Denial management and Recovery

We at Healthcare Medical Billing Solutions LLC, as a response to the ever changing medical billing environment, and the lessening of reimbursement amounts, are now offering a new service to practices that are not our present billing accounts. Obviously our contracted billing accounts already receive denial management as part of their contract, but there are a lot of practices and facilities that could benefit from our expertise but do not want to add employees or switch billing entities. We understand. However, all of that being said, the providers may not be happy with the amount of money that is left in their AR and are not happy about having to write off large balances. Sometimes they simply need a “second opinion” and see if in fact any of that old AR is collectible. Every day that the claims/balances sit in the AR, there is money slipping away due to possible timely filing restrictions or the passing of appeal deadlines. We can help.

Healthcare Medical Billing Solutions, LLC has 44 years combined experience in billing, coding, auditing, correspondence, insurance and patient collections. This includes time working within the largest commercial insurance carrier in the country. We understand billing and collections from every possible angle. The industry is not stagnant. It is ever changing for a purpose. The days of billing and knowing what the end result would be are over. The rules change constantly and one’s billing company, whether in house or outsourced, must constantly be looking at trends and reviewing every EOB that comes across the desks for clues .EOBs are the roadmap to understanding what the insurance companies are doing. Insurance companies are outsourcing a lot more to other countries. These countries do not understand our healthcare system and have been given standard lines as replies to our questions. They actually just want you to go away and give up and in many cases it works for them. Not so with us. We will continue to pursue a new path to understanding exactly what they are doing, all within compliance with the law.

How does this work for you? We would like to review your AR to see what is there and if in fact it is collectible. The more information made available to us the better. If we can see in your software where we can see how it was billed, and if has been appealed or worked, we will have a clear picture of what is there. Then we really have to get to work. We have to figure out why it was not paid. That means time on the phone with the carrier until we get THE answer. Then we go to work to get it reprocessed, whatever it takes.


A provider came to us concerned about the large outstanding A/R in over 150 days up to over a year old which was scheduled to be written off shortly. We first examined the account with a mini-audit and saw there was potential money to be collected. We immediately tackled the A/R with fervor and in under 90 days, Healthcare Medical Billing Solutions, LLC was able to collect over $62,000.00 on 93 claims.

Another group asked us to audit their A/R just to be sure they were maximizing their collections. In doing so, we discovered that for the most part, the A/R was clean but there were some coding and billing issues that needed to be addressed to expedite payments. With the billing tips and process feedback, they were able to streamline their billing and correspondence and feel confident that they were running efficiently and not leaving anything on the table.

Our Model.

Healthcare Medical Billing Solutions, LLC starts out by reviewing your A/R in over 90 days. We are looking for patterns, carriers, and opportunities to bring in additional funds, give you an accurate picture of your A/R (what is truly collectible from the insurance companies) or what needs to be dropped to the patient level. Within this process, if we are given access to your billing system or to accurate data requested, we can aid your billers and coders with excellent feedback which in turn can only improve your billing process. While we are reviewing and auditing, we also begin the process of bringing in the money. In essence, we are combing through your A/R with two things in mind: cleaning up your A/R and collecting money that should have been collected. Our clients can rest assured that we will leave them with an accurate A/R when we’ve finished helping them. We don’t cherry pick-we go after ALL of it.

The Investment.

For $3,500.00 upfront, Healthcare Medical Billing Solutions, LLC will provide a mini-audit that includes a comprehensive review. Then, for any monies we are able to collect for the practice, we will invoice between 11-15% of net collections, agreed upon by both parties but based on caseloads and procedure/specialty type. Remember, we are going after the aging monies that have been left on the A/R to expire, often because they may be the more complicated cases that your employees haven’t the time or the knowledge to work.

References are available by request.

For further questions, or to put us to work, please contact us at (844)469-4936.
Healthcare Medical Billing Solutions, LLC
1403 Eastchester Drive, Suite 104
High Point, NC 27265