Our services include fully managed solutions for billing, coding, benefits management, prior authorizations, credentialing, accounts receivable (AR), and support from virtual assistants. Additionally, we offer comprehensive bookkeeping and payroll services.
We proactively identify and resolve global billing conflicts early, diligently monitor payer trends across your contracts, and maintain disciplined accounts receivable follow-up to ensure that insurance receivables remain low and predictable. While you focus on serving your community, we safeguard the revenue that makes it all possible.
We offer comprehensive management of hospital and insurance credentialing, along with efficient scheduling for surgeries and new patients. Our services include coding compliance oversight and governance dashboards that provide you with clear visibility into revenue performance — analyzed by provider, location, and payer. Every appointment, every claim, and every provider credential is meticulously managed, empowering your group to grow with confidence.
Running a practice solo means wearing too many hats. We work alongside you as a fractional practice management and revenue cycle management (RCM) partner — handling insurance credentialing, billing, coding, prior authorizations, and accounts receivable (AR) follow-up so seamlessly integrated that it feels like your own in-house team. You get expert operations without the overhead of building one.
From the moment a referral arrives, we manage the process seamlessly. We coordinate with your Director of Nursing, the referral source, and the patient to get the appointment scheduled. After that, we verify benefits, handle prior authorizations, and track unit utilization throughout the care episode. With most members limited to 60 authorized units per year, proactive authorization management is essential — it’s crucial for keeping your agency financially healthy.
Every radiology study begins with a referral and culminates in reimbursement — but numerous issues can arise in between. We efficiently receive and coordinate incoming referrals, verify patient benefits prior to the study, and manage prior authorizations to ensure that your imaging center never performs a scan that won't be reimbursed. Our billing specialists expertly handle the complete claim lifecycle across various payers, guaranteeing accurate coding and prompt reimbursement for every modality you provide.
The financial impact of a single denied claim for an ASC center is significantly greater than that of other billing processes. Given the high costs associated with surgery fees, a single coverage oversight can result in thousands of dollars lost. To mitigate this risk, we verify benefits prior to scheduling the procedure, ensuring that the correct diagnosis and CPT codes receive authorization. Our expert coders manage multi-specialty surgical claims across various payers, submit them promptly, and maintain a disciplined accounts receivable follow-up process, ensuring your receivables remain stable.
PHP and IOP billing represent one of the most complex processes, including bundled reimbursement and intense scrutiny from payers regarding medical necessity. We verify benefits as part of every authorization request and identify documentation issues. A frequent trigger for denial in these programs is the copying of clinician notes from one date of service to another. By catching this at the authorization stage, we effectively protect revenue before it becomes at risk.
In my 30 years of experience, I have found the best medical billing company.
You can always count on MediCommerce for upfront and honest service.
This partnership is characterized by being both responsive and supportive, which contributes to its overall success.
Timeliness is crucial, and being reliable and dependable is essential.
They actively listen to you and present all the available options, empowering you to make the best decision.
This experience was phenomenal and had a positive impact.
The process is easy, ensuring effective communication and a timely turnaround.
