Healthcare practices need to carry out their medical billing tasks efficiently to obtain prompt and timely payment. Professional medical billing management services go a long way when it comes to submitting accurate claims and ensuring a better cash flow. Moreover, honest and accurate billings are a priority for virtually every healthcare provider organization.

A medical billing company can provide a whole array for professional medical billing solutions.

  • The service provider takes care of enrollment into the billing system by entering patient demographic information as well as insurance details.
  • The insurance information is verified to ensure that the patient is a plan member and has adequate coverage. Benefits and scope of services covered are scrutinized. The payer may be requested for details such as eligibility dates, requirements for pre-authorizations, deductibles, Imedical Healthcare Solutions copayments, and so on. Availability of secondary coverage may also be examined. Authorizations are also verified on diagnosis and the CPT codes describing procedures.
  • Accurate coding services are provided for all medical specialties. Professional coders ensure that the correct codes are used for diagnosis and treatment. Inaccurate coding is one of the main reasons for claim rejection. The specialists take care to avoid upcoding – use of a billing code that warrants a payment rate that is higher than that of the service provided. Errors in coding can results in physicians being accused of fraud. Coding services offered would include:
    • Hospital / in-patient coding
    • Emergency room e-code evaluation
    • Medical coding audits
    • Backlog coding resolution services
    • DRG/ICD-9-CM coding validations
    • CPT medical coding
    • ASCs – Ambulatory Surgical Centers Coding
    • ICD-9 coding based on AMA and CMS guidelines


Other important services included in the medical billing and management services package are billing and reconciling of accounts and Accounts Receivable collection. The experts that the medical billing company has on its team follow up on unpaid claims and go all out to maximize payment collection from insurers as well as patients.

Advantages of Partnering with the Right Medical Billing Company

Healthcare practices should always take care to partner with a HIPAA-compliant company. This would ensure the safety of sensitive patient information in accordance with federal regulations. All records would be maintained in electronic format. Other important things to look for

  • Solutions in quick turnaround time
  • An exclusive manager on each client project
  • Periodical reports and analysis
  • Regular QA checks for all processes
  • System based eligibility checking
  • System based claims scrubbing
  • Quarterly coding updates
  • No long term yearly contracts