Outsourced Medical Billing Services
Partner with Healix RCM to streamline your revenue cycle management. Our expert team reduces administrative burden while maximizing collections for clinics, physician groups, and ambulatory surgery centers nationwide.
Benefits of Outsourcing Medical Billing
Financial Performance
- ✓Reduce claim denials by 28-40% through expert coding and submission practices
- ✓Increase first-pass claim acceptance rates to 95% or higher
- ✓Cut accounts receivable days by 20-30% with aggressive follow-up
- ✓Boost overall collections by 15-25% within the first year
Operational Efficiency
- ✓Eliminate overhead costs of in-house billing staff and software
- ✓Access to certified coders and billing specialists without recruitment hassles
- ✓Scale services up or down based on practice volume and needs
- ✓Focus clinical staff time on patient care instead of administrative tasks
What's Included in Our Service
Charge Entry
Accurate and timely entry of charges from encounter forms, EMR systems, or provider documentation with quality assurance checks.
Coding Review
Certified coders review all diagnoses and procedures to ensure optimal reimbursement and compliance with coding guidelines.
Eligibility & Benefits
Pre-service verification of patient insurance coverage, copays, deductibles, and benefit limitations to prevent claim rejections.
Claims Submission
Electronic submission of clean claims within 24-48 hours with real-time tracking and status monitoring.
Denial Management
Systematic analysis and resolution of denied claims with appeals processing and documentation to maximize recovery rates.
AR Follow-up
Aggressive follow-up on outstanding claims with payers using phone, portal, and written correspondence to accelerate payments.
Patient Billing
Professional patient statements, payment processing, payment plans, and customer service for patient billing inquiries.
Reporting & Analytics
Comprehensive monthly reports with key metrics, trends analysis, and actionable insights to optimize revenue performance.
Our Implementation Process
Discovery & Assessment
We analyze your current billing process, identify improvement opportunities, and create a customized implementation plan.
Data Setup & Integration
Secure transfer of patient data, payer contracts, and integration with your practice management system.
Payer Enrollment & Credentialing
Verify provider credentials and ensure all payer enrollments are current and properly configured.
Go-Live & Transition
Begin processing claims with dedicated support during the first 30 days to ensure smooth operations.
Ongoing Optimization
Continuous monitoring, performance analysis, and process improvements to maximize revenue and efficiency.
Expertise Across Medical Specialties
Primary Care
Family Medicine, Internal Medicine, and Pediatrics with expertise in preventive care, chronic disease management, and wellness visits.
Specialty Care
Cardiology, Orthopedics, Dermatology, and other specialties requiring complex coding and prior authorization expertise.
Behavioral & Therapy
Behavioral Health,Physical Therapy, and other therapy services with understanding of session-based billing and outcome measures.
We also serve Dental practices, Ambulatory Surgery Centers, Imaging Centers, and other healthcare facilities.Contact us to discuss your specialty's unique requirements.
Transparent Pricing & Engagement Models
Percentage of Collections
Pay only when we collect. Rates typically 4-8% based on practice size and complexity. No upfront costs or monthly minimums.
Most popular for smaller practices
Fixed Monthly Fee
Predictable monthly cost based on provider count and claim volume. Ideal for practices wanting budget certainty.
Best for larger, stable practices
Hybrid Model
Combination of low fixed fee plus reduced percentage. Balances predictability with performance-based pricing.
Flexible for growing practices
Security & Compliance You Can Trust
HIPAA Compliance
- •Signed Business Associate Agreements (BAAs) with all clients
- •Encrypted data transmission and storage systems
- •Access controls and user authentication protocols
- •Regular compliance training for all staff members
Data Security
- •Comprehensive audit logs of all system access and changes
- •Secure VPN connections and firewall protection
- •Regular security assessments and vulnerability testing
- •Backup and disaster recovery procedures
Proven Results: Success Story
Family Medicine Practice Increases Collections by 32%
Before Healix RCM:
- • 18% claim denial rate
- • 65 days average AR
- • $847,000 annual collections
- • 2.5 FTE billing staff
After 12 Months:
- • 7% claim denial rate
- • 42 days average AR
- • $1,118,000 annual collections
- • $156,000 annual cost savings
Frequently Asked Questions
How quickly can we transition to your outsourced medical billing service?
Most practices can transition within 30-45 days. We handle payer enrollment, credentialing verification, and data migration to ensure a seamless handoff with minimal disruption to your revenue cycle.
What percentage of collections do you typically charge?
Our fees typically range from 4-8% of collections depending on practice size, specialty, and service complexity. We also offer fixed-fee and hybrid models. Contact us for a customized quote based on your specific needs.
Do you handle all insurance types including Medicare, Medicaid, and commercial payers?
Yes, we process claims for all major payers including Medicare, Medicaid, commercial insurance, workers' compensation, and patient self-pay. Our team stays current with payer-specific requirements and updates.
How do you ensure HIPAA compliance and protect our patient data?
We maintain strict HIPAA compliance with encrypted data transmission, access controls, audit logs, and signed Business Associate Agreements. Our team receives regular compliance training and our systems undergo security audits.
What reporting and visibility will we have into our billing performance?
You'll receive comprehensive monthly reports including collections, denial rates, AR aging, and key performance metrics. We also provide real-time access to our client portal for claim status and account details.
Can you handle prior authorizations and patient billing as part of the service?
Absolutely. Our full-service offering includes prior authorization management, patient statement generation, payment processing, and patient inquiry handling to provide complete revenue cycle support.
What if we're not satisfied with the service quality or results?
We offer transparent service level agreements and typically include a 90-day trial period. If you're not satisfied, we'll work to address concerns or provide a smooth transition back to in-house billing or another provider.
Ready to Optimize Your Revenue Cycle?
Join hundreds of healthcare practices that have streamlined their billing operations and increased collections with Healix RCM. Get started with a free analysis of your current revenue cycle performance.