Medical Billing

Medical Billing

HealthsDriven Medical Billing Services
Medical
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.

What We Support

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.

Claims Submission & Management

Accurate, timely electronic claim submission to all payers with real-time tracking & status monitoring

Medical Coding (ICD-10 / CPT)

Certified coders applying accurate ICD-10, CPT & HCPCS codes to maximize reimbursement & reduce denials

Denial Management & Appeals

Proactive denial analysis, corrected claim resubmission & formal payer appeals to recover lost revenue

Patient Billing & Collections

Clear, compliant patient statements, payment plan management & balance resolution with sensitivity

Revenue Cycle Analytics

Real-time dashboards tracking AR days, collection rates, denial trends & payer performance metrics

Payer Credentialing & Enrollment

End-to-end provider enrollment with Medicare, Medicaid, commercial plans & managed care organizations

98%
First-Pass Claim Rate
$50M+
Revenue Recovered
30+
Specialties Served
24/7
Dedicated Support
Who We Work With

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.

Our Solutions

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
Our Process

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.

1

Free Revenue Cycle Assessment

We audit your current billing performance, payer mix, denial rate & AR aging. No cost, no commitment required.

2

Credentialing & System Setup

We handle payer enrollment, EHR/PM integration & coding protocol setup while recovering your oldest outstanding claims.

3

Claims Go Live & AR Improves

Clean claims submit daily. Denials drop. Aged AR shrinks. You receive weekly performance reports from your dedicated billing team.

4

Continuous Optimization

Monthly reviews, payer contract renegotiation support & coding updates keep your revenue cycle performing at its peak.

Why Choose Us

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.

Full Coverage

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 VerificationReal-time insurance eligibility & benefits checks performed before every patient visit to prevent claim rejections at submission
Charge Capture & EntryReview and entry of all charges from superbills, encounter forms or EHR documentation with fee schedule compliance checks
Medical CodingICD-10-CM, CPT, HCPCS Level II & modifier assignment by CPC-certified coders specialized in your practice's clinical specialty
Claims SubmissionElectronic claim submission to all payers within 24 hours of charge entry, with pre-submission scrubbing to catch errors before they cause denials
Payment PostingManual and ERA/EOB payment posting, contractual adjustment reconciliation & payer underpayment identification
Denial ManagementDenial categorization, root-cause analysis, corrected resubmission, first-level appeals & second-level payer escalations
Patient BillingPatient statement generation, payment portal management, payment plan setup & compassionate balance resolution
Credentialing & EnrollmentProvider enrollment with Medicare, Medicaid, commercial payers & MCOs including CAQH maintenance & re-credentialing tracking
FAQ

Common Questions From Healthcare Providers

Straight answers to the questions we hear most from practices considering outsourced medical billing.

Revenue cycle management (RCM) refers to the full administrative and financial process a healthcare provider uses to track patient care episodes from registration and appointment scheduling through the final payment of a balance. It includes eligibility verification, charge capture, medical coding, claim submission, payment posting, denial management, and patient collections. HealthsDriven manages this entire cycle on your behalf so your clinical team can stay focused on patient care.
HealthsDriven charges a percentage of collected revenue — typically ranging from 3% to 8% depending on specialty, claim volume, and service complexity. This performance-based model means we only earn more when you collect more. There are no setup fees, no hidden charges, and no flat monthly fees that reward inaction. Most practices find that outsourcing to HealthsDriven costs less than maintaining an in-house billing department when factoring in salaries, benefits, training, and software.
We support over 30 medical specialties including primary care, internal medicine, cardiology, orthopedics, neurology, psychiatry, behavioral health, physical therapy, home health, hospice, urgent care, dermatology, gastroenterology, OB/GYN, podiatry, chiropractic, and more. Each specialty has a dedicated billing team with specialty-specific coding expertise — not a generalist team applying uniform billing rules across all service types.
Every denied claim is reviewed within 48 hours of receipt. Our denial management team categorizes the denial by type (eligibility, authorization, coding, timely filing, etc.), identifies the root cause, corrects the claim, and resubmits or initiates a formal appeal — all within payer-specific timely filing windows. We also generate monthly denial trend reports that identify systemic issues — like documentation gaps or authorization failures — before they create future denials.
Most practices begin seeing clean claims submitted within 5–7 business days of completing onboarding. We simultaneously begin working your aged AR backlog, so recovered revenue from previously uncollected claims often arrives within the first 30–45 days. Denial rates typically drop and first-pass claim rates improve significantly within the first 60–90 days as our pre-submission scrubbing and coding review processes fully replace your prior workflow.
Yes. HealthsDriven is EHR and PM system agnostic. We work directly within your existing platform — including Epic, Athenahealth, eClinicalWorks, Kareo, DrChrono, Modernizing Medicine, Office Ally, and many others — so there is no disruption to your clinical workflow and no requirement to migrate to a new system. Our team trains on your specific platform during onboarding and operates within your existing setup from day one.

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