Medical billing is the part of running a practice that nobody went to school for, and it is the part that decides whether the work you already did gets paid. We enter charges, scrub and submit claims, post payments and chase what does not come back, inside the system you already use. You keep seeing patients. We keep the money moving.
What end-to-end medical billing includes
Every encounter that closes in your EHR becomes a charge within one business day. We enter it from the note or superbill, run it through payer-specific edits and NCCI checks, and submit it within 48 hours of receiving the encounter. When the remittance comes back we post it line by line, not as a lump sum, so underpayments and zero-pay lines are visible the day they land. Anything denied or unpaid at 30 days goes into follow-up with a named owner and a next action. Rejections at the clearinghouse are corrected the same day rather than left in the inbox. The point is that nothing sits.
The problems practices bring us
The pattern is familiar by now. A/R over 90 days has crept past a third of total receivables. There is a denial queue nobody has opened since the last biller left, and some of those denials are already past the appeal window. The front desk has turned over twice in a year, so eligibility checks are hit or miss and registration errors are producing CO-16 denials by the dozen. None of this is a moral failure. It is what happens when billing is one of six jobs a person holds. We take it off the desk, and we start by telling you exactly how much is recoverable and how much is already gone.
We work inside your existing EHR and PM
We do not move your data or make you buy software. Our billers work inside Tebra, AdvancedMD, eClinicalWorks, athenahealth, DrChrono, Practice Fusion, Office Ally, NextGen and TherapyNotes every day, and we can usually be productive in a system we have not seen before within a week. You grant role-based logins, we sign a BAA before we touch anything, and every claim, payment and note we enter is in your system with our user stamped on it. That matters for two reasons. You can audit our work whenever you want without asking permission. And if you ever leave, nothing needs to be exported or rebuilt, because it was never anywhere else.
The denials we see most, and what fixes them
CO-16 means the claim was missing information, usually a subscriber ID, a referring NPI or a place of service that does not match the payer file. CO-97 with a modifier 25 dispute means the payer bundled an E/M visit into a procedure done the same day, and the remedy is documentation showing a separately identifiable service, not a resubmission with the same modifier. CO-29 is timely filing, and once the window is gone there is no appeal on the merits, only proof of an earlier submission. CO-4 is a procedure code that needed a modifier and did not have one. We track each of these by payer and by provider so the same one stops repeating.
What you get every week and every month
A weekly A/R report lands in your inbox every Monday. It shows charges, payments, adjustments, denials received, denials resolved, and aging by bucket, with the 90-plus bucket broken out by payer so you can see where the old money is sitting. You have a dedicated US-based account manager who knows your payers and your providers and does not need the history explained. Once a month we hold a review call to go through trends, unpaid claims over a threshold you set, and any write-offs we are recommending, which you approve or decline. There is no long-term contract. After the first 90 days the agreement runs month to month, and if we are not earning the fee you can walk.
How the free billing audit and 30-day trial work
Before you commit to anything we run a free billing audit on your last 90 days of claims. You give us read-only access to your PM system, and inside a week we send back a written summary: aging by bucket and payer, denial volume by reason code, claims approaching filing deadlines, and an estimate of what is recoverable versus what is gone. No pitch is attached. If you want to proceed, the first 30 days run as a trial. We work new claims alongside your existing process, you compare the two, and you can stop at day 30 with no fee for the trial period if the numbers do not hold up.
What Is Included
- Claims out within 24 to 48 hours
- Payment posting and reconciliation
- Denials worked by reason code
- Weekly A/R report
| Medicare timely filing limit | Claims must be filed within one calendar year of the date of serviceSource: CMS, Medicare claim submission period |
|---|---|
| Coding edits applied to every claim | NCCI procedure-to-procedure pairs and medically unlikely editsSource: CMS, National Correct Coding Initiative |
| Business associate requirement | A written BAA is required before a billing company may handle PHISource: HHS, HIPAA Privacy Rule |
Medical Billing Services: Common Questions
We charge a percentage of what we collect, typically 4 to 7 percent depending on specialty, claim volume and how much cleanup the existing A/R needs. There are no setup fees, no per-claim charges and no software fees. If we do not collect, we do not get paid, which keeps our incentives lined up with yours.
No. The first 90 days are a fixed initial term so that both sides can judge the work on a full quarter of data. After that the agreement runs month to month and either party can end it with 30 days written notice. We keep clients by doing the work, not by holding them to paper.
We start with the free audit so we know what is open and what is about to expire. Then we agree a cutover date with you and your current biller. New claims from that date are ours, and we inventory every open claim before it so nothing falls between two vendors. Most transitions take two to three weeks.
That is your choice. Some practices leave the old A/R with the outgoing biller to finish, and some hand it to us as a separate cleanup project priced on its own. Either way we tell you up front which claims are still recoverable and which are past the filing or appeal window, so you are not paying anyone to chase dead balances.
Yes to both. We sign a Business Associate Agreement before receiving any access, and our staff work under role-based logins that are logged in your own system. PHI is never sent through email or the website contact form. We can provide our BAA template or work from yours.
Within 48 hours of receiving the encounter, and usually the next business day. Clearinghouse rejections are corrected and resent the same day they appear. If your providers close notes late, we will tell you, because a claim cannot go out before the documentation exists and slow charting is the most common cause of slow billing.