Medical billing services manage the full claims process for healthcare practices, including insurance eligibility verification, charge entry, CPT and ICD-10 coding, claim submission, denial management, and payment posting. MedCare MSO performs these steps on the practice’s behalf, typically charging a percentage of net collections, to reduce denials and shorten reimbursement time. Our medical billing solutions combine EDI and electronic claims processing to streamline billing and improve the practice’s overall cash flow.
MedCare MSO delivers these services across 50+ specialties, with a 98.5% first-pass clean-claim rate and go-live in 14 days.
A number of organizations consider the clean claim ratio as a measure of billing effectiveness. However, this metric is just one measurement. A claim may be correctly filed, received, and accepted by the payer, but it can still fail to yield the expected payment amount. The true revenue impact is based on a series of developments that occur after filing the claim.
According to industry standards, healthcare organizations usually lose about 5-10% of the revenue because of inefficiencies in billing, missed follow-ups, coding mistakes, and late reimbursements. Even practices with a clean claim ratio of 95% and above may still have cash flow problems if their net collection percentage drops below 95%.
Revenues leak in the interval between clean claims and actual collections:
Before making a change to the way your practice handles billing, understanding the current situation is most important. An audit is needed to provide information on the current status of claims, denials, and aged AR, while establishing whether or not the fee schedules are in line with payer contracts.
The audit includes:
Please provide the following information, so our team can connect with you within 12 hours.
Or call us as 800-640-6409
MedCare MSO is always aware of the need for changes in coding and medical billing services. Correct billing and coding ensure payments are made in a timely manner, and rules are followed correctly. MedCare MSO establishes secure two-way electronic links with Availity, Change Healthcare, and all major payers such as Blue Cross Blue Shield, Aetna, UnitedHealthcare, Cigna, and Humana to provide real-time updates about the claim status.
Our proactive strategies for recovering AR allow us to reduce outstanding AR by 35%. We follow up on overdue accounts of patients and insurance companies. We have generated revenue from 120 days’ aged AR reports.
We offer complete provider billing services at competitive prices. Our qualified medical billers provide all the necessary services, and their specialization in the reimbursement process ensures maximum income for independent providers. Check our Physician Billing Services for specialty-specific details.
Our Medical Credentialing service assists with smooth payer enrollment and improving network participation. Our well-trained team helps you get connected with the payer networks and navigate through the process. We have successfully conducted 95% of credentialing in the industry.
Denial Management is a methodical, evidence-based process to find and rectify every single payment denial. We use specialized AI-driven billing software to turn losses into revenue, bring AR days to the lowest levels, and adhere to HIPAA throughout the revenue cycle.
Apart from our free onboarding audit, we also conduct quarterly audits to analyze every medical record against the standards of Medicare & Medicaid, identify hidden causes of revenue loss, and provide feedback to help improve quality rating and trust levels with payers.
Regardless of the method used, our claim submissions are facilitated through our Optimized process, which ensures that CPT, ICD, and NPI codes are not being decoupled or coupled. Our payer validation methods, along with our instant confirmations, reduce reimbursement times while ensuring compliance with the necessary ANSI and CMS rules every time.
This Service enables you to get accurate patient coverage information. The system will validate insurance in real time and assist in verifying benefits and pre-authorization from payers
Our Payment Posting services will ensure that your accounting records are accurate. It helps manage payments, adjustments, and denials, assisting practices in speeding up the reconciliation process.
Our patient billing and statements services are designed to improve the patient payment experience. We provide easy-to-understand, clear, and simple online statements to help patients choose the best mode of payment for them.
It help you analyze the CPT Codes taking into account payer contracts, RVU data, and market benchmarks so that you identify low-price services and gaps in pricing. Ultimately we will assist in the development of a proper fee schedule ensuring proper reimbursement, income protection, and financial transparency.
HIPAA · SOC 2 · ICD-10 & ICD-11 · CPT · CMS-1500 · Clearinghouse-ready · OIG exclusion checks.
Maximize reimbursements and profits by up to 35%. Outsourcing medical billing services is a perfect solution compared to in-house billing because it offers higher savings, improved billing accuracy, faster claims processing, easier batch payments, and specialized knowledge.
Complete over 75,000 claims a day as a result of innovative medical billing automation technology.
Customizable healthcare billing services that are tailored to all your needs, thus minimizing income losses due to inaccurate billing.
There is no reason to hire and educate in-house staff, which allows cutting recruitment and payroll expenses by nearly 50%, and automating the process allows reducing costs for medical billing and making administration more effective.
Real-time access to all your reports regarding revenue trends, billing, claims status, and accounts receivable.
An experienced manager in the healthcare billing services who supervises and provides you with the necessary support.
Through monthly audits of fee schedules and structured AR reviews, we manage to detect unrecorded income.
Medical billing is stronger when it’s connected to the rest of your revenue cycle. Explore the tools MedCare MSO clients use alongside our professional medical billing services to improve efficiency and streamline their workflows:
Helps manage all clinical documentation required for a hassle-free billing process
Captures all clinical documentation at the time of patient visit
Offers coding suggestions in real time in order to lighten the load of the coder.
Offers tracking of receipts, appointment scheduling, and tracking of claims.
There are no longer any issues with billing. Our AI-powered medical billing software provides easier claims management, updates patient records faster, modernizes scheduling, provides immediate updates, and processes payments in a more convenient and efficient manner. It integrates smoothly with your existing process and delivers efficient medical billing services.
As a top medical billing services company, we manage the entire process of EDI implementation, documentation, and billing process management. The good thing is there are no software installation charges, and you still remain in control of your practice at all times.
MedCare MSO utilizes its own knowledge base, which has 3 million rules. Therefore, it adheres to proper ICD-10, CPT, and HCPCS medical coding when creating claims and is able to identify errors before submissions. As part of our Medical Billing Services, we help practices achieve accurate claim creation and improved revenue cycle performance, resulting in a 98.5% first-pass clean-claims rate.
Features & processes:
We work as a medical billing service provider that has built a reputation over the years by delivering the best-in-class coding service for varied specialties. Our experts have in-depth knowledge of payer-specific requirements, state-level regulations, and regional-to-commercial payer behaviors.
Our extensive medical billing and coding services, tailored to your practice’s specialty and state-level payer regulations, ensure your practice receives what it needs.
Are you seeking a reliable US-based medical billing company to optimize your revenue cycle?
Our experience with MedCare MSO has been consistently positive and in particular the support and professionalism provided by James Archer.
Founder, ODAT Services
I highly recommend MedCare MSO if you are looking for help with your billing and gain some freedom to see more patients or manage your business.
Practice Owner, TXEC
MedCare MSO has been an excellent organization to work with, I highly recommend them for their quality of service and commitment to excellence.
Back Office Manager, STST
We are definitely impressed by the Team’s performance. I worked with a lot of different folks from all over the world on different business transactions, and Mark is truly a top notch talent!
Director of Corporate Development, SC & SF
MedCare MSO’s exceptional communication and expertise elevated our RCM experience and my bank accounts!
Owner, R.D.
MedCare MSO did a great job with our billing and helping clean up old AR. Regular updates and good communication were very appreciated.
Co-Owner, PCP
Chief Operating Officer, MAKO MEDICAL LABORATORIES
Chief Executive Officer, CARE NOW CLINIC
Chief Operations Officer, ION DIAGNOSTICS
Co-Founder, AW Care
Working with MedCare MSO has been a game-changer for my practice. Their expertise in medical billing, AR management, and coding has significantly streamlined our revenue cycle, reduced claim denials, and improved cash flow. The team is proactive, detail-oriented, and always available to address my concerns.
Practice Owner, F&A Clinic
We have experienced tremendous improvements within our billing and claims department that we have entrusted MedCare MSO to manage.
President/CEO, RLT
I am impressed with MedCare MSO’s promptness to respond to any inquiries, with the time they dedicate to reviewing each one of the cases.
Practice Owner/FBH
Medical billing is the process of submitting and following up on claims to health insurance companies to get paid for medical services. This process is complex and involves several steps, starting with patient registration, demographic entry, and insurance verification. Once those steps are complete, the process moves on to charge entry where services are added, then medical coding, where medical procedures are translated into CPT and ICD-10 codes. Then claim submission, where the coded claims are sent to insurance for payment. Finally, payment posting, where payments are received and applied. Medical billing can be done in-house or outsourced to third-party companies, giving medical practitioners revenue optimization and operational efficiency.
Our fee is transparent, starting from 2.99% of net collections, with no hidden charges.
We import your payer rules, set up ERA/EFT, and go live in 14 days.
Revenue cycle management (RCM) is the total process of managing the finances of a healthcare organization from patient registration to payment posting. This complex process has many steps, including managed billing, charge capture, coding, and insurance verification. Effective RCM allows healthcare providers to have improved cash flow, reduced administrative burdens, and optimized finances, so specialists can focus more on patient care.
Medical billing is the process of submitting and following up on claims to insurance companies to get paid for services rendered. It’s a big part of the revenue cycle and directly affects the financial health of a medical provider.
We handle claim denials by thoroughly analyzing the root cause, correcting errors, and promptly resubmitting the claims. For appeals, we gather necessary documentation, follow payer guidelines, and advocate for accurate reimbursement.
Yes. We utilize real-time claim scrubbing software to identify and rectify errors before submission, addressing incomplete information, coding errors, and insurance verification issues to streamline billing and improve efficiency.
Yes. We provide fully HIPAA-compliant medical billing services and employ robust security measures to safeguard patient data, including:
Payment posting times can differ based on the speed of individual insurance companies. We work diligently to ensure prompt posting, actively monitor claim status, and follow up with payers for faster processing. You’ll receive regular reports on account activity, including copays collected, AR per payer, denials, claim status, and payment details.
Yes. This integration allows for efficient data exchange and streamlines the scheduling process you can schedule appointments directly within your EHR, with up-to-date patient balance information available on the scheduler and timely copayment reminders.
We provide comprehensive billing solutions tailored to the needs of various healthcare providers, from individual doctors to large hospitals and specialized clinics.
Cardiology, OB-GYN, Radiology, Orthopaedics, Mental Health, and more.
This depends on practice size and internal capacity. In-house billing offers more direct oversight but requires hiring, training, and ongoing certification costs. When you outsource medical billing services to a third party, it typically reduces overhead and brings dedicated coding expertise, but the right choice depends on your claim volume, specialty complexity, and current denial rate.
Key factors include: clean-claim rate and how it’s measured, transparency in reporting (can you see claim status and AR in real time), specialty-specific experience, contract flexibility, and whether fees are tied to actual collections rather than flat rates.
No. Reputable medical billing service providers offer real-time dashboards and reporting so you retain full visibility into claims, denials, and collections, even though day-to-day processing is handled externally.
Ready to maximize your revenue while reducing administrative work? Let’s team up! Our medical billing expert will reach out within 12 hours.
Please provide the following information, so our team can connect with you within 12 hours.
Or call us as 800-640-6409
ODAT Services
I am writing on behalf of ODAT Services to express our strong satisfaction with MedCare MSO, and in particular the support and professionalism provided by James Archer.
Our experience with MedCare MSO has been consistently positive. The team has demonstrated reliability, responsiveness, and a clear understanding of the operational and compliance needs of our organization. James Archer has been especially instrumental—bringing a high level of expertise, clear communication, and a solutions-oriented approach to every interaction.
James is proactive, knowledgeable, and dependable, making complex processes easier to navigate and helping ensure our operations run smoothly. His professionalism and commitment to service have made MedCare MSO a valued partner to our organization.
We are pleased to recommend MedCare MSO and James Archer without reservation and look forward to continuing our work together.
Travis Gannon
Founder
ODAT Services
TXEC
I have worked with MedCare MSO for the past eight months, and it has been a great experience. Moses, Mark, Travis, Sebastian, and Tammy have been a pleasure to work with, as well as the rest of the team, including the credentialing folks.
I highly recommend this group and MedCare MSO if you are looking for help with your billing. They will meet with you once a week to review the issues that need to be fixed to improve your payment and capture rate.
If you are looking for help with your billing and gain some freedom to see more patients or manage your business, this is the team you need to work with.
Dr. Jose Correa
Practice Owner
TXEC
STST
MedCare MSO has been an excellent organization to work with. Mark has consistently demonstrated outstanding attention to detail, thorough documentation, and strong professionalism in maintaining accurate records of his findings.
His reliability and dedication have contributed greatly to a positive experience.
I highly recommend MedCare MSO for their quality of service and commitment to excellence. I can’t say enough good things about Mark and his company.
Thank you
Shaunna Mock
Back Office Manager
STST
SC & SF
Hi Ali, I hope this message finds you well. I wanted to give you some feedback on the team.
We are definitely impressed by the Team’s performance. Definitely what we were looking for from switching partners.
In particular Mark Zaiden has been very helpful. In my 5+ years of experience as a M&A Professional, I worked with a lot of different folks from all over the world on different business transactions, and Mark is truly a top notch talent!
Austin has done a great job of leading the communications process and keeping the train going in the right direction. Tammy and some other folks have been key players as well. We really are happy with everyone on the team.
I wanted to pass this feedback along to you as we are really pleased with working with MedCare MSO so far.
Have a great weekend!
Max Owens
Director of Corporate Development
SC & SF
R.D.
MedCare MSO’s exceptional communication and expertise elevated our RCM experience and my bank accounts!
Most helpful is the open/responsive communication of their team with my office and each other, along with the specialty levels of expertise amongst my team for each aspect of RCM.
Kelly Ballou
Owner
R.D.
F&A Clinic
Working with MedCare MSO has been a game-changer for my practice. Their expertise in medical billing, AR management, and coding has significantly streamlined our revenue cycle, reduced claim denials, and improved cash flow. The team is proactive, detail-oriented, and always available to address my concerns.
I would like to take time to recognize two members of MedCare MSO specifically. Moses for his exceptional support and dedication. He is always responsive, and knowledgeable, and goes above and beyond to ensure smooth operations. His professionalism and commitment make a huge difference in our day-to-day workflow. George also for his quick feedback and recognition of what is needed most. He is extremely efficient and always available for clarification and to share his knowledge and expertise.
I highly recommend MedCare MSO to any healthcare provider looking for a reliable and efficient billing partner.
RLT
Hello,
I am writing this email to express our appreciation of the MedCare MSO’s team and all they have done for our business at RLT. In the past year, we have experienced tremendous improvements within our billing and claims department that we have entrusted MedCare MSO to manage. We went from having over $100k in uncollected/billed claims to now reaching near $100k in collection some months.
We are also happy to express our thankfulness that MedCare MSO is now helping us acquire new contracts with different insurance companies. This will in effect benefit everyone involved, allowing us to expand our services and provide more resources for our staff/business partners.
Please note special appreciation for the following:
David Lucas
Mario Ortega
Ambrose William
FBH
I have been a customer of MedCare MSO for one year. They have provided billing and credentialing services for my private behavioral health practice, and I am impressed with their promptness to respond to any inquiries, with the time they dedicate to reviewing each one of the cases, and with their willingness to educate me and my staff about the ever-changing rules of medical billing and the best use of coding. This is a company I Trust with my billing needs.
Dr. Neufeld
Practice Owner
FBH
