Your patients first — your billing, on us ◆ Reduce claim denials and improve cash flow ◆ HIPAA-compliant medical billing you can trust ◆ Your patients first — your billing, on us ◆ Reduce claim denials and improve cash flow ◆ HIPAA-compliant medical billing you can trust ◆
OUR SERVICES

Our Complete Services.

Full-service medical billing and revenue cycle support — from front office through credentialing, denial management, and patient billing.

FRONT OFFICE

Front Office

Front Office

Scheduling Patient Appointments

Efficient appointment scheduling plays a critical role in maintaining smooth clinic operations and patient satisfaction. Our scheduling support services help practices manage appointments effectively while reducing no-shows and scheduling conflicts.

Smoother scheduling, fewer no-shows.

Scheduling Patient Appointments

Services include

  • Appointment scheduling and rescheduling
  • Appointment confirmations
  • Managing cancellations and waitlists
  • Coordinating provider availability
  • Updating patient demographic information
  • Assisting with appointment reminders

Key benefits

  • Improved patient experience
  • Better provider utilization
  • Reduced administrative workload
  • Increased operational efficiency
Front Office

Eligibility & Benefits Verification

Verifying insurance coverage before services are provided is one of the most important steps in preventing claim denials and unexpected patient balances. Our team verifies active coverage, benefits, and patient responsibility before services are rendered.

Verify coverage before services are rendered.

Eligibility & Benefits Verification

Services include

  • Active insurance coverage
  • Effective dates
  • Copay responsibilities
  • Deductible amounts
  • Coinsurance obligations
  • Out-of-pocket maximums
  • Coverage limitations
  • Referral requirements
  • Authorization requirements

Key benefits

  • Reduced claim denials
  • Improved patient satisfaction
  • Faster reimbursement
  • Increased collection accuracy
Front Office

Provider Network & Participation Verification

Insurance networks change frequently. We help ensure providers remain properly enrolled and identified within payer networks.

Stay properly enrolled with every payer.

Provider Network & Participation Verification

Services include

  • Verification of provider participation status
  • Confirmation of in-network and out-of-network status
  • Monitoring payer enrollment status
  • Updating provider affiliations
  • Maintaining accurate payer records

Key benefits

  • Reduced network-related denials
  • Improved reimbursement accuracy
  • Better payer communication
Front Office

Referral Management

Many insurance plans require referrals before specialist services can be performed. We obtain, validate, and coordinate referrals so specialist visits proceed without billing delays.

Secure and track required referrals.

Referral Management

Services include

  • Obtaining referrals from PCPs
  • Tracking referral validity
  • Ensuring documentation completeness
  • Coordinating with specialists
  • Verifying referral requirements with insurance companies

Key benefits

  • Reduced claim rejections
  • Improved patient care coordination
  • Faster specialist scheduling
Front Office

Prior Authorization & Retro Authorization

Certain services require payer approval before treatment is rendered. We manage prior, urgent, and retro authorization requests with full documentation and payer follow-up.

Approvals secured before treatment begins.

Prior Authorization & Retro Authorization

Services include

  • Prior authorization requests
  • Urgent authorization submissions
  • Retro authorization requests
  • Tracking authorization status
  • Insurance follow-up
  • Documentation submission

Key benefits

  • Reduced authorization denials
  • Improved reimbursement success
  • Faster treatment approvals

Common services

Imaging studiesSurgeriesInjectionsPhysical therapySpecialty medications
BILLING & CLAIMS

Billing & Claims

Billing & Claims

Medical Coding Services

Accurate coding is essential for clean claims and proper reimbursement. ICD-10, CPT, and HCPCS coding with compliance monitoring and audit support.

Accurate coding for clean claims.

Medical Coding Services

Services include

  • ICD-10 diagnosis coding
  • CPT procedure coding
  • HCPCS coding
  • Modifier review
  • Coding compliance monitoring
  • Coding audits

Key benefits

  • Improved claim accuracy
  • Reduced denials
  • Compliance support
  • Optimized reimbursement
Billing & Claims

Charge Entry

Charge entry converts provider documentation into billable claims. We review superbills, enter charges, and run quality checks before claims are created.

Turn documentation into billable claims.

Charge Entry

Services include

  • Reviewing superbills
  • Entering CPT and ICD-10 codes
  • Reviewing modifiers
  • Verifying units and charges
  • Quality checks before claim creation

Key benefits

  • Accurate claim generation
  • Reduced billing errors
  • Faster claim submission
Billing & Claims

Claims Submission & Management

We prepare, review, and submit claims electronically to insurance payers — correcting rejections and tracking every payer response.

Scrubbed claims, submitted electronically.

Claims Submission & Management

Services include

  • Claim scrubbing
  • Electronic claim submission
  • Rejected claim correction
  • Clearinghouse monitoring
  • Claim tracking

Key benefits

  • Faster claim acceptance
  • Reduced rejections
  • Improved payment turnaround
Billing & Claims

Payment Posting

Accurate payment posting provides visibility into practice revenue. ERA, EOB, and patient payments posted with full reconciliation support.

Clear visibility into practice revenue.

Payment Posting

Services include

  • ERA posting
  • EOB posting
  • Patient payment posting
  • Adjustment posting
  • Reconciliation support

Key benefits

  • Accurate financial reporting
  • Better cash flow tracking
  • Reduced posting errors
REVENUE RECOVERY

Revenue Recovery

Revenue Recovery

Denial Management & Appeals

Denied claims represent lost revenue opportunities if not addressed quickly. We analyze denials, identify root causes, prepare appeals, and resubmit corrected claims.

Recover revenue from denied claims.

Denial Management & Appeals

Services include

  • Denial analysis
  • Root cause identification
  • Claim corrections
  • Appeals preparation
  • Resubmission support
  • Trend reporting

Key benefits

  • Increased collections
  • Reduced recurring denials
  • Improved payer performance
Revenue Recovery

Accounts Receivable (AR) Follow-Up

Outstanding claims require proactive follow-up to ensure payment. We pursue unpaid claims with status checks, payer calls, and aging account management.

Proactive follow-up on outstanding claims.

Accounts Receivable (AR) Follow-Up

Services include

  • Claim status checks
  • Insurance follow-up calls
  • Reprocessing requests
  • Appeals follow-up
  • Aging account management

Key benefits

  • Improved collections
  • Reduced aging balances
  • Better revenue recovery
Revenue Recovery

Patient Billing & Support

Clear patient communication improves satisfaction and collections. We handle billing inquiries, statements, and balance explanations with professionalism.

Clear billing communication for patients.

Patient Billing & Support

Services include

  • Patient billing inquiries
  • Statement support
  • Balance explanations
  • Payment assistance
  • Professional patient communication

Key benefits

  • Improved patient experience
  • Reduced billing confusion
  • Better collections
CREDENTIALING

Credentialing

Credentialing

Credentialing & Provider Enrollment

We assist providers with enrollment and credentialing requirements — initial credentialing, re-credentialing, CAQH, and payer enrollment end to end.

Faster network participation.

Credentialing & Provider Enrollment

Services include

  • Initial credentialing
  • Re-credentialing
  • CAQH maintenance
  • Payer enrollment
  • Medicare enrollment
  • Medicaid enrollment

Key benefits

  • Faster network participation
  • Reduced enrollment delays
  • Improved reimbursement access

Ready to improve your revenue cycle?

Contact AkoreMD today for a free consultation and discover how our billing experts can help increase collections, reduce denials, and streamline your practice operations.

Schedule a Free Consultation →View our services