Medical Billing Service
Medical Billing Service - An overview
Medical billing is the process of managing claims with health insurance companies to receive payment for services provided to patients. This includes submitting claims, following up on unpaid claims, and ensuring medical procedures are accurately coded. With many insurers having different requirements, managing this process can be complex and time-consuming for healthcare providers.
At AMedical Billing Services, we simplify this process for healthcare professionals across the U.S. Our team has deep experience in medical billing, coding, and claims management. We understand the ins and outs of insurance claims and work to ensure your practice receives accurate and timely payment.
Benefits of Our Medical Billing Services
These benefits outline how AMedical Billing Services can improve your practice’s financial health, efficiency, and compliance. The service is designed to simplify your billing process while delivering faster, more accurate reimbursements and allowing you to focus on patient care.
1. Maximized Revenue
Our medical billing services help you increase your revenue by ensuring accurate and timely claim submissions. By reducing errors, optimizing coding practices, and improving claim follow-ups, we help you receive the full reimbursement you are entitled to. With fewer claim denials and quicker processing, your practice can maintain a steady income flow.
2. Time and Resource Efficiency
Billing can be time-consuming and complex. Outsourcing your billing allows your staff to focus on patient care and practice management while we handle all the administrative tasks related to billing. You’ll save time, reduce stress, and improve operational efficiency by allowing professionals to manage your billing needs.
3. Reduced Claim Denials
Medical claim denials can lead to delayed payments and financial strain. Our experienced team ensures claims are submitted accurately, reducing the chances of denials. If claims are rejected, we actively work on resolving the issue by appealing, correcting errors, and resubmitting claims. This proactive approach helps ensure you get paid for your services.
4. Improved Cash Flow
With accurate coding, timely submissions, and rigorous follow-ups, our medical billing services can significantly improve your practice’s cash flow. We ensure that claims are processed quickly, and payments are posted promptly, which leads to fewer delays and consistent revenue.
5. Compliance and Reduced Risk
Staying compliant with the latest regulations, such as HIPAA, insurance guidelines, and billing codes, is crucial in today’s healthcare environment. Our team is trained to ensure your billing process adheres to these standards, reducing the risk of penalties or audits. We keep up with changes in the industry to ensure your practice stays compliant at all times.
6. Expertise in Complex Billing
Our team has extensive knowledge in medical billing, including working with different specialties, payers, and insurance plans. Whether you’re a small practice or a larger medical facility, we have the expertise to navigate the complexities of your billing needs, ensuring you get reimbursed quickly and accurately.
7. Scalability
As your practice grows, so do your billing needs. Our services are designed to scale with your practice. Whether you’re adding more providers or increasing your patient base, we can easily adjust our billing services to accommodate changes, ensuring your practice continues to run smoothly.
8. Transparent Pricing
We believe in providing clear and upfront pricing with no hidden fees. Our medical billing services are cost-effective, with pricing that matches the size and needs of your practice. We work with you to ensure that you’re getting value for your investment without unexpected costs.
9. Better Patient Experience
Billing mistakes can lead to confusion and frustration for patients. With our accurate and timely billing processes, patients receive clear and concise statements, reducing confusion and increasing satisfaction. By improving your practice’s billing process, you’ll also improve the overall patient experience.
10. Dedicated Support
With our medical billing services, you’ll have a dedicated team of professionals to support you every step of the way. Whether you have questions about your claims, need assistance with denied claims, or require detailed financial reporting, we’re here to help. Our team is always available to provide reliable support and guidance.
Eligibility and Criteria for Our Medical Billing Services
Who Can Benefit?
Our medical billing services are designed for a wide range of healthcare providers, including:
- Private Practices: Physicians, dentists, chiropractors, and specialists.
- Group Practices: Multi-provider practices looking for scalable billing solutions.
- Hospitals: Large healthcare facilities requiring comprehensive billing management.
- Specialty Care Providers: Clinics or specialists in fields like cardiology, oncology, orthopedics, and more.
- Behavioral Health Providers: Mental health professionals and therapists.
Eligibility Requirements
To qualify for our medical billing services, your practice should:
- Be a licensed healthcare provider or practice.
- Be operating under valid payer contracts and insurance agreements.
- Have a clear billing structure and needs assessment.
- Be committed to improving your revenue cycle management and overall billing efficiency.
If your practice meets these basic requirements, we’re ready to assist you in streamlining your billing and maximizing your revenue
Why Choose AMedical Billing Services?
Managing your medical practice’s billing can be overwhelming, especially with the constant changes in insurance policies, coding standards, and regulatory requirements. Our team at AMedical Billing Services is here to simplify the process and help you achieve maximum reimbursement for your services. With our proven track record of efficiency, accuracy, and compliance, we ensure that your practice remains financially healthy.
Here are some of the reasons why healthcare providers across Alabama, Alaska, Arizona, and all other states choose AMedical Billing Services:
- Expertise Across Specialties: Whether you are a primary care physician, specialist, or a hospital, we understand the unique billing requirements of your practice. Our team is equipped with the knowledge and expertise to handle the billing complexities specific to your medical speciality.
- End-to-End Billing Solutions: From coding and claim submission to denial management and payment posting, we provide a full range of medical billing services. Our goal is to optimize your revenue cycle and reduce administrative burdens.
- Accurate and Timely Billing: At AMedical Billing Services, we understand that accuracy and timeliness are key to ensuring you get paid for the care you provide. Our team adheres to strict billing standards and best practices to ensure that all claims are submitted accurately and on time.
- Compliance and Security: We stay up-to-date with healthcare regulations and requirements, including HIPAA, to ensure that your practice is compliant. Additionally, we use secure systems and processes to protect your patient data.
Our Medical Billing Services Include:
1. Medical Coding Services
Accurate coding is vital for proper reimbursement. Our team of certified coders ensures that all services provided are correctly coded using the latest ICD-10, CPT, and HCPCS codes. We specialize in a variety of coding systems, helping to ensure that your claims are filed correctly the first time.
2. Claim Submission and Follow-Up
AMedical Billing Services streamlines the claims submission process to insurance companies. We ensure that claims are submitted correctly and promptly, reducing the likelihood of delays or denials. If any issues arise, we follow up with the insurance carriers to ensure that your claims are processed efficiently.
3. Denial Management
Claims denials are an unfortunate part of the billing process. Our team is experienced in reviewing denials, identifying the reasons behind them, and taking the necessary steps to resolve them. We work diligently to appeal denied claims and ensure that you receive the reimbursement you deserve.
4. Payment Posting
After your claims are processed, we handle the posting of payments to your accounts. Our team reconciles payments, ensuring that all amounts are correctly applied to the appropriate patient accounts and that any discrepancies are addressed immediately.
5. Patient Billing and Collections
We also assist with patient billing, helping your practice maintain a steady cash flow. We send out patient handle payment collections, and ensure clear communication regarding balances due. Our team works with patients to resolve outstanding balances efficiently.
6. Medical Billing Audits
Regular billing audits are crucial to maintaining compliance and ensuring that your practice is receiving proper reimbursement. Our auditing services review your billing practices and identify areas where improvements can be made to optimize your revenue cycle.
States We Serve
AMedical Billing Services serves healthcare providers across all 50 states. Whether you are located in Alabama, Alaska, Arizona, California, Florida, Texas, or any other state, we are here to help you streamline your billing process and ensure timely payments. We understand the local regulations, insurance policies, and billing requirements for each state, which allows us to offer tailored services that meet your practice’s unique needs.
How It Works
1. Consultation
We begin with a consultation to understand your practice’s specific billing needs, goals, and challenges. This allows us to develop a tailored strategy that aligns with your objectives.
2. Customized Service Plan
Based on the consultation, we develop a customized billing service plan for your practice, outlining the services we will provide and the expected outcomes.
3. Implementation and Management
Once we have your information, we begin managing your billing process. Our team will handle all aspects of your billing, ensuring that claims are submitted accurately and on time, payments are processed efficiently, and any issues are resolved promptly.
4. Ongoing Support
We provide ongoing support to ensure that your practice continues to receive maximum reimbursement. If there are any changes in regulations, coding standards, or insurance policies, we update our processes to remain compliant.
Ready to Optimize Your Revenue Cycle?
At AMedical Billing Services, we are committed to helping healthcare providers across the nation streamline their billing processes, reduce administrative overhead, and improve cash flow. Whether you operate a small practice in Alaska or a large hospital in New York, our team is here to assist you.
Contact us today to learn more about how our medical billing services can help your practice thrive. Our experts are ready to provide you with a comprehensive, customized solution that meets your specific needs.
How We Work
An easy-to-understand explanation of the process:
- Consultation – We understand your billing needs and tailor a solution.
- Document Setup – We gather necessary patient and payer information.
- Claim Submission – Claims are submitted accurately and on time.
- Denial Management & Follow-Up – We handle rejections and ensure claims are paid.
- Ongoing Reporting – Regular updates and reports on the status of your revenue cycle.
Trust Badges or Certifications
Specialized Medical Billing Solutions
Every specialty has unique billing challenges, from complex coding requirements to strict insurance regulations. At AMedical Billing Services, we provide customized billing solutions designed to maximize reimbursement while reducing administrative burdens.
Primary Care & Family Medicine
Focus Areas: Preventive care, chronic disease management, wellness visits
Common Codes: E/M codes (99202-99215), preventive codes (99381-99397)
Challenges: High patient volume, bundling preventive and acute services
Our Solution: Ensure accurate documentation for wellness vs. problem-focused visits, reducing denials
Cardiology Billing
Focus Areas: ECGs, stress tests, echocardiograms, catheterizations
Common Codes: 93000 (ECG), 93306 (Echocardiogram), 92920 (Coronary angioplasty)
Challenges: Time-based and procedure-based coding, prior authorization requirements
Our Solution: Pre-authorizations for high-value procedures, avoiding undercoding for complex treatments
Orthopedic Billing
Focus Areas: Fractures, joint replacements, physical therapy
Common Codes: 29881 (Knee arthroscopy), 20610 (Joint injection), 27130 (Total hip replacement)
Challenges: Correct use of global periods, differentiating post-op follow-ups
Our Solution: Compliance with Medicare’s Global Surgical Package to prevent denials
Mental Health & Behavioral Health Billing
Focus Areas: Therapy sessions, psychiatric evaluations, telehealth
Common Codes: 90837 (60-min therapy), 90791 (Psychiatric evaluation), 96130 (Psych testing)
Challenges: Insurance restrictions on session limits, modifier usage for telehealth
Our Solution: Verify coverage, use GT/95 modifiers for telehealth claims, ensure compliance with parity laws
Chiropractic & Physical Therapy Billing
Focus Areas: Spinal adjustments, rehab exercises, neuromuscular re-education
Common Codes: 98940 (Chiropractic adjustment – 1-2 regions), 97110 (Therapeutic exercises)
Challenges: Strict Medicare guidelines, proving medical necessity
Our Solution: Documentation audits to ensure medical necessity for continued care
Oncology Billing
Focus Areas: Chemotherapy, radiation therapy, infusion services
Common Codes: 96413 (Chemo infusion), 77427 (Radiation therapy management)
Challenges: High-cost treatments, complex prior authorizations
Our Solution: Verify benefits before treatment, detailed coding to prevent downcoding
Radiology & Imaging Billing
Focus Areas: X-rays, MRIs, CT scans, ultrasounds
Common Codes: 70553 (MRI brain), 74177 (CT abdomen/pelvis with contrast)
Challenges: Billing technical vs. professional components, NCCI edits
Our Solution: Ensure correct modifier usage (26, TC) to separate professional and technical fees
Anesthesia & Pain Management Billing
Focus Areas: General anesthesia, epidurals, nerve blocks
Common Codes: 01967 (Epidural for labor), 64450 (Nerve block injection)
Challenges: Time-based billing, proper ASA modifiers
Our Solution: Document anesthesia start/end times, apply base units + time units correctly
Urgent Care & Emergency Medicine Billing
Focus Areas: Acute illness, minor injuries, same-day procedures
Common Codes: 99281-99285 (Emergency visits), 12001 (Wound repair)
Challenges: Point-of-care testing reimbursement, triage-level denials
Our Solution: Ensure correct E/M level selection to maximize reimbursement
Seamless Integration with EMR/EHR Systems
We work with leading practice management systems, ensuring a smooth billing process:
- Epic
- Cerner
- Athenahealth
- Kareo
- AdvancedMD
- eClinicalWorks
Why Choose Our Specialty Billing Services?
✔ Certified Coders – Our team is AAPC/AHIMA certified, ensuring accurate coding.
✔ Denial Prevention & Appeals – We analyze claim trends and appeal when necessary.
✔ HIPAA & Compliance Focused – We stay updated on industry regulations.
✔ Revenue Optimization – We ensure 100% claim accuracy to maximize reimbursement.
Specialized Medical Billing Solutions with Case Study
In addition to our expertise in billing across various medical specialties, here’s a real-world case study demonstrating how our services have improved revenue, reduced denials, and streamlined operations for a healthcare provider.
Case Study: Increasing Revenue for an Orthopedic Practice
Client Profile
- Specialty: Orthopedic Surgery
- Location: Texas
- Practice Size: 4 surgeons, 2 physician assistants (PAs), and 1 physical therapy unit
- Billing Issues:
- High rate of claim denials due to incorrect modifiers
- Underbilling for joint replacement surgeries
- Inconsistent documentation for post-op care, leading to reimbursement delays
Our Approach & Solution
Corrected Coding Errors & Modifier Usage
- Implemented the correct CPT codes & modifiers for surgical procedures
- Applied modifier 57 (Decision for Surgery) for pre-op visits
- Used modifiers 51, 59, and RT/LT appropriately to prevent bundling errors
Improved Documentation for Global Surgical Period
- Educated physicians on proper documentation for post-op follow-ups
- Ensured claims included appropriate E/M codes when post-op care wasn’t bundled
Claim Auditing & Denial Management
- Conducted a retrospective audit of the last six months’ denials
- Appealed improperly denied claims, recovering $120,000 in lost revenue
- Implemented automated claim scrubbing before submission
Revenue Cycle Optimization
- Reduced claim submission-to-payment time from 45 days to 18 days
- Increased practice revenue by 22% within six months
- Maintained an average claim acceptance rate of 98.7%
Results & Key Takeaways
- Faster Reimbursements – Improved documentation and correct coding led to quicker payments
- Fewer Claim Denials – Reduced coding errors and rejections by 85%
- Higher Revenue – Recovered lost income and optimized revenue cycle
Let’s Optimize Your Practice’s Billing
If your medical practice is experiencing claim denials, delayed reimbursements, or compliance concerns, we can help. Our team specializes in:
- Accurate medical coding & compliance
- Denial management & appeals
- Revenue cycle optimization
- Custom billing solutions for all specialties
Contact us today for a FREE Revenue Analysis and discover how we can increase your revenue and reduce billing headaches.
Frequently Asked Questions (FAQs) – Medical Billing Services
What is medical billing, and why is it important?
Medical billing is the process of submitting and following up on claims with insurance companies to receive payment for healthcare services. It ensures that providers are reimbursed accurately and in a timely manner, improving financial stability and cash flow.
How does outsourcing medical billing benefit my practice?
Outsourcing medical billing reduces administrative burdens, minimizes claim denials, ensures compliance with insurance regulations, and accelerates reimbursement. It allows healthcare providers to focus on patient care while experts handle the complexities of billing.
How do I know if my practice is a good fit for your services?
Our services are ideal for private practices, group practices, hospitals, specialty care providers, behavioral health professionals, and urgent care centers. If your practice struggles with claim denials, delayed reimbursements, or compliance issues, we can help.
What types of medical specialties do you support?
We handle billing for a wide range of specialties, including but not limited to: Primary Care & Family Medicine, Cardiology, Orthopedics, Mental & Behavioral Health, Chiropractic & Physical Therapy, Oncology, Radiology & Imaging, Anesthesia & Pain Management, and Urgent Care & Emergency Medicine.
How does your medical billing process work?
Our billing process includes consultation, claim submission, denial management, payment posting, and ongoing support.
How long does it take to process and submit a claim?
We submit most claims within 24-48 hours of receiving complete documentation. The processing time for reimbursement depends on the payer but typically ranges from 7 to 30 days.
What happens if a claim is denied?
If a claim is denied, our team immediately reviews the reason for denial, corrects any errors, and resubmits it. We also handle appeals when necessary to maximize reimbursement.
Do you handle prior authorizations?
Yes, we assist with pre-authorization requests and insurance verification to ensure that services are approved before they are rendered.
Are your billing services HIPAA compliant?
Yes. We strictly adhere to HIPAA regulations and use secure, encrypted systems to protect patient data.
Do you stay up to date with coding and regulatory changes?
Yes. Our team continuously monitors updates to ICD-10, CPT, HCPCS, and payer policies to ensure compliance with industry standards.
Can you help with audits or compliance checks?
Yes. We conduct regular billing audits to identify potential errors, ensure compliance, and prevent issues that could lead to insurance audits or financial penalties.
Do you integrate with my existing Electronic Medical Records (EMR) or Electronic Health Records (EHR) system?
Yes. We work with all major EMR/EHR systems, including Epic, Cerner, Athenahealth, Kareo, AdvancedMD, eClinicalWorks, and more.
Do you provide reports on billing and financial performance?
Yes. We offer detailed financial reports, including claim status, revenue cycle trends, and denial rates, to help you make data-driven decisions for your practice.
How much do your medical billing services cost?
Our pricing is transparent and customized based on your practice’s size and billing needs. We typically charge a percentage of collected revenue or a flat monthly fee, depending on your preference. There are no hidden fees.