Medical Billing FAQs

Medical billing is the process of submitting and following up on claims with health insurance companies to receive payment for services rendered. It involves charge entry, coding, claim submission, payment posting, and AR follow-up.

Medical billing involves submitting claims and handling payment processes, while medical coding is the translation of diagnoses and procedures into standardized codes (like CPT, ICD-10).

Clean claims are those submitted without errors or omissions and are processed without the need for additional information.

Common causes include coding errors, eligibility issues, missing information, and lack of prior authorization.

Most commercial insurers pay within 15–45 days of claim submission. Government payers like Medicare may take 10–30 days.

Our full-service billing includes eligibility verification, prior authorizations, charge entry, coding, claim submission, denial management, payment posting, AR follow-up, and credentialing.

Yes. While we recommend full-service billing, we also offer standalone services such as credentialing and coding support based on client needs.

Absolutely. We customize our offerings to align with your practice needs.

Yes, we work with the most popular EHRs and billing systems. Our team adapts to your existing setup.

Yes, we specialize in mental health billing and understand the unique documentation, CPT codes, and payer policies involved.

Oncology billing often involves more complex treatments, drug codes, and payer pre-authorizations. We tailor our process to each specialty.

Yes. We manage prior authorizations, CPT coding, and payer-specific rules for physical therapy practices.

Definitely. Our workflows are scalable and designed to support single-specialty or multi-specialty groups.

Credentialing is the process of verifying a provider’s qualifications with insurance networks. It's necessary for in-network participation and reimbursement.

It usually takes 60–90 days, depending on the payer and completeness of documentation.

Yes, we manage all phases of credentialing: initial, recredentialing, and revalidation.

You can, but you may not receive reimbursement until credentialing is complete. Some payers allow retroactive billing.

We investigate the reason, correct the issue, and resubmit or appeal the claim promptly.

Our AR team reviews aging reports, contacts payers, and documents every interaction to ensure timely resolution.

We review denial codes, identify trends, fix underlying issues, and submit corrected claims or appeals as needed.

Typically, less than 20% of your AR should be over 90 days old. We aim to keep it lower.

Yes. We follow strict HIPAA guidelines and conduct regular audits to protect PHI.

We use secure file transfer protocols, access controls, and encrypted communication tools.

We use encrypted platforms and limit access to authorized team members only.

Yes. We provide BAAs to ensure full HIPAA compliance in all data exchanges.

Pricing depends on claim volume, specialty, and scope. We offer both percentage and flat fee models.

We offer both. You can choose based on what works best for your practice.

No. We offer flexible agreements, including monthly and quarterly options.

Simply contact us through our website or call our team. We'll schedule a discovery call and start with a tailored proposal.