You have examined the patient. Documentation complete. Now here’s the bit that has nothing to do with medicine: being paid for it.
That’s the purpose of Health XRCM. We take care of everything involved in medical billing from the visit date to payment. We verify coverage, code the interaction, file the claim, follow up with the payer and manage denials when they occur. You receive your team’s time back, and your claims get the consideration they deserve.
We’re a U.S. based medical billing company with a qualified team behind every account. Our mission is simple – file claims quicker, reduce denials and earn your reimbursements sooner.
Faster claims go out. Charges don’t wait in line for someone to come along. When a visit is documented we code it, verify it and electronically send it. The first claim that hits the payer will begin processing first.
Less denials to battle. Most denials are from modest, mundane blunders. A mistyped digit in an insurance number. A procedure that required pre-authorization and was not approved. A modifier that was left out. We check for these errors before the claim leaves, because it is a lot easier to correct a claim before submission than it is to appeal a claim after refusal.
Payments come earlier. Filing a claim is just the first half of the war. Somebody’s have to post the payment, catch an underpayment, and chase when a claim goes silent. We stick with that from beginning to end.
There are many medical billing companies who declare they can perform the job. Here’s what we think really counts.
Our professionals have been in the patient-care business so they understand what a provider’s documentation is meant to say and how it relates to reimbursement.
Salaries, benefits, software, training, it all adds up quickly. When you outsource your provider billing services, you’re usually paying for results, not all that overhead.
Your code, submission and follow-up all live in one spot, so problems don’t get lost across departments.
We tell you how claims are progressing, what is being refused and where the money is.
Less time on hold with insurance companies, more time for patients.
Insurance eligibility and verification of benefits Review of coordination of benefits Prior authorization assistance
Code review and charge entry Claim scrubbing & clearinghouse submission CMS-1500 and UB-04 forms for paper and electronic claim submissions Monitoring of timely filing deadlines
Payment posting/reconciliation Denials and appeals analysis A/R follow-up and underpayment review Patient statements & follow up on balance
Regular Performance Reporting
If you are torn between hiring a biller and outsourcing, here’s an honest side-by-side comparison.Billing in-houseCost of Outsourcing with Health X-RCMSalaries, benefits, software licenses, training, and office space A service cost without the overhead of employing a billing team.
Coverage Slows or stops when your biller is out sick, on vacation, or leaves A team manages your account, so work continues.
Expertise Depends on who you can hire and keep Certified professionals who work only on billing.
Payer changes You have to keep up with them yourself Handled by the billing team as part of the job.
Staff focus Front-desk and clinical staff get pulled into billing tasks Your staff keeps focused on patients.
Reporting Usually produced by hand, whether built at all Regular reporting on claims, denials and A/R
We submit claims to Medicare, Medicaid, and commercial insurance carriers. They all have their own regulations, edits and deadlines. For example, Medicare typically requires claims to be submitted within 12 months of the date of service, and many commercial payers offer you far less time. It’s natural to keep an eye on those windows.
We work with ICD-10-CM for diagnoses, CPT for procedures and services, and HCPCS Level II for supplies, drugs, and other items outside CPT.
Billing means handling protected health information, and HIPAA governs how that data must be protected. Any billing partner with access should have a Business Associate Agreement and should handle patient data with care at every stage from the first claim to the last report.
If unpaid claims and billing paperwork are eating into your practice, it's worth a chat. Schedule a meeting with the Health XRCM team and we’ll show you how our medical billing services may match your practice.
These are the services that get a provider paid for care already rendered. That includes everything from verifying insurance, coding visits, submitting claims, posting payments, working denials, following up on unpaid claims, and billing patients for their portion.
By fixing the problems before the claim is filed. Checking eligibility, confirming authorizations, evaluating codes and modifiers, and scrubbing against payer restrictions all lessen the odds of a refusal.
Depends on the company and your profession. Many providers find outsourcing costs less than keeping an in-house billing team once they add up salary, benefits, software, and training.
It depends on the size of your practice and the systems involved. A transition typically includes setting up access to your EHR or practice management system, connecting to a clearinghouse, loading your fee schedules, and deciding how claims already in progress will be handled.
