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Reduction in AR
Collection Ratios
Revenue Increase
Days Turnaround Time
First Pass Clean Claims Rate
Collection Ratios
By outsourcing your billing services to us, you can expect revenue growth of up to 20%
Reduction in A/R
Massachusetts has one of the most complex healthcare environments in the country. Between MassHealth, Blue Cross Blue Shield of Massachusetts, Tufts Health Plan and many commercial payers claims can be very complicated. Getting every claim right requires expertise. One small coding error or a missed authorization can delay your payment by weeks or wipe it out entirely.
MedCare MSO takes complete ownership of your billing cycle so you never have to worry about it again. Our medical billing services in Massachusetts cover everything from patient eligibility verification from first day to final payment reconciliation. We catch errors before claims leave our desk. We follow up on every unpaid or underpaid claim until your practice gets what it is owed. Your staff stops drowning in billing tasks and starts spending their energy on your patients.
Many Massachusetts practices have no idea how much money slips away each month through preventable billing mistakes. Incorrect procedures, missing referral documentation and slow denials follow-up collectively reduce your collections without you even noticing. Our medical billing services near Massachusetts identify exactly where the leaks are and plug them first.
When you outsource medical billing services in Massachusetts to MedCare MSO the improvement in your revenue is visible within the first billing cycle. Clean claims go out on time. Denial rates fall sharply. Your A/R stops aging. Practices across Massachusetts continuously see stronger collections, lower overhead costs and a smooth billing process that finally runs the way it should.
Our medical billing and coding services in Massachusetts are customized to meet the unique needs of healthcare providers across a wide range of specialties, ensuring efficient revenue cycle management for both small practices and large healthcare facilities.
Massachusetts providers operate in a highly regulated and highly competitive healthcare market. MassHealth compliance requirements are strict. Commercial payer contracts are updated constantly. Practices in Boston, Worcester, Lowell, Cambridge and Springfield all face these pressures while trying to grow. You need a medical billing services provider who knows Massachusetts well. Avoid generic national companies using one-size-fits all billing for your needs.
Every claim, every report and every patient record we handle meets full HIPAA compliance standards. We use strict access controls, secure file transfer protocols and regular internal audits to protect your data.
Our billers review every claim for accurate coding, correct modifiers and complete documentation before submission. We monitor policy updates from MassHealth and all major Massachusetts commercial carriers in real time.
Moving to our Massachusetts medical billing services costs nothing upfront. There are no onboarding fees, no software charges and no hidden items on your invoice. Transitioning is smooth, fast and completely risk free from very first day.
We deliver clear, detailed claim reports, collections, denial trends and A/R aging on a regular schedule. You always know the status of every dollar owed to your practice. Our reporting gives you the financial visibility you need to make smart decisions and plan for growth.
No platform switch required. Our Massachusetts medical billing experts work directly within your current EHR and healthcare systems for smooth, uninterrupted operations.
No two specialties bill the same way. A psychiatry practice in Boston has completely different coding requirements than a cardiology group in Worcester or a nephrology clinic in Springfield. When you choose MedCare MSO as your outsourcing medical billing services partner in Massachusetts you get a billing team trained specifically in your specialty. We build your entire billing workflow around your procedures, your payers and your documentation patterns so every claim that goes out is accurate and compliant for maximum reimbursement.
For the initial claim, MassHealth will accept the claim within 90 days from the date of service, and if MassHealth is the primary insurance, within 90 days of the EOB from the other insurance. Miss it and the claim will be denied on the billing date and you will be entered into a documented waiver process. We fill in the window and properly utilize the 90-day waiver process when we have to.
That’s the ordering, referring, and prescribing (ORP) rule. MassHealth denies a claim if the ordering or referring provider’s NPI is missing, or if that provider isn’t enrolled with MassHealth, even as a nonbilling provider. It catches practices that take referrals from outside clinicians constantly. We check ORP enrollment before the claim goes out so the denial never happens.
Several do. For some specialty services the PCC plan and Primary Care ACOs require referrals; the commercial HMOs here impose their own referral and authorization requirements. A clean denial is a missing referral. Referrals and authorizations are confirmed prior to the visit and paperwork is filed with the claim.
The primary insurer will be billed first and MassHealth will be billed after their EOB within that 90-day period, which is the “payer of last resort. One of the more frequently seen denials that we encounter when we acquire a practice that is preventable is billing MassHealth out of sequence. All active coverage is confirmed at intake and claim sequences are done appropriately.
Yes. The time required to get set up in MassHealth POSC and contract with the large Massachusetts commercial plans is significant, and there won’t be a clean bill until they are in place. We process enrollment, re-validation and credential by payer to keep your providers active and your claims payable.
Ready to maximize your revenue while reducing administrative work? Let’s team up! Our medical billing expert will reach out within 12 hours.
