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Clean Claims. Fast Payment. Zero Compliance Risk — That's Our Billing Standard

Every claim that leaves our system is scrubbed, validated, and formatted to the exact specification of the receiving payer. Our CPB-certified billers don't just submit claims — they engineer payment.

What We Do

Our billing team performs meticulous charge entry — converting coded encounters into billable claims with all required data elements: provider NPI, place of service code, date of service, referring provider information, claim frequency code, and all diagnosis-procedure linkages. Every field is validated against payer-specific requirements.

Before any claim is transmitted, it passes through our multi-layer scrubbing: CCI Edit Check for unbundling violations, LCD/NCD coverage verification, modifier validation, fee schedule application, duplicate claim detection, and required field validation.

We submit all claims electronically via HIPAA-standard EDI 837 transaction sets through integrated clearinghouse connections (Availity, Change Healthcare, Waystar, Trizetto). Electronic submission dramatically reduces processing time. When payers require paper (CMS-1500 or UB-04), we produce, audit, and mail with tracking.

Every major insurance company has unique billing requirements. Our billing team maintains a current library of payer-specific billing guidelines and applies them to every claim. Missing a payer's timely filing deadline is a non-appealable denial. Our system tracks every deadline.

Once primary payer processes, secondary and tertiary claims are submitted with the primary EOB attached. Our CPB-certified specialists hold the AAPC's gold standard credential for insurance billing expertise.

What's Included

Charge Entry & Validation

Meticulous data element verification

Multi-Layer Claim Scrubbing

CCI, LCD/NCD, modifier, fee schedule checks

Electronic Submission (837)

All major clearinghouses integrated

Payer-Specific Guidelines

Current rules for every major payer

Timely Filing Management

Zero missed deadlines

Secondary/Tertiary Billing

Complete COB billing sequence

Why This Matters for Your Revenue

0.7%
First-pass acceptance rate
0-48 hrs
Average submission turnaround
0%
Timely filing deadline miss rate
FAQ

Frequently Asked Questions

We work with all major clearinghouses including Availity, Change Healthcare, Waystar, and Trizetto, selecting the optimal channel for each payer.

Claims are typically submitted within 24-48 hours of receiving coded encounters, ensuring maximum timeliness.

Rejections are corrected and re-transmitted within 24 hours. We track rejection patterns to prevent recurring issues.

Yes, we handle professional (CMS-1500) and institutional (UB-04) claim formats for all practice and facility types.

We stay current on evolving telehealth billing requirements including place of service codes, modifier 95, and payer-specific telehealth policies.

Yes — commercial, Medicare, Medicaid, Tricare, workers comp, auto, and all state-specific programs.

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