Healthcare & Medical Billing
Medical billing, RCM and the systems that sit around a practice's revenue.
Medical billing, revenue cycle management, coding, credentialing and the patient-facing systems around them. Every workflow here is designed around regulated data handling rather than retrofitted to it, and our team includes people who have worked in clinical settings.
What you end up with
- A written picture of where revenue leaks between the visit and the payment
- Claims scrubbed and coded before submission rather than corrected after rejection
- Denials tracked by cause, with the repeating ones fixed at the source
- Billing and intake workflows documented, so the process does not live in one person's head
- A signed Business Associate Agreement, with protected health information handled through HIPAA-aware workflows
Tools and platforms
- Epic
- athenahealth
- eClinicalWorks
- NextGen
- AdvancedMD
- Kareo / Tebra
- DrChrono
- Availity
- Waystar
- Change Healthcare
- Claim.MD
- Office Ally
- HL7 v2
- FHIR
- CMS-1500
- 837P / 835
- ICD-10-CM
- CPT
- HCPCS
Services
9 services in Healthcare
Each one has its own page covering what the work involves, what you receive and the trade-offs.
AI Medical Billing
The billing cycle run end to end, with automation where it earns its place.
Revenue Cycle Management
The whole cycle, from patient scheduling to the final payment.
Medical Coding
Diagnosis and procedure codes that match the documentation.
Denial Management & Appeals
Working denials by cause, inside the payer's deadline.
Prior Authorization
Keeping authorisations valid from the order to the date of service.
Provider Credentialing
Getting providers enrolled, and keeping that enrolment current.
Patient Scheduling Automation
Fewer empty slots, and fewer manual reminder calls.
EHR & EMR Integration
Making the clinical record talk to everything else.
Healthcare Marketing & Patient Acquisition
Reaching patients without putting their data into ad platforms.
How we think about it
Why healthcare projects fail
The technical detail that decides whether this work pays back, written for someone who has to sign off on it.
Where the money actually leaks in a practice
Revenue loss in a medical practice is rarely dramatic. It is a claim that went out with a missing modifier, an authorisation that quietly expired, a patient whose coverage had changed since the last visit, an appeal that sat inside the payer's deadline and then past it. Each one is small. Together they decide whether the practice looks profitable or not, and almost none of them are visible in the clinical record. The work starts by making them visible.
Denials usually repeat, and that is the good news
Most denials are not random. They come from a short list of causes that repeat month after month: eligibility, authorisation, coding, medical necessity documentation, timely filing, coordination of benefits. A denial you can classify is a denial you can prevent, because the fix is almost always upstream of the claim. We work the queue by cause rather than by date received, which is what turns denial management from a clean-up task into a reduction in volume.
What HIPAA-aware means here, plainly
There is no HIPAA certification, and we will not claim compliance on your behalf, compliance is an obligation you carry as a covered entity, and we support it. In practice that means: a Business Associate Agreement is signed before any protected health information changes hands, access is limited to the people who need it, data moves over encrypted channels, and we work inside the policies you set rather than inventing our own. Where an automated step would move PHI somewhere it should not go, we build around it.
Automation helps, but only after the process is clean
It is tempting to point AI at a broken billing process and hope it fixes itself. It does not. If eligibility is verified at the wrong moment, or the note does not document what is being billed, an automated step just produces the same error faster. We automate where the work is genuinely mechanical and verifiable, reading documents, extracting details, flagging likely denials, drafting a first version of an appeal, and we leave clinical and coding judgement with people. We will tell you when an automation is not worth its complexity.
Questions
Before you book a call
Are you HIPAA compliant?
We do not claim that, and you should be cautious about any vendor that does, because there is no HIPAA certification to hold. What we can tell you is how the work is designed: we sign a Business Associate Agreement, we limit access to protected health information to the people who need it, we use encrypted channels, and we follow the policies your practice sets. Compliance remains your ongoing obligation as a covered entity, and we work in support of it rather than claiming to replace it.
Do you replace our billing staff or work alongside them?
Either can work, and the honest answer is that it depends on what your team is for. Some practices keep front-desk and payment posting in house and hand us the scrubbing, submission and denial work. Others want the whole cycle managed. We will scope it after looking at where the time actually goes, and we will say when an in-house team is better placed for a task than we are.
Which EHR and practice management systems do you work in?
Common ones include Epic, athenahealth, eClinicalWorks, NextGen, AdvancedMD and Kareo or Tebra, usually reached through your clearinghouse. What matters more than the logo is what the vendor allows: claim and remittance exports, API access, and whether an interface engine is permitted. We check that before quoting, because it changes the approach more than any other single answer.
Can you sign a Business Associate Agreement?
Yes, and we will not touch protected health information before one is in place. The BAA sets out what we may do with the data, how it is protected, what happens to it when the engagement ends, and how a breach would be handled. If a subcontractor of ours would ever handle PHI on your behalf, they are covered by the same requirement.
Tell us where the manual work is
A 30-minute call. We map the process, tell you what we would automate or build first, and what it costs. No retainer before you agree the scope.
- No retainer before scope is agreed
- Written plan you can act on alone
- Worldwide delivery, on your hours