Frequently Asked Question

Medical billing is a major part of the overall healthcare network. The network encompasses everything from medical insurance to patient care best practices, hospital facilities, and private practices. Health billing systems are multifaceted and can be split into three basic types:

1. Closed System

A closed billing system does not allow transfers of medical information between facilities or providers. It is designed for use within a single organization. A common example is the use of EMRs (Electronic Medical Records), which are digital versions of paper charts in a clinician's office. EMRs are self-contained and not shared with external parties such as labs or other physicians.

2. Open System

An open billing system supports the sharing and transfer of data across different healthcare providers and facilities. EHRs (Electronic Health Records) are an example of an open system, enabling collaborative care. Software platforms like AllMeds, ADVANCEDMD, GE Centricity, and McKesson typically support open systems. While open systems improve coordination, they must be carefully managed to comply with HIPAA and protect patient privacy.

3. Isolated System

Isolated systems are completely separate from healthcare providers and facilities. Personal Health Records (PHRs) fall into this category and are maintained by patients themselves. While PHRs help patients manage their health information, they are not official medical records and cannot legally replace EMRs or EHRs. They can, however, be used to support medical documentation when integrated correctly.

Each billing system has its own strengths and limitations. The right choice depends on the practice's workflow, collaboration needs, and privacy preferences. After selecting the appropriate type, you can move forward with choosing the best software solution to support your billing system.

We have spent years perfecting our service and process so we can deliver world-class service at all times. Our services include:

1. Patient Enrolment

We enter patients into the billing services management system. After verifying missing information, we gather all necessary demographic data for accurate billing.

2. Insurance Verification

To ensure payments for services provided, our expert team verifies patient eligibility and keeps your practice updated on visit statuses.

3. Authorizations

We proactively handle insurance authorizations for procedures and services, ensuring that you are covered and reimbursed appropriately.

4. Medical Coding

Our certified coders are proficient across specialties and coding systems including DRG, ICD-10-CM, CPT, E-codes, HEDIS, and audits — ensuring precise documentation.

5. Medical Billing

As one of the largest US medical billing firms, we handle Medicare, Medicaid, Workers’ Compensation, No-Fault/PI, and major commercial insurance billing with unmatched accuracy.

6. Payment Posting

We ensure all insurance and patient payments are properly posted, line-by-line, to avoid revenue loss and ensure every payment is accounted for.

7. Account Receivables (A/R) Management

Our skilled A/R team handles collections and negotiations with insurance providers, answering claims and customer queries to reduce aging receivables.

8. Reporting

Transparency is key. We provide easy-to-understand, customized reports and assign Revenue Cycle Management (RCM) managers to regularly meet and update you.