services
Enhancements that differentiate premium billing providers.
- Practice benchmarking and consulting
- Contract negotiation and fee schedule analysis
- Credentialing alert system (for renewals)
- Patient call center support (for billing queries)
- Business continuity and disaster recovery planning
- Marketing and growth strategy support for practices