Services Background

Core Service Lines

Twelve RCM Services.
One Accountable Team.

Every MeBilling service is supported by trained billing, coding, and RCM specialists who work within your approved EMR/PM workflows.

How Our Services Work

12 services.
One accountable team.

See how our specialty-organized billing teams manage the complete revenue cycle — from coding and claims through denial management, IDR, and arbitration — all in-house.

— What We Do

The Full Scope of MeBilling Services

From clean claim submission to formal arbitration — every service your revenue cycle depends on, handled in-house by the specialists who do it every day.

Audit Services
COMPLIANCE

Audit Services

A billing audit is a revenue recovery tool, not just a compliance checkbox. Our AAPC-certified auditors examine coding accuracy, documentation quality, charge capture, and denial patterns to surface exactly where revenue is quietly leaving your practice — and how to stop it.

  • E/M level, surgical coding, and modifier accuracy audits
  • DRG validation, HCC/risk adjustment, and “CDI” gap analysis
  • Compliance gap reporting with a clear remediation roadmap
Enrollment & Credentialing
PROVIDER LIFECYCLE

Enrollment & Credentialing

Every day a provider waits on credentialing is a day your practice cannot bill. We manage the complete enrollment lifecycle across 90+ payer networks — from initial application through CAQH attestation, license renewals, and revalidation — with billing and credentialing handled by the same team so gaps are caught immediately.

  • Medicare, Medicaid, PECOS, CAQH, and 90+ commercial payer networks
  • NPI, TIN, EDI (claims, ERA & EFT) enrollment and maintenance
  • Proactive revalidation and license deadline monitoring
Medical Coding
CLINICAL ACCURACY

Medical Coding

One wrong modifier or a missed digit can turn a billable service into a denial. Our CPC and CPMA-certified coders are organized by specialty — oncology coders code oncology — applying ICD-10, CPT, and HCPCS codes with the depth and payer-specific precision that generalist teams can't match.

  • ICD-10, CPT, and HCPCS coding across all specialties and facility types
  • Modifier precision: 25, 59, 50, TC/26, and payer-specific rules
  • HCC and risk adjustment coding for Medicare Advantage populations
Revenue Cycle Management
END-TO-END RCM

Revenue Cycle Management

From patient registration to final payment posted — MeBilling manages the complete billing lifecycle with no subcontractors and no accountability gaps. Our 98%+ “clean claim rate” means fewer denials, faster cash, and a revenue cycle that performs at the level your practice earns.

  • Registration, eligibility verification, and prior authorization management
  • Claims scrubbing and submission within 48 hours of date of service
  • Denial management, A/R follow-up, and real-time performance dashboards
Federal IDR (No Surprises Act)
NSA / IDR

Federal IDR (No Surprises Act)

The No Surprises Act created a formal legal pathway — Independent Dispute Resolution — for providers to challenge payer underpayments on out-of-network claims. Most practices leave this revenue uncollected simply because they lack the bandwidth to pursue it. We manage the entire IDR process in-house, from eligibility screening to payment enforcement.

  • NSA eligibility review and QPA benchmarking analysis
  • Federal IDR portal submission and timeline management
  • Post-determination payment collection and enforcement
Old Claims Recovery
RECOVERY

Old Claims Recovery

Claims at 90, 120, or 180 days are not automatically uncollectable — but they need a different approach than standard A/R follow-up. Our recovery team categorizes outstanding claims by recoverability, rebuilds the documentation trail needed for late appeals, and collects revenue that most practices have already written off.

  • Aged A/R stratification and recoverability assessment by payer
  • Timely filing analysis and jurisdiction-specific reconsideration arguments
  • Documentation reconstruction and recovery outcome reporting
Payment Posting & Reconciliation
FINANCIAL OPS

Payment Posting & Reconciliation

Payment posting is the financial record of your practice — not clerical admin. Every ERA processed and every remittance reconciled establishes whether payers are actually paying what they owe. We post daily, validate against contracted rates, and pursue every variance — your books reflect reality, not assumption.

  • ERA auto-posting and manual remittance processing completed daily
  • Contractual rate reconciliation with underpayment variance follow-up
  • Patient balance calculation and real-time A/R dashboards
Injury Claims Management
LIABILITY & INJURY

Injury Claims Management

Injury billing — workers' compensation, motor vehicle accidents, personal injury — operates under a completely different framework from standard insurance billing. Lien structures, letter of protection arrangements, and state-specific workers' comp regulations require dedicated expertise that most billing teams simply don't carry.

  • Workers' comp billing under state-specific fee schedules and regulations
  • MVC billing across PIP and liability, with adjuster follow-up managed in-house
  • Personal injury lien filing and letter of protection management
Claims Negotiation
PAYER RELATIONS

Claims Negotiation

Many payer disputes can be resolved through skilled direct negotiation — before formal appeals or IDR become necessary. Our negotiation team engages payers directly on underpayments, global claim disputes, and systematic contract rate deviations, building fact-based cases grounded in your contractual terms and market benchmarks.

  • Single-claim and pattern-level underpayment negotiation and recovery
  • Contractual rate enforcement with documented dispute history
  • Escalation pathway management: negotiation → appeals → IDR → arbitration
Appeals & Reconsideration
DENIAL RESOLUTION

Appeals & Reconsideration

Every denial has a case to be made — if you know how to make it. Our appeals process is built claim by claim, not template by template. We categorise each denial by root cause, identify the strongest reconsideration pathway, and construct appeals backed by clinical documentation and coding evidence tailored to the specific rejection reason.

  • Root cause categorisation: coding, clinical, eligibility, or administrative
  • Per-claim appeal letters with supporting documentation — never templated
  • Peer-to-peer review coordination and denial pattern tracking
Arbitration & Mediation
FORMAL DISPUTE

Arbitration & Mediation

When negotiation and formal appeals are exhausted, arbitration and mediation are the next escalation — and they require a different kind of preparation. We manage both in-house, assembling the evidentiary record and procedural submissions needed to pursue disputed claims through formal channels without the cost of outside counsel.

  • Evidence package development and case preparation for arbitration
  • Mediation coordination with payer representatives and third parties
  • Resolution tracking and payment enforcement after decisions are rendered
State Reporting
COMPLIANCE

State Reporting

State-level reporting requirements vary by jurisdiction and payer type — and missing them can affect both reimbursement and licensure. We monitor reporting obligations specific to your operating states and manage all required submissions on your behalf, so regulatory deadlines never fall through the cracks of your billing operation.

  • State-specific payer reporting obligations tracked and filed by jurisdiction
  • Medicaid encounter data submissions and agency coordination
  • Workers' comp state form filing and audit-ready compliance documentation