What is the difference between medical coding and medical billing?

Medical coding converts clinical documentation into standardized codes (ICD-10, CPT). Medical billing uses those codes to submit claims to payers and manage collections. CODEMED does both under one roof.

How quickly can outsourced billing reduce our A/R days?

Most CODEMED clients see A/R days drop within 60–90 days as denial root causes are addressed and clean claim rates improve. Average reduction is 14 days.

Do you handle denial management and appeals?

Yes — denial management and payer-specific appeals are core services. We identify root causes, fix upstream errors, and recover what you're owed.

What is a clean claim rate and what should ours be?

A clean claim rate measures the percentage of claims accepted by payers on first submission. Industry average is 75–85%. CODEMED clients average 98%.

Hospital & Physician Billing Services

What's included

End-to-end revenue cycle services

From the first eligibility check to the final dollar collected — and the infrastructure that makes it all sustainable.

01 Front-End Operations · before the claim exists

ELIGIBILITY

Eligibility & benefits verification

Coverage, benefits, and authorization requirements confirmed before the visit — so claims don't fail for reasons you could have caught at scheduling.

PRIOR AUTH

Prior authorization support

We track payer auth requirements, submit requests, and follow them to approval, keeping high-dollar procedures from stalling in the queue.

CREDENTIALING

Credentialing & provider enrollment

New providers enrolled with every payer before their first patient, and revalidations tracked so nobody quietly falls out of network.

TRAINING

Front office education

Your front desk is the first line of defense for clean revenue. We train registration and scheduling staff on eligibility, collection, and data accuracy at the point of service.

02 Charge Capture & Claims · getting the right claim out the door

CHARGES

Charge capture

Every billable service documented, coded, and captured. We close the gap between what your providers do and what actually gets billed.

EHR

EHR selection & software assistance

Vendor-neutral guidance on selecting, configuring, and optimizing your EHR and practice management system for billing performance, not just documentation.

CLAIMS

Claim scrubbing & submission

Claims edited against payer-specific rules before they leave the building. First-pass acceptance is the cheapest dollar in revenue cycle.

03 Collections & Recovery · everything owed, pursued

DENIALS

Denial management & appeals

Root-cause analysis on every denial, appeals written by credentialed coders, and process fixes that keep the same denial from coming back.

A/R

A/R recovery

Aged receivables worked systematically by payer and dollar value — including the legacy A/R your team stopped touching months ago.

UNDERPAYMENTS

Payer underpayment audits

We compare actual reimbursement against your contracted rates line by line and pursue the variance. Most practices never check.

POSTING

Payment posting & reconciliation

ERAs and paper EOBs posted accurately and reconciled to deposits, so underpayments and takebacks surface instead of hiding in the ledger.

04 Strategy & Advisory · the infrastructure underneath it all

CONTRACTING

Payer contracting

Contract review, fee schedule benchmarking, and negotiation support — so you know exactly what you signed and whether it's worth renewing.

PATIENT PAY

Patient financial counseling

Clear estimates, payment plans, and financial conversations handled before and after care — improving collections without sending patients to collections.

REPORTING

RCM reporting & analytics

Monthly reporting on the KPIs a CFO actually acts on: days in A/R, denial rate, net collection rate, and where the leakage is.

Gain clarity. Get paid faster.

End-to-end revenue cycle services

Assessment first, always

Clean coding deserves clean billing