Clean claims go out daily, not weekly. We run payer-specific scrubbing and NCCI edits before submission, manage clearinghouse rejections the same day they post, track EDI acknowledgements to confirm every claim actually reached the payer, and keep a first-pass acceptance rate you can see in your dashboard.

Certified coders assign CPT, ICD-10-CM, HCPCS and modifiers using specialty-specific rules. We reconcile every encounter and operative note against submitted charges so nothing is dropped, downcoded or left uncaptured, and we send documentation feedback to your providers before it turns into a denial.

ERA and EOB payments are posted line by line, not in bulk. We reconcile deposits to remittances daily, verify allowed amounts against your contracted rates, catch silent underpayments, and route every adjustment, write-off and patient balance to the right bucket so your books actually tie out.

Every denial is worked, categorized and traced back to its root cause. We appeal with payer-specific templates, clinical documentation and medical necessity support, escalate to peer-to-peer and external review when needed, and then fix the upstream process so the same denial stops repeating.

Aged claims do not age out on our watch. We work A/R by payer, dollar value and aging bucket, call and portal-check instead of waiting, escalate stalled claims, and take on legacy and post-transition A/R that other vendors abandoned.

We verify coverage, benefits and patient responsibility before the visit, and obtain prior authorizations for imaging, procedures, injections, therapy and specialty drugs. Auth numbers, units and expiry dates are tracked so a valid authorization is on file the day the service is performed.

Preventive versus problem-oriented visits, immunization administration, screening bundles, in-office labs, and value-based incentive programs decide whether a primary care practice is profitable. We help independent and small group practices protect margin, close quality gaps, and get paid for the care coordination work they already do.

Psychiatry, outpatient therapy, and integrated behavioral health carry authorization limits, session caps, carve-out payers, and parity disputes that general billers rarely understand. We manage benefit verification, telehealth place-of-service and modifier rules, time-based psychotherapy coding, collaborative care management, and appeals when medical necessity is challenged.

Surgical revenue depends on getting professional and facility billing to agree. We handle ASC grouper and payer-specific fee schedules, implant and high-cost supply carve-outs, multiple-procedure reductions, bilateral and co-surgeon rules, anesthesia coordination, and out-of-network negotiation so the case you performed is the case you get paid for.