Medical Billing
Billing
At HealthsDriven, we help healthcare providers navigate claim submission, payer credentialing, denial management, and revenue cycle optimization — so you can focus entirely on delivering exceptional patient care while we maximize every dollar you've earned.
Medical Billing Services We Provide
We support healthcare providers across every specialty with accurate, compliant, and revenue-maximizing billing services — from first claim submission to final payment collection.
Built for Healthcare Providers at Every Stage
Whether you're a solo practitioner just getting credentialed or a multi-location group practice managing thousands of claims monthly, HealthsDriven provides the billing infrastructure to protect and grow your revenue.
Solo & Small Group Practices
We handle your full revenue cycle so you can practice medicine without the administrative burden — from credentialing your first payer contracts to collecting on your last outstanding balance.
Growing Multi-Location Groups
Expanding to new locations or adding providers? We scale your billing operations, standardize your coding protocols, and ensure every new site is enrolled and billing on day one.
Hospitals & Health Systems
Reduce AR days, improve clean claim rates, and strengthen denial recovery across your entire facility — with specialty billing expertise across every department and service line.
Everything Your Practice Needs to Maximize Revenue
From credentialing your first payer contract to recovering your oldest unpaid claims — we provide the systems, expertise, and support to optimize every stage of your revenue cycle.
End-to-End Revenue Cycle Management
We manage your entire revenue cycle from patient registration and eligibility verification through charge capture, claim submission, payment posting, and final collections — so no revenue slips through the cracks.
- Insurance eligibility & benefits verification before every visit
- Charge capture review & fee schedule optimization
- Electronic claim submission to all payers within 24 hours
- Payment posting, ERA reconciliation & balance resolution
Provider Credentialing & Enrollment
Getting credentialed is the gateway to getting paid. We manage your payer enrollment applications, follow up on approvals, and ensure every provider in your practice is contracted and ready to bill from day one.
- Medicare & Medicaid provider enrollment & PECOS management
- Commercial payer & MCO contracting applications
- CAQH profile creation, maintenance & attestation
- Re-credentialing tracking & expiration monitoring
- Group & individual NPI registration & taxonomy updates
Denial Management & AR Recovery
Every denied claim is lost revenue waiting to be recovered. Our denial management team identifies root causes, corrects and resubmits claims, and pursues formal payer appeals to recapture every dollar owed to your practice.
- Denial root-cause analysis & prevention strategy
- Corrected claim resubmission within payer timely filing limits
- Formal first-level & second-level payer appeals
- Aged AR review & prioritized recovery on high-balance claims
- Monthly denial trend reporting with actionable insights
Medical Coding & Compliance Audits
Accurate coding is the foundation of maximum, compliant reimbursement. Our certified coders review your documentation, assign the most specific codes available, and audit your existing records to identify undercoding and compliance risks.
- ICD-10-CM, CPT & HCPCS Level II coding by certified coders
- E&M level optimization & documentation improvement guidance
- Prospective & retrospective coding audits
- Modifier application review & bundling/unbundling analysis
- OIG compliance risk assessment & corrective action planning
From Onboarding to Optimized Revenue — in Weeks
Our proven 4-step process gets your claims flowing, denials shrinking, and collections growing faster than any in-house billing team could achieve.
Free Revenue Cycle Assessment
We audit your current billing performance, payer mix, denial rate & AR aging. No cost, no commitment required.
Credentialing & System Setup
We handle payer enrollment, EHR/PM integration & coding protocol setup while recovering your oldest outstanding claims.
Claims Go Live & AR Improves
Clean claims submit daily. Denials drop. Aged AR shrinks. You receive weekly performance reports from your dedicated billing team.
Continuous Optimization
Monthly reviews, payer contract renegotiation support & coding updates keep your revenue cycle performing at its peak.
Why Healthcare Providers Choose HealthsDriven
We combine deep medical billing expertise with a hands-on, provider-first approach — so you get measurable revenue results, not just outsourced paperwork.
Specialty-Dedicated Billing Teams
Your claims are handled by coders and billers who specialize in your specific specialty — not a generalist team applying one-size-fits-all billing rules to complex clinical documentation.
All 50 States & All Major Payers
We bill across all 50 states with established relationships and payer-specific expertise covering Medicare, Medicaid, all commercial plans, VA, and managed care organizations.
98% First-Pass Claim Rate
Our pre-submission claim scrubbing and coding review process catches errors before they reach payers — resulting in faster payments, fewer denials, and lower rework costs for your practice.
100% HIPAA Compliant
Every process — from claim data handling to patient billing — operates within a fully HIPAA-compliant framework with BAAs in place, SOC 2 security controls, and encrypted data transmission.
Fast Onboarding & Quick Wins
Most providers see their first clean claims submitted within 5–7 business days of onboarding. We also pursue your oldest aged AR immediately — so you see recovered revenue before your first billing cycle closes.
Transparent, Performance-Based Pricing
We charge a percentage of collections — never a flat fee that rewards inaction. Our success is directly tied to how much revenue we recover for your practice, month after month.
Medical Billing Services at a Glance
A summary of the core revenue cycle management services we provide — and that we help you measure, optimize, and grow month over month.
| Service Type | What It Includes |
|---|---|
| Eligibility Verification | Real-time insurance eligibility & benefits checks performed before every patient visit to prevent claim rejections at submission |
| Charge Capture & Entry | Review and entry of all charges from superbills, encounter forms or EHR documentation with fee schedule compliance checks |
| Medical Coding | ICD-10-CM, CPT, HCPCS Level II & modifier assignment by CPC-certified coders specialized in your practice's clinical specialty |
| Claims Submission | Electronic claim submission to all payers within 24 hours of charge entry, with pre-submission scrubbing to catch errors before they cause denials |
| Payment Posting | Manual and ERA/EOB payment posting, contractual adjustment reconciliation & payer underpayment identification |
| Denial Management | Denial categorization, root-cause analysis, corrected resubmission, first-level appeals & second-level payer escalations |
| Patient Billing | Patient statement generation, payment portal management, payment plan setup & compassionate balance resolution |
| Credentialing & Enrollment | Provider enrollment with Medicare, Medicaid, commercial payers & MCOs including CAQH maintenance & re-credentialing tracking |
Common Questions From Healthcare Providers
Straight answers to the questions we hear most from practices considering outsourced medical billing.
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