MedCare Billing Solutions offers full-service revenue cycle management services designed to maximize reimbursements, prevent claim denials, and streamline your practice's financial operations.
Insurance eligibility verification is the foundation of a healthy revenue cycle. Confirming coverage before each encounter prevents denials at the source â before a claim is ever submitted.
Our team verifies active coverage, benefits, deductibles, copays, coinsurance, and prior authorization requirements in real time using direct payer connections. We support all major payer portals and 270/271 EDI transactions.
Accurate medical coding is the difference between a paid claim and a denied one. Our AAPC and AHIMA-certified coders are experts in CPT, ICD-10-CM, HCPCS Level II, and E/M coding across 25+ specialties.
Our proprietary AI coding assistant pre-reviews all documentation, flagging potential errors, upcoding risks, and missed codes before your certified coder finalizes the submission. This dual-layer approach delivers our industry-leading 98% clean claim rate.
Speed and accuracy in claims submission directly impact your cash flow. We submit electronic claims (EDI 837) within 24 hours of encounter documentation, with real-time status tracking from submission to payment.
Our team monitors claim statuses daily, proactively following up with payers on any claims approaching filing limits or showing no movement. We track every claim through to final resolution â paid, adjusted, or appealed.
Denied claims represent lost revenue that most practices never fully recover. Our dedicated denial management specialists analyze every rejected claim, identify root causes, and file targeted appeals â all within payer deadlines.
We track denial patterns over time to identify systemic issues â whether they're coding-related, authorization-related, or eligibility-related â and implement process changes that reduce future denial rates by up to 40%.
Aging AR is a silent revenue killer. Our accounts receivable specialists work all outstanding balances systematically â from current to 120+ day aging buckets â using persistent payer follow-up, patient billing, and escalation protocols.
Our clients consistently achieve industry-leading AR days of 18 days or fewer, compared to a national average of 35â45 days. We also handle patient statements, payment plans, and manage sensitive collections with compliance and compassion.
Credentialing delays mean revenue delays. Our credentialing specialists manage the entire provider enrollment process â from initial application to approval â for Medicare, Medicaid, and all major commercial payers.
We handle CAQH profile creation and maintenance, group enrollment, re-credentialing cycles, and payer contract management. Our average credentialing completion time of 3 weeks beats the industry average of 90+ days.
Our teams are organized by specialty, ensuring your billing is handled by experts who understand your specific procedures, payer contracts, and compliance requirements.
Complex cardiac coding for cath, EP, and imaging procedures.
View Cardiology Billing âSurgery, sports medicine, and joint replacement billing.
View Orthopedic Billing âEEG, EMG, neurology consults, and infusion coding.
View Neurology Billing âChemo, radiation, and oral oncology drug billing.
View Oncology Billing âSurgical and vision procedure billing expertise.
View Ophthalmology Billing âPsychiatric, substance abuse, and telehealth billing.
View Mental Health Billing âWell-child visits, vaccines, and developmental screenings.
View Pediatric Billing âRespiratory therapy, sleep studies, and PFT billing.
View Pulmonology Billing âComprehensive primary care and chronic disease management.
View Internal Medicine Billing âDental surgery and jaw reconstruction billing.
View Oral & Maxillofacial Billing âSkin procedures, biopsies, and Mohs surgery billing.
View Dermatology Billing âUnified billing across providers and service lines.
View Multi-Specialty Groups Billing âPreventive care, chronic disease, and acute care coding.
View Family Practice Billing âEndoscopy, colonoscopy, and GI procedure billing.
View Gastroenterology Billing âSurgical, diagnostic, and oncologic urology billing.
View Urology Billing âHigh-volume walk-in clinic billing and facility fee coding.
View Urgent Care Billing âSpinal manipulation billing and Medicare AT modifier compliance.
View Chiropractic Billing âPT/OT billing, functional limitation reporting, PQRS.
View Physical Therapy Billing âOur billing specialists will analyze your current revenue cycle and recommend a customized solution â for free, with no obligation.
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