Fast, Smart, and Compliant-Driven Medical Billing Services

End claim denials, streamline collections, and gain real-time performance insights.

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Medical Billing Services

The complexities of medical billing, especially the errors, compliance risks, claim denials, and delayed reimbursements, can drain productivity, hinder revenue generation, and most importantly, lose patient trust. We provide accurate medical billing services that help us serve hospitals, private practices, urgent care centers, and specialty clinics with medical billing solutions. We ensure optimal revenue cycle management with ICD-10/CPT/HCPCS coding, charge entry, claim scrubbing, AR follow-up, denial management, and compliance reporting. With minimal denials, optimal revenue, and total compliance over your billing operations, we guarantee clean claim rates, payer-specific edits, rapid reimbursement cycles, and complete regulatory compliance.

MBE Statistics

Medical Billing Services We Offer

We provide medical billing for hospitals and other healthcare providers to ensure a higher clean claim rate and significantly minimize downstream denial management efforts by reducing first-pass rejections. Here’s what you can do with our comprehensive list of services:

Claims Submission and Processing
Claims Submission
and Processing

We manage every aspect of claim generation, including data validation against payer requirements, and electronic and paper claim submissions for optimal management.

Coding and Documentation
Coding and Documentation

Our certified medical coders assign appropriate ICD-10, CPT, and HCPCS Level II codes, based on clinical documents, to fulfill compliance needs and accurate charge capture.

Denial Management and Appeals
Denial Management and Appeals

We identify and categorize denial codes and payer feedback;root trends and we then execute structured appeals by resolving rejections faster through corrections, documentation support, and timely resubmission.


Payment Posting and Reconciliation
Payment Posting and Reconciliation

We accurately post all payments (ERA and EOB) at the claim level with all associated adjustments and write-offs by identifying funded reimbursements and billed amounts.

AR Follow-up & Denial Management
AR Follow-up & Denial Management

We actively track and manage unpaid claims per aging bucket by performing payer-specific follow-ups, escalations, and resolutions to recover outstanding balances efficiently and reduce days in AR.

Comprehensive Reporting
Comprehensive Reporting

We provide actionable reports such as clean claim rates, denial percentages, aging summaries, and net collection ratios to measure performance and compliance with set benchmarks.


Patient Billing and Inquiries
Patient Billing and Inquiries

We produce accurate, easy-to-understand patient statements, and address incoming billing queries with complete transparency—explaining insurance benefits, co-payment requirements, and outstanding balances.

Insurance Verification and Eligibility
Insurance Verification and Eligibility

We check insurance eligibility, plans, co-pay amounts, and any pre-authorizations needed before submitting claims, ensuring correct billing and minimizing potential denials.

The ORCM Advantage

With us, healthcare providers can reduce denials, reconcile revenue more quickly, and stay audit-ready with compliance thanks to operational agility and payer alignment provided at every step of the medical billing cycle.

On-Demand Scribe-Plus-Service
Comprehensive Lifecycle Management
We take care of the complete billing cycle from charge entry to billing collection, ensuring no claims are neglected, underpaid, or unjustly written off.
Data-Driven Quality Review
Payer-Specific Claim Scrubbing and Edits
Our pre-submission edits undergo payer-specific scrubbing and ensure industry-specific billing rules and coding practices, ensuring higher first-pass acceptance and decreasing the chances of denial further down the line.
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Advanced Collections and Aging Balance Strategy
We optimize the collection of aging accounts by categorizing them based on age and balance, focusing on high-value and time-sensitive claims first, thus collecting more while reducing bad debt and improving recovery rates across all aging categories.
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Specialty-Aligned Coding Accuracy
We achieve compliant-maximized reimbursement across the clinical spectrum when our certified coders apply specialty-specific modifiers, bundling, and global period tracking.
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Integrated denial resolution appeals workflow
Resolved and analyzed appeals, incorporated denial and underpayment root cause analysis, counted documentation resubmission, and escalation to the payer.
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Daily Remittance and Overpayment Matching
We achieve financial precision by monitoring the line-pay, tracking underpayment, and discrepancy flagging in real time.
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Insurance Verification with Pre-Authorization Triggers
To avoid scheduling or billing conflicts due to eligibility or authorization rejections, we verify coverage details and assess eligibility for pre-authorization requirements.
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Compliance and Security
Our SOC 2 / ISO 27001 certifications validate data protection protocols to ensure HIPAA compliance, secure transmission, and audit readiness.
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Transparent RCM Metrics and Compliance-Ready Reporting
Our reporting suite offers a comprehensive overview of active claims, denial rates, and collection efficiency, providing real-time reporting and supporting audit readiness, thereby enabling compliance-driven strategic financial planning.

Our Medical Billing Company’s Process Flow

Data Collection and Aggregation
01
Patient Data & Insurance Verification
Coding and Documentation
02
Medical Coding & Charge Entry
Claim Submission
03
Claims Scrubbing & Submission
Follow-Up and Denial Management
04
Payment Posting & Reconciliation
Payment Posting and Reconciliation
05
AR Follow-Up & Denial Management
Payment Posting and Reconciliation
06
Reporting & Performance Optimization

Additional Services We Offer as Medical Billing Providers

Healthcare Data Entry Services

We accurately enter and digitize patient records, clinical data, and insurance information to ensure error-free documentation for glitch-free healthcare operations.

Medical Transcription Services

Our transcription specialists convert voice-recorded clinical notes into structured, compliant medical documents with specialty-specific terminology accuracy.

Healthcare Analytics Services

Our data-driven insights from clinical, operational, and financial datasets improve patient outcomes, optimize workflows, and enhance revenue cycle performance.

Healthcare Call Center Services

Our HIPAA-compliant patient communication support includes appointment scheduling, inbound inquiries, and medical information assistance to enhance patient engagement and service delivery.

Unlocking Success: Inspiring Case Studies on Healthcare Offshore Service

Check how we have handled past projects with expertise and professionalism.

case study

Comprehensive Back Office Support for a Health Insurance Company in California

case study

Optimized Billing Service by using Medisoft Software, for an internal medicine practice in Florida, specialized in non-surgical illnesses

case study

Expert Management of Extensive Healthcare Records & Customer Support for a USA-based Healthcare BPO

Simplify medical coding and billing with our expert services. Let us transform your healthcare billing for success!

FAQs

What is your company’s first pass claim acceptance rate on average, and what steps are taken to maintain it?
We achieve high first-pass acceptance rates through payer-specific claim scrubbing, real-time edits, and compliance-centric coding accuracy. Clearinghouse rejection monitoring safeguards scrubbing feedback loops.
What approach do you take to resolve multi-payer, multi-specialty claim issues?
Our medical billing firm retains compliance with specialty-level coding guidelines, enforces modifier accuracy, and houses custom libraries for each recognized payer, which allows for tailored claim processing for multiple specialties and insurance providers.
What approach is taken to track and resolve recurring denial issues?
We analyze the root cause of denial with remittance advice codes, trends, and aging summaries to assess denial mandates. Workflow steps undergo precise adjustments to mitigate future denial occurrences.
What steps are taken to ensure HIPAA and CMS compliance?
We update policies, adjust billing workflows according to regulatory changes, and perform internal audits to enforce compliance with HIPAA and CMS during policy shifts and regulatory amendments.
Do you provide detailed reporting beyond the standard RCM KPIs?
Yes, we do. We provide comprehensive reports containing payer mix profitability, reimbursement variance by CPT code, and encounter lag analysis to enable strategic financial forecasting.
How do you integrate with our existing EHR/PM system?
We work with your system’s onsite or cloud-based workflows and customize data mapping, claim submission, and reporting to maintain workflow continuity in the clinical areas.
How do you handle underpayments and contract variance discrepancies?
We calculate remittance variances against fee schedules, isolate discrepancies, and initiate remedies while adhering to the payer's contractual obligations.
Are you able to quickly scale operations during seasonal or volume increases?
Absolutely. Our recruitment strategy and agile workflow processes enable scaled precision, speed, and regulatory adherence during set seasonal and volume increases.
How do you maintain oversight on outsourced accounts receivable and billing functions?
We offer secured access to claim, account receivable aging, and real-time payment posting information. Together with regular strategy and performance alignment calls, we ensure seamless function.