Services

We enter charges, scrub every claim against payer edits, and file electronically within one business day of receiving your encounters. Errors get caught before submission, not discovered in a denial thirty days later.

Scrubbing is specific to your payer mix, not generic. We maintain edit rules per payer and per plan, and update them when a payer changes policy, so the same rejection does not recur across your claim volume.

• Charge entry from your EHR or superbills within 24 hours
• Claim scrubbing against NCCI edits and payer-specific rules before anything goes out
• Primary, secondary, and tertiary filing across commercial, Medicare, and Medicaid payers

We post ERAs and paper EOBs daily, line item by line item, and reconcile posted payments against your actual bank deposits. If the remit says one number and the bank says another, we find out why that day, not at month end.

Posting quality decides whether every downstream number can be trusted. Contractual adjustments are applied against your actual fee schedules, so underpayments surface as variances instead of disappearing into write-offs.

• Daily ERA and EOB posting with contractual adjustments applied correctly
• Deposit reconciliation, so your books match your remits
• Patient payment posting and credit balance resolution, including refunds owed

Unpaid claims don't age out on our watch. Every claim past 30 days is worked on a fixed schedule, prioritized by age and dollar value, with the outcome of every touch documented. We don't wait for payers to pay. We follow up until they do.

Each claim carries a status, a next action, and a date. Timely filing and appeal windows are calendared per payer, so no claim dies because a deadline passed while it sat in a queue.

• Claims worked by aging bucket and dollar priority, on a published cadence
• Payer calls and portal follow-up with notes on every claim, every time
• Monthly aging review with you: what's outstanding, why, and the next action on each bucket

Every denial gets a decision within two business days: correct and resubmit, appeal with documentation, or escalate. Then we go one step further and track why claims deny by payer, code, and reason, and fix the source so the same denial stops showing up.

Appeals are built with the documentation each payer actually requires: medical records, coding rationale, policy citations. A denial worth appealing is appealed properly once, not resubmitted blind three times.

• Corrections and appeals filed with supporting documentation, inside payer deadlines
• Denial trend reporting by payer, CPT code, and denial reason
• Front-end fixes to eligibility, authorization, and coding that cut repeat denials at the source

A lapsed CAQH attestation or a missed revalidation can stop payment for months. We handle initial credentialing, payer enrollment, revalidations, and ongoing maintenance on a deadline-first calendar, so paperwork never becomes the reason a claim doesn't pay.

Every provider's enrollment status is tracked payer by payer, with effective dates, revalidation windows, and document expirations in one register. When you add a provider or a location, enrollment starts before their first patient is seen.

• New provider enrollment with commercial and government payers, tracked application by application
• CAQH attestations, document renewals, and demographic updates kept current
• Revalidation deadlines calendared and worked months ahead, not the week they're due

Once a month you get a report a practice owner can read in ten minutes: what was billed, what was collected, what's outstanding, and what we're doing about it. The numbers tie to your bank deposits, not to estimates.

Behind the summary sits the full detail: charges, payments, and adjustments by provider, payer, and CPT code. When a number moves, the report says why, and what we are doing about it in the month ahead.

• Monthly summary in plain English, with full detail behind it if you want to dig
• The metrics that matter tracked over time: days in A/R, clean claim rate, net collection rate, denial rate
• A standing review call to walk through the numbers and agree on next steps