Physician Billing Services

Our certified coding specialists (CCS) and professional billers (CPB) possess an in-depth understanding of current medical coding and billing regulations, ensuring accurate claims submissions for a wide range of specialties. These specialties include primary care, cardiology, dermatology, and orthopedics. Here is how we tailor our workflows and simplify physicians medical billing services.

• Integrate billing software with digital systems such as electronic health records (EHR), electronic medical records (EMR), and electronic data interchange (EDI) to capture data quickly and speed up the billing process for electronic claims submission.
• Capture patient details (demographics, physician referral information, relevant insurance numbers (Medicare, Medicaid, or Social Security), and medical history) and insurance payer information (coverage type, prior authorization details, and claims address) for claims documentation completeness.
• Assign professionals with special expertise for handling multiple billing models, including value-based billing, telemedicine billing, capitation billing, episode-of-care billing, etc.
• Ensure claims documentation accuracy through AAPC-mandated code specificity. Our team utilizes the full spectrum of coding systems, including ICD-10 diagnoses, E/M codes for service complexity, HCPCS Level II codes for specific procedures and supplies, relevant modifiers, and CPT codes for healthcare services, ensuring detailed and compliant claims. 
• Maintain specific physician billing with correct CPT code ranges including 99201–99499 - office visits, hospital visits, consultations; 00100–01999 - anesthesia services, 10000–69999 - surgical procedures; 70010–79999 - radiology procedures, and more.
• Submit claims adhering to Medicare and Medicaid specific fee schedules and payment regulations and private insurance payers such as Blue Cross Blue Shield Association, Humana, etc, maximizing potential reimbursements.
• Designate a dedicated claims status specialist to field patient inquiries and act as a liaison with payers, actively monitoring claims for timely adjudication.
• Receive EOB from payers, resolve any disputes, and initiate an appeals process to gain maximum reimbursement for the rendered services.
• Furnish clear, patient-specific reports outlining charges, insurance approvals, deductibles, copayments, and coinsurance with the help of EOB reports from payers.
• Send patient reports to notify them about their payment responsibilities (out-of-pocket expenses) to prevent unpaid claims for our clients.