Niche & Specialized Billing
Billing services tailored to specific industries or complex use cases, requiring deep domain knowledge and custom workflows. Designed to ensure accuracy, compliance, and optimized revenue for specialized operation
Commercial Insurance Billing & Collections
We navigate the specific policies of private payers like Aetna, Cigna, UnitedHealthcare, and BCBS to maximize reimbursement rates. Commercial carriers often have unique coverage rules, pre-determination requirements, and fee schedules that differ significantly from government programs. We tailor our billing and follow-up strategies to align with these specific carrier guidelines, ensuring that you receive the full negotiated rate for every service rendered without unnecessary delays.
Provider Credentialing & Payer Enrollment
Complex Documentation Management
We prepare and manage all required injury-related documentation, ensuring accurate proof of causality and medical necessity for worker’s compensation claims.
Multi-Party Communication Coordination
We act as the central point of contact between employers, insurance adjusters, and attorneys to keep claims moving efficiently.
Lien Handling & Negotiation
Our team manages lien filings and negotiations to secure payment for services that fall outside standard health insurance processes.
State-Specific Compliance & Filing
All required state-specific forms are completed and submitted correctly, ensuring your practice is properly compensated for high-effort injury cases.
Dental Billing
We manage CDT coding and cross-coding for oral surgery, ensuring you capture revenue from both dental and medical plans. Many oral health procedures qualify for medical coverage, but they require distinct coding expertise to navigate the gap between the two systems. We analyze each case to determine the optimal billing pathway, handling pre-determinations and specific clauses to maximize patient benefits and provider reimbursement.
Pharmacy Billing
We handle Point-of-Sale (POS) adjudication and resolve rejection codes like “Refill Too Soon” or “Prior Auth Required” to protect pharmacy margins. In an industry facing tightening reimbursements and DIR fees, real-time accuracy is essential. We troubleshoot adjudication errors immediately to prevent revenue loss at the counter, ensuring that you recover the full drug cost plus dispensing fees.
