End-to-End Medical Billing & RCM Services
Engineered to capture every dollar your practice earns. From dual-scrubbed coding to aggressive denial recovery, we handle your revenue operations with clinical precision and complete transparency.
6 Core Clinical Billing & RCM Services
Tailored revenue cycle solutions engineered for solo practitioners, specialty clinics, and enterprise health systems.
Medical Billing Services
Our AAPC-certified coders (CPC & CPMA) perform multi-tier claim scrubbing prior to transmission. We ensure appropriate ICD-10-CM/PCS diagnosis linking, CPT/HCPCS modifier assignment (-25, -59, -78, -79), and CCI edit checks.
- ✓ Multi-Tier Code Scrubbing: Eliminates unbundling & downcoding.
- ✓ Daily Batch Transmissions: Claims submitted within 24 hours.
- ✓ Underpayment Audits: Remittances verified against fee schedules.
Revenue Cycle Management
Full-spectrum RCM optimization transforming administrative burdens into predictable cash flow. We oversee patient scheduling, eligibility checks, charge entry, clearinghouse routing, ERA posting, and secondary filing.
- ✓ 24-Hour Claim Processing: Accelerated billing for prompt revenue.
- ✓ Automated ERA Posting: Fast payment reconciliation with zero delay.
- ✓ Executive BI Analytics: Real-time tracking of collections & aging.
Medical Coding Services
ICD-10-CM/PCS and CPT coding services strictly aligned with provider clinical documentation to eliminate payer rejections and optimize RVU productivity.
- ✓ AHIMA & AAPC Coders: Certified specialists across 35+ medical subspecialties.
- ✓ CCI & MUE Validation: Correct Coding Initiative edit checks prior to billing.
- ✓ Documentation Feedback: Monthly provider education on chart specificity.
Billing & Coding Audit
We monitor, identify, and rectify critical compliance errors to eliminate revenue leakage, prevent CMS audits, and capture unbilled specialty revenue.
- ✓ Historical Claim Sampling: Deep 90-day chart and claim audit.
- ✓ Underbilling Analysis: Uncover missed CPT add-on codes and modifiers.
- ✓ Compliance Risk Scoring: Benchmark your practice against national peers.
AR and Denial Management
Aged accounts receivable directly threaten practice solvency. Our aging A/R recovery unit methodically investigates all claims over 60, 90, and 120+ days old, pursuing commercial, Medicare, and Medicaid payers until settled.
- ✓ Aging Bucket Clean-Up: Intensive liquidation of claims past 90 days.
- ✓ Direct Payer Phone Escalation: Specialists negotiating with adjudicators.
- ✓ Timely Filing Protection: Systematic tracking ensures zero lost claims.
Physician Credentialing Services
Expanding your practice or onboarding new physicians? AlphaCare manages the entire credentialing and payer enrollment process. We maintain your CAQH profile, submit Medicare/Medicaid applications, and negotiate commercial paneling.
- ✓ CAQH Profile Management: Continuous re-attestation and updates.
- ✓ Multi-Payer Paneling: Blue Cross, UHC, Aetna, Cigna, Humana, Medicare.
- ✓ Hospital Privileging Support: Expedited facility appointment coordination.
Verification & Prior Authorization
Front-desk verification errors cause over 60% of all initial claim rejections. Our team validates patient eligibility, co-pays, deductibles, and out-of-pocket maximums before visits while securing mandatory prior authorizations.
- ✓ Real-Time Eligibility Checks: Coverage verified 24-48 hours prior.
- ✓ Fast Prior Authorization: Direct clinical necessity documentation.
- ✓ Patient Co-Pay Clarity: Clear upfront balance guidance for front desk.
Ambulatory Surgical Center Billing
Complex multi-specialty facility fee billing, implant reimbursement tracking, and Medicare ASC payment indicator optimization tailored for surgical centers.
- ✓ Facility vs Professional Billing: Dual UB-04 and CMS-1500 coordination.
- ✓ High-Cost Implant Carve-Outs: Invoice verification for maximum payer payback.
- ✓ Operative Note Scrubbing: Complex surgical coding audit.
The 5-Stage Revenue Cycle Workflow
A structured, continuous operational cycle designed for clinical speed, zero filing lapses, and maximum financial yield.
Encounter Capture
Patient scheduling, demographic verification, and real-time eligibility checks prior to clinical arrival.
Dual Coding Scrub
Dual-level AAPC certified code audit, modifier verification, and automated clearinghouse pre-checks.
Payer Adjudication
Daily EDI 837 claim submission, clearinghouse acceptance verification, and ERA 835 payment tracking.
Denial Resolution
Immediate <48-hr appeal of any rejected claim, documentation retrieval, and payer phone escalation.
Reconciliation & Growth
Accurate secondary billing, clean patient statements, and monthly executive financial reporting.
Full Revenue Cycle Management Solutions
Select any service below to explore our certified workflows, standard operating procedures, and guaranteed outcomes.
Medical Billing
Dual-level claim scrubbing and electronic transmission within 24 hours. We verify patient demographic data, link ICD-10 to CPT with appropriate medical necessity modifiers, and eliminate billing errors before submission.
- Multi-tier claim scrubbing preventing CCI edit rejections
- Electronic claims submission with 98%+ first-pass rate
- Fee schedule analysis to capture underpayments
Works with 50+ Practice Management & EHR Systems
No need to learn new software. AlphaCare works directly inside your current EHR platform.
Search AlphaCare Services & Specialties
Find immediate information on medical billing rates, AAPC certified coding, specialty coverage, denial management, or credentialing. Click search below to filter all site resources instantly.
Medical Billing
Claims submission, payment posting, and EOB reconciliation.
Clinical Specialties
Cardiology, orthopedics, radiology, dermatology & 50+ areas.
Practice Audit
24h custom denial analysis and revenue leakage report.
See How Much We Can Lift Your Monthly Collections
Schedule a 15-minute consultation with an AlphaCare billing specialist. We'll evaluate your current billing bottlenecks and show you our exact roadmap to 98% clean claims.