Medical Billing and Coding Services

We work with solo practitioners, group practices, urgent care centers, behavioral health clinics, surgical groups, and healthcare facilities across all 50 states. Our pricing starts at 2.49% of net collections, well below the industry average of 4 to 10%. And we only get paid when you get paid. We handle everything from credentialing through patient billing.

Charge Capture Review

Before any claim goes out, we verify that every billable service from the encounter has been captured. Missed charges are the most common source of revenue leakage in medical practices. A study by the Advisory Board found that the average physician leaves $43,000 per year in uncaptured charges. Our team cross references your documentation against the services rendered to close that gap.

Coding by AAPC Certified Professionals

Our coders hold active AAPC and AHIMA certifications. They assign ICD-10-CM diagnosis codes, CPT procedure codes, and HCPCS Level II codes based strictly on the clinical documentation. We code to the highest specificity the documentation supports. No upcoding, no undercoding, no guesswork. When documentation is insufficient, we query the provider before submitting rather than making assumptions that lead to denials.

Claim Scrubbing and Clean Submission

Every claim is scrubbed against payer-specific edits before submission. We catch the errors that cause denials: missing patient demographics, invalid code combinations, authorization number mismatches, timely filing risks, and bundling conflicts. Claims go out clean the first time through CMS-1500 forms for professional services and UB-04 forms for institutional billing.

Electronic Submission and Tracking

Claims are submitted electronically through our clearinghouse connections with all major payers including UnitedHealthcare, Aetna, Cigna, BCBS plans, Humana, Medicare, and Medicaid programs in every state. We verify patient eligibility before submission, track every claim from submission through adjudication, and flag any that haven't received a response within the expected processing window.

Payment Posting and Reconciliation

When remittances come back, we post payments, identify underpayments by comparing allowed amounts against contracted rates, flag denials for immediate follow up through our A/R recovery process, and reconcile your expected reimbursement against what was actually paid. You see every dollar accounted for.

Denial Prevention and Root Cause Analysis

We don't just work denials after they happen. We analyze denial patterns across your entire book of business to fix the root causes upstream. If a specific payer is consistently denying a specific code combination, we adjust the workflow to prevent it. Initial claim denial rates across the industry hit 11.8% in 2024. Our clients see rates well below that because we catch problems before they become denials.