Medical Billing Services

Complete revenue cycle management for medical practices

Maximize Your Revenue with Expert Medical Billing

Our comprehensive medical billing services handle every aspect of your revenue cycle, from patient onboarding to final payment. We combine advanced technology with expert billing professionals to ensure maximum reimbursement and minimum administrative burden.

Medical Coding Services

Accurate coding is the foundation of successful medical billing. Our certified coders ensure every service is properly documented and coded for maximum reimbursement.

What We Cover:

ICD-10-CM Diagnosis Coding - Precise diagnosis classification for all medical conditions including musculoskeletal disorders, chronic diseases, and acute conditions
CPT Procedure Coding - Complete coverage of all medical procedures including evaluations, treatments, surgeries, and examinations
HCPCS Level II Codes - Proper coding for supplies, equipment, and services not covered by CPT codes
Modifier Application - Correct use of modifiers to indicate special circumstances and prevent claim denials
NCCI Edits Compliance - Automated checking against National Correct Coding Initiative to prevent bundling issues
Regular Code Updates - Stay current with annual CPT and ICD-10 updates and quarterly changes

Claims Management

Efficient claims processing is crucial for maintaining healthy cash flow. We handle the entire claims lifecycle from submission to payment.

Our Process:

Electronic Claims Submission - Submit claims to Medicare, Medicaid, and all major commercial payers electronically for faster processing
Claim Scrubbing - Pre-submission review and error correction to reduce rejection rates by up to 95%
Real-Time Eligibility Verification - Verify insurance coverage before services are rendered
Claim Status Tracking - Monitor claims from submission through payment with automated follow-up
Payment Posting - Accurate and timely posting of insurance payments and patient payments
ERA/EOB Processing - Automated processing of Electronic Remittance Advice and Explanation of Benefits
Secondary Claims Filing - Automatic filing to secondary insurers when applicable

Appeals & Denial Management

Don't leave money on the table. Our expert team fights for every dollar you've earned with comprehensive denial management and appeals.

How We Help:

Denial Analysis - Identify patterns and root causes of denials to prevent future occurrences
First-Level Appeals - Prepare and submit appeals with supporting documentation within required timeframes
Second-Level Appeals - Escalate complex cases with detailed medical necessity documentation
Peer-to-Peer Reviews - Coordinate clinical reviews with insurance medical directors when needed
Documentation Enhancement - Train your team to improve documentation quality and reduce denials
Denial Prevention - Proactive measures to address common denial reasons before claims are submitted
Success Rate Reporting - Track and report appeal outcomes to measure effectiveness

Insurance Verification

Eliminate surprise denials and improve collections with thorough insurance verification before every patient visit.

Verification Services:

Real-Time Eligibility Checks - Verify active coverage and benefits before appointments
Benefit Breakdown - Detailed analysis of deductibles, copays, coinsurance, and visit limits
Pre-Authorization Management - Obtain required authorizations to prevent claim denials
Coverage Limitations - Identify visit limits, excluded services, and coverage restrictions
Out-of-Network Benefits - Verify benefits for patients with out-of-network coverage
Patient Financial Responsibility - Calculate and communicate expected patient costs upfront
Multi-Payer Coordination - Identify and coordinate benefits for patients with multiple insurances

Provider Credentialing & Enrollment

Get enrolled with insurance networks quickly and efficiently. We handle the complex credentialing process so you can focus on patient care.

Credentialing Services:

Initial Credentialing - Complete enrollment with Medicare, Medicaid, and commercial payers
CAQH Profile Management - Create and maintain your CAQH ProView profile
Re-Credentialing - Handle periodic re-credentialing to maintain network participation
Payer Enrollment - Enroll with insurance companies and manage contracting
License Monitoring - Track professional license renewals and expiration dates
Document Management - Maintain secure storage of all credentialing documents
Expedited Processing - Follow up with payers to accelerate approval timelines

Revenue Cycle Management

Optimize every step of your revenue cycle from patient registration through final payment with our end-to-end management services.

Complete RCM Services:

Patient Registration - Accurate demographic and insurance information capture
Charge Capture - Ensure all services are properly documented and billed
Claims Submission - Timely filing of clean claims to all payers
A/R Management - Proactive management of accounts receivable aging
Payment Processing - Efficient posting of payments and adjustments
Patient Collections - Professional collection of patient balances
Financial Reporting - Comprehensive reporting on practice financial performance

Practice Onboarding & Training

Get up and running quickly with our comprehensive onboarding program designed specifically for medical practices.

Onboarding Process:

Initial Assessment - Evaluate current workflows and identify improvement opportunities
Data Migration - Seamless transfer of patient records and financial data from your existing system
System Configuration - Customize the platform to match your practice workflows
Staff Training - Comprehensive training for all team members on relevant features
Go-Live Support - Dedicated support during your first weeks of operation
Ongoing Education - Regular webinars, tutorials, and updates on new features
Best Practices Consulting - Guidance on optimizing billing and coding practices

Compliance & Audit Support

Stay compliant with ever-changing healthcare regulations and be prepared for audits with our compliance management services.

Compliance Services:

HIPAA Compliance - Ensure all operations meet HIPAA privacy and security requirements
Coding Audits - Regular internal audits to ensure coding accuracy and compliance
Documentation Review - Evaluate clinical documentation to support medical necessity
Payer Audit Support - Assist with responding to insurance company audits
Medicare Compliance - Stay current with Medicare billing rules and regulations
Regulatory Updates - Keep you informed of relevant regulatory changes
Fraud Prevention - Implement controls to prevent billing errors and potential fraud

Why Choose HealthClaimExperts.com for Your Medical Billing?

98% First-Pass Rate

Our claim scrubbing technology and expert coding ensure claims are accepted on first submission

30% Revenue Increase

Practices see an average 30% increase in collections within the first 6 months

Days in A/R Reduced

Reduce your average days in accounts receivable from 45+ to under 30 days

Expert Support

Certified medical billers and coders specializing in medical billing

Ready to Optimize Your Medical Billing?

Schedule a free billing analysis to see how much you could be earning