Services
Medical Billing & Claims Management
We run your claims from eligibility check to posted payment, inside the systems you already use.
What we do
Most revenue problems start before a claim is ever sent. A missed eligibility check, a missing authorization or a typo in a member ID can cost weeks. Our billing service covers the full path a claim takes, so problems are caught early and money arrives sooner.
Eligibility and benefits verification
Before the visit, we confirm active coverage, plan type, copay, deductible status and whether the service needs a referral. If something looks off, we flag it to your front desk so it can be fixed before the patient is seen.
Prior authorization support
For services that need approval, we help gather the clinical details payers ask for, submit the request through the payer's portal or by fax, and track the status. Your team sees which authorizations are pending, approved or denied.
Charge entry
We enter charges from your encounter notes or superbills, check them against the payer's rules, and hold anything that looks incomplete. Questions go back to your team in one organized list, not a stream of emails.
Electronic claim submission
Claims go out through your clearinghouse after scrubbing for common errors. We review rejections the same day we see them and resubmit once corrected.
Payment posting
We post insurance payments and adjustments from ERAs and EOBs, and reconcile deposits so your ledger matches your bank. Underpayments and unexpected adjustments are flagged for follow-up.
Patient statements (optional)
If you want us to, we send clear patient statements on a set schedule and answer basic balance questions. Many practices keep this in-house; it is your choice.
Fee schedule optimization
We cross-check your fee schedule against your payer contracts so you are not charging below what payers allow for your specialty.
Daily, weekly and monthly reporting
A daily advance eligibility report before your doors open, a weekly overview of charges and collections by payer, and monthly executive analytics with aged summaries and payer performance.
Our workflow
- 1
Map your current process
We learn your EHR/PM setup, fee schedule, payer mix and who does what today.
- 2
Set up access and rules
We get secure user access, confirm clearinghouse settings and agree on how charges reach us.
- 3
Daily claim work
Eligibility, charge entry, scrubbing and submission happen on a daily cycle.
- 4
Post and reconcile
Payments are posted and deposits reconciled; exceptions go to follow-up.
- 5
Follow up on open claims
Unpaid claims are worked by age and balance until they are paid, appealed or resolved.
- 6
Report and review
Monthly numbers and a call to agree on what to improve next.
What you can expect
These are the standards we work to and report against. They are commitments we aim for, not guarantees, because some steps depend on payers and on information from your practice.
- We aim to submit clean claims within one to two business days of receiving complete charge information, with a 95% first-pass success rate as our working standard.
- We aim to review clearinghouse rejections within one business day.
- We post payments on a regular cadence agreed during onboarding, typically several times a week.
- Your front desk receives a daily advance eligibility report, you get a weekly practice overview, and monthly executive analytics with a review call.
- You always have one named person to contact with questions.
Common questions
Find out where your revenue is leaking.
A free, no-obligation review of your claims and payor contracts, explained in plain language.