Specialty billing

Billing built for Hospitals

Facility and professional billing expertise for community and critical access hospitals — UB-04 and CMS-1500 under one roof.

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The challenges

Where hospitals revenue leaks

Complex facility billing: DRGs, revenue codes, chargemaster maintenance
High-dollar claims where single denials carry five-figure stakes
Staffing shortages hitting HIM and patient financial services hardest

Our playbook

How we fix it

Dual-competency teams covering UB-04 and professional claims
DRG validation and clinical documentation improvement support
High-dollar claim escalation with dedicated senior follow-up
24/7 coverage that clears backlogs overnight

Core solutions

What hospitals clients typically use

Medical BillingEnd-to-end claim submission, scrubbing, and follow-up that gets you paid faster — engineered to a 98%+ first-pass clean claim standard.

Medical CodingAAPC- and AHIMA-certified coders delivering 95%+ accuracy across ICD-10, CPT, and HCPCS — with built-in audit protection.

CredentialingEnd-to-end provider lifecycle management — credentialing, primary source verification, expirable tracking, and AI-monitored compliance from application to recredentialing.

Denial ManagementEvery denial worked within 48 hours and root causes eliminated — because the best denial strategy is preventing the next one.

AI Revenue IntelligenceMachine learning that predicts denials before submission, prioritizes A/R by recovery probability, and finds patterns humans miss.

MIPS & Quality ReportingFull Quality Payment Program management — measure selection, data capture, submission, and score optimization that turns MIPS from a penalty risk into a payment adjustment you earn.

Get a billing health check for your hospitals practice

Free, 30 minutes, with a consultant who knows your specialty's codes and payers. We'll benchmark your denial rate, A/R days, and collections — and tell you exactly what we'd fix first.

Book my free consultation