How We Protect Your Practice From Denials:
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Collection Ratio
Trusted by
AR Reduction
Revenue Increase
Serving Specialties
The state reports over 2 million denied claims annually, with complex credentialing across Highmark Western regions, Independence Blue Cross in Philadelphia, and UPMC networks statewide. Medicaid providers struggle with PROMISe enrollment requirements that cause immediate rejections. Telehealth claims under new state legislation need specific place-of-service designations that most billers miss.
Our medical billing services in Pennsylvania fix these problems with expert knowledge and clear processes. Medcare MSO handles PROMISe registrations, workers’ compensation paperwork, and credentialing with all major Pennsylvania insurers. We use the correct codes every time. We get authorizations approved before you treat patients. When claims get denied, we appeal using strategies that work with your local insurance companies.
Our medical billing services in Pennsylvania address state-specific payer requirements and compliance standards, helping practices increase revenue by 20-30% through expert handling of regional insurers.
We call up Highmark, IBX, UPMC, whoever the patient has. Check their coverage before they walk in. Saves you from finding out mid-appointment that nothing's covered.
Getting prior authorizations approved in Pennsylvania is a nightmare, with different forms for every payer. We deal with that mess so you don't have to wait three weeks for a response.
Your documentation gets coded right the first time. PROMISe won't accept claims without specific formatting, and Pennsylvania fee schedules change constantly. We stay on top of it.
Your documentation gets coded right the first time. PROMISe won't accept claims without specific formatting, and Pennsylvania fee schedules change constantly. We stay on top of it.
Pennsylvania insurers deny claims for dozens of reasons. We track what went wrong, write appeals that reference the exact contract language they can't ignore, then resubmit.
Payments come in through ERA feeds. We post them, but more importantly, we catch when Highmark pays $200 instead of $350 and actually follow up.
Your patients get bills they understand, not insurance jargon. When they call confused about their EOB, we explain it instead of transferring them back to you.
PROMISe enrollment expires. Networks drop you if the paperwork's late. We make sure none of that happens by tracking every deadline for every location you have.
Monthly dashboards show what's working and what's costing you money; which payers are slow, which procedure codes get denied the most.
We handle medical billing services in Pennsylvania for 50+ specialties. Mental health practices face authorization denials from managed care plans. Cardiology needs different modifiers for Highmark versus Independence Blue Cross. Orthopedics battles workers’ compensation Chapter 127 rules. Primary care gets claims rejected when PROMISe registration lapses.
Surgical billing fails without correct facility codes, lab work needs proper medical necessity documentation, and radiology claims require authorization across different Blue Cross regions. Telehealth services must follow Act 42 rules with specific POS codes. Our medical billing Pennsylvania specialists catch these state-specific errors before submission, keeping your denials below the state’s 13.6% average rate.
We handle medical billing services in Pennsylvania for 50+ specialties. Mental health practices face authorization denials from managed care plans and cardiology needs different modifiers for Highmark versus Independence Blue Cross. Orthopedics battles workers’ compensation Chapter 127 rules. Primary care gets claims rejected when PROMISe registration lapses.
We protect patient data through HIPAA-certified systems with 256-bit encryption and secure data centers. Our team undergoes Pennsylvania-specific compliance training on state Medicaid rules, workers’ compensation documentation standards, and credentialing requirements. Regular audits ensure your practice stays protected from penalties and maintains billing accuracy.
Pennsylvania’s 13.6% denial rate and PROMISe system complexities cost practices thousands monthly. Your team can’t master regional payer differences, workers’ compensation rules, and telehealth requirements alone. Outsourcing to Medcare MSO solves these challenges while you focus on patient care.
Automated data synchronization with your existing EHR software reduces manual errors and improves billing efficiency.
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
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We handle your entire billing process, from insurance verification to claim submission to payment posting. This includes Pennsylvania-specific requirements like PROMISe registration and workers’ compensation compliance.
Most services charge 3-7% of monthly collections. While you pay a percentage, practices typically see 20-30% revenue increases because we reduce denials and speed up payments.
PROMISe is Pennsylvania’s Medicaid management system. Every provider needs a 13-digit PROMISe ID, or Medicaid and CHIP claims will be rejected immediately before reaching adjudication.
Yes. We manage LIBC-9 medical report forms, meet 30-day payment timelines, handle fee review applications, and ensure compliance with Pennsylvania’s workers’ compensation regulations.
We work with all major Pennsylvania payers, including Highmark, Independence Blue Cross, UPMC Health Plan, Capital Blue Cross, Aetna, UnitedHealthcare, and Pennsylvania Medicaid managed care organizations.
Partner with us for reliable, accurate medical billing services tailored to Virginia healthcare providers.
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Or call us as 800-640-6409
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
