We can consult with your team to create processes and procedures to maximize Medical Billing and Credentialing success with these services:

Medical Billing Management

• • • Full-cycle billing services, from claim submission to payment posting.
    • Accurate coding using ICD-10, CPT, and HCPCS standards to maximize reimbursements.
    • Denial management and appeals to recover lost revenue.
    • Accounts receivable (A/R) follow-up to reduce outstanding balances.

Credentialing Services

• • • Provider enrollment with insurance networks (e.g., Medicare, Medicaid, private payers).
    • Credentialing application preparation and submission for physicians and allied health professionals.
    • Re-credentialing and ongoing maintenance to ensure compliance and uninterrupted billing.
    • Verification of licenses, certifications, and malpractice insurance.

Revenue Cycle Optimization

• • • Comprehensive revenue cycle analysis to identify inefficiencies.
    • Customized strategies to improve cash flow and reduce claim denials.
    • Patient billing and collections support, including payment plan setup.
    • Financial reporting and analytics for better decision-making.

Compliance & Audit Support

• • • HIPAA-compliant billing processes to protect patient data.
    • Regular audits of billing practices to ensure regulatory adherence.
    • Assistance with payer audits and documentation requirements.
    • Training on coding and billing updates (e.g., annual CMS changes).

Consulting & Strategic Guidance

• • • Practice setup for new providers, including billing system recommendations.
    • Workflow optimization to streamline administrative tasks.
    • Payer contract negotiation to secure favorable reimbursement rates.
    • Tailored solutions for specialty practices (e.g., behavioral health, orthopedics, midwifery).