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Medical billing is the process of translating the care a provider delivers into a claim, submitting that claim to the responsible payer, and following it through to payment. It covers patient and insurance information capture, charge entry, coding review, claim submission, payment posting, denial handling and collection of any remaining patient balance.

A medical billing company takes on the administrative work of getting a practice paid. That typically includes eligibility verification, coding support, claim preparation and submission, payment posting, denial and appeal work, accounts receivable follow-up, patient billing questions and reporting on how the revenue cycle is performing.

Revenue Cycle Management (RCM) is the end-to-end management of a patient's financial encounter — from scheduling, registration and eligibility verification, through coding, claim submission and adjudication, to payment posting, denial resolution, accounts receivable and final collection. Billing is one part of RCM; RCM is the whole cycle and the reporting around it.

We work denials from both ends. Existing denials are triaged by reason code, payer and dollar value, then corrected, rebilled or appealed where appropriate. At the same time we categorize denial reasons to find the pattern behind them — an eligibility step being skipped, a modifier applied incorrectly, a payer policy that changed — and address it in the upstream workflow so the same denial stops recurring.

Yes. We provide CPT, HCPCS Level II and ICD-10-CM coding support, including modifier review and feedback to providers when documentation does not support the code being billed. Coding is applied with the specialty-specific conventions and payer policies relevant to your service lines.

Yes. We verify active coverage, plan-level benefits, patient responsibility such as copays and deductibles, and whether a service requires prior authorization. Because a large share of preventable denials originate before the visit, verification is one of the highest-value steps in the cycle.