Rural Healthcare Billing Services

Specialized Rural Healthcare Billing Solutions That Maximize Revenue, Minimize Denials, and Ensure Total Compliance

Why Choose Our Hospital-Based Physician Billing Solutions?

Deep Rural Healthcare Experience: Our team understands the unique billing, payer, and coding challenges faced by rural hospitals, clinics, and critical access facilities—including swing beds, telehealth, and provider-based clinics.
Custom In-House Technology: Our billing platform integrates with rural hospital EMRs, small practice management systems, and government reporting tools, ensuring accuracy and speed even with limited local IT resources.
Regulatory Compliance: Stay fully compliant with CMS, critical access hospital (CAH), Medicaid, and rural-specific regulations. We help safeguard vital reimbursements and protect your facility’s bottom line.

Rural & CAH Coding Expertise: Proficient in coding for rural health settings—including critical access hospitals, provider-based clinics, outpatient services, swing bed care, and telehealth. Expert in applying correct codes for varied rural patient encounters.
Complex Care Billing: Accurate management of multidisciplinary and cross-setting care scenarios, including transitions between inpatient, swing bed, outpatient, and clinic visits, ensuring all eligible services are captured and reimbursed.
Integration & Accuracy: Automated interfaces for rural EMRs, patient registration, and scheduling streamline data entry and minimize manual billing errors, even with limited local resources..
Modifier Management: Application of rural-specific modifiers (e.g., CAH, telehealth, 25, 26, TC, 59), ensuring services are properly identified, optimizing payments, and reducing denials.

Clean Claim Submission: Ensure every claim is built with the correct CPT/HCPCS codes, documentation, and payer-specific rules.
Denial Analysis & Appeals: Rapid response to denials, focused on root-cause analysis, resubmission, and appeals to recapture lost revenue.
Payment Posting & Reconciliation: Detailed payment posting, with customized reports tracking collections, adjustments, and outstanding balances.

EMR and Hospital Data Transfers: Automated interfaces for imaging studies, reports, and patient demographics, minimizing manual entry and errors.
Customizable Workflows: Adapt quickly to your hospital or group’s processes for scheduling, reporting, and patient prep.

Productivity Dashboards: View volume by modality, provider productivity, and reimbursement trends in real time.
Revenue Cylcle Analytics: Track days in A/R, denials rates, and charge lag to proactively spot and solve issues

Specialties

EDI Claims Billed

Denial Rate