For independent practices
Medical billing for independent practices
We send your claims, chase the ones that stall, appeal the denials and post the payments, all from inside the EHR you already use. We're taking on new practices now.
We sign a BAA before we see patient data
We've worked hands on in these systems
Where the money goes
It usually isn't one big mistake
A claim bounces because of a typo in a member ID. Nobody reopens it, and four months later the filing window has closed. That's one claim, and in a busy office it can happen all year.
- Nobody checked the coverageThe visit gets billed to a plan that ended last month.
- The rejection got missedThe clearinghouse sent it back, and it never got reopened.
- The denial sat too longThe fix would have taken ten minutes, but the appeal window has closed.
- The underpayment went unnoticedThe payment posted, and nobody compared it with the contract rate.
Someone works your denials
Each denied claim goes to a biller who reads the reason, fixes what can be fixed and gets it back to the payer before the deadline. Small claims get worked too, since those are the ones that tend to get dropped when the office is busy.
How we handle denials
You can see where your money is
Your report covers what came in, what got denied and what's still open, written so you don't need a billing background to read it. If a number moved, it tells you why and what we're doing next.
What's in the report
Your staff keep the same system
We log in to your EHR with our own named accounts, so there's nothing to migrate and nothing new for the front desk to learn. You keep your data, and you can take our access away whenever you like.
The EHRs we know
Medical billing services
What we can take off your plate
Most practices don't need all of this on day one. Start with whatever's giving you the most trouble.
- Medical billing We prepare, check, submit and follow up on claims within your agreed scope.
- Denial management Denied claims worked by cause and deadline, and tracked to an outcome.
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A/R recovery Aged insurance balances sorted by value and deadline, then worked within the agreed scope. -
Payment posting Payments posted and reconciled to deposits, with underpayments flagged for follow up. -
Insurance verification We check coverage before the visit and tell your front desk about the problems. -
Coding support We check CPT and ICD-10 codes against the note and take questions to the provider. -
Credentialing Payer applications and CAQH upkeep, with follow up, at a fixed fee per application. - Billing analytics Collections, denials, claim acceptance and A/R in a monthly report with next steps.
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Care management billing We check prerequisites first, then support the billing for CCM, CPO, RPM and PCM.
The full cycle
What happens when a claim doesn't pay
It goes back into the cycle with someone assigned to it, instead of sitting in a report until it's too late to do anything.
- 1 EligibilityCoverage checked
- 2 Coding checkCodes validated
- 3 ClaimScrubbed, submitted
- 4 PayerStatus monitored
- 5 PaymentPosted, reconciled
Rejected, denied or underpaid claims go back around
- DenialCause, fix, deadline
- A/R follow upBy value and deadline
How it works
You can stop after the first step
- 1 Send us a few reportsYour aged A/R and denial reports are usually enough to start. We look through them for free and send you what we found in writing.
- 2 Pick what to hand overThat can be all of your billing, or just the denials nobody has time for. We send a written proposal and sign a BAA before we touch any patient data.
- 3 Watch the numbersWe work the claims in your agreed scope and send reports on the schedule in your agreement. Your baseline comes from your own data, so you can check our work.
Who does the work
Experienced billers on your account
- You'll have a named contact, and you can pick up the phone and ask about any claim.
- When we need something from your office, we'll say which claim, what's missing and by when.
- We won't change a code unless the note supports it, and we won't bill anything the record doesn't back up.
- Insurance payments keep going straight to your practice's bank account.
- Your billing work is done in the United States.
Who we serve
Independent, physician owned practices
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Primary care Lots of small claims across a broad mix of payers. -
Family medicine Patients of all ages on one schedule, with vaccines and a different set of rules for each payer type. -
Internal medicine Medicare heavy schedules with complex patients and care management programs. -
Geriatrics Almost all Medicare and Medicare Advantage, plus programs for care between visits. -
House call practices Billing for home visits, plus the home health and hospice work that goes with them. -
Something else? We can also consider small specialty practices, so please ask.
Own a billing company?
Thinking about retiring from your billing business?
We're looking to acquire small billing companies and client portfolios. Our preferred structure pays you a share of revenue over an agreed period, with a gradual handover so your clients aren't left wondering who to call.
Questions
What to ask a billing company
What does the free billing audit include?
We go through your outstanding A/R, denied claims, rejection rates, payment delays and workflow gaps, then send you what we found in writing. We only ask for the minimum necessary data, with the right authorization, and you're under no obligation afterward.
How much does medical billing cost?
For full service billing, it's generally a percentage of the payments your practice receives on the claims we manage, with a monthly minimum. The rate depends on your volume and specialty and on how much of the work you hand us, and you'll get it in a written proposal after the audit. See how pricing works.
Do we have to change our EHR?
No, you keep what you have and we log in to it. Our team has hands on experience with Epic, athenahealth, eClinicalWorks and AdvancedMD.
Who does the work on our claims?
Our billers do, inside your system under named user accounts. They review coding changes and appeals before anything goes to a payer, and we won't bill what the record doesn't support.
How do you protect patient data?
We keep HIPAA safeguards in place, and we sign a BAA before accessing patient data. Access is role based and activity gets logged. Read about our safeguards.
Who receives the insurance payments?
You do. They keep going directly to your practice account. We see the remittance data because we need it to post and reconcile, and we don't hold your money.
Can we try you without replacing our current biller?
Yes. The free audit doesn't change anything in your office, and the 30 day denial recovery pilot runs alongside whatever arrangement you have now.
Can you guarantee higher collections?
No, and we'd be careful with anyone who says they can. Results depend on your payers and your documentation, and on your patient mix. We can show you your baseline and what changes from there.
Find out what your claims are leaving behind
Send us your denial and A/R reports and we'll give you a written review for free. You can keep your current biller while you decide.