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Medical Billing Services

Medical Billing That Follows Every Claim Through to Payment

From eligibility checks to final payment posting, Getwell Healthcare Solutions manages the billing work that keeps cash flowing, and shows you exactly where each claim stands.

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  • Claims scrubbed before submission
  • Denials worked by root cause
  • Regular A/R and payer reporting
Stethoscope resting on a laptop keyboard used for medical billing
Physician reviewing billing documents at a desk

Overview

Billing Support Designed Around Your Practice

Billing problems rarely start at the claim. They often begin with a missed eligibility check, an outdated insurance card, a coding mismatch or a provider who is not yet enrolled with a payer. Our billing service looks at the whole path, not just the submission step.

We work inside your existing practice management system and clearinghouse whenever possible, follow your fee schedules and payer contracts, and coordinate with your front desk on the information we need to submit clean claims.

  • Charge entry and CPT, ICD-10 and HCPCS coding review
  • Electronic claims submission and rejection handling
  • ERA/EOB payment posting and reconciliation
  • Denial management, appeals and A/R follow-up
  • Patient statement support and practice reporting

Our Billing Process

How a Claim Moves Through Our Workflow

Each step has a defined owner and a defined hand-off, so claims do not sit unnoticed.

  1. Eligibility and benefits

    Coverage, plan details and authorization requirements are confirmed before the visit when schedules are shared with us.

  2. Charge capture and coding review

    Charges are entered from encounter documentation and checked for CPT, ICD-10 and HCPCS consistency and modifier use.

  3. Claim scrubbing and submission

    Claims are validated against payer and clearinghouse edits, then submitted electronically.

  4. Rejection and status tracking

    Clearinghouse and payer rejections are corrected and resubmitted, and claim status is monitored.

  5. Payment posting

    ERA and paper payments are posted, adjustments reviewed, and patient responsibility transferred.

  6. Denials and A/R follow-up

    Denied, underpaid and aging claims are worked, corrected or appealed until resolved.

  7. Reporting

    You receive reports on collections, aging, denials and open issues, with time to review them together.

Billing specialist preparing insurance claims on a laptop

Claims Submission

Clean Claims Start Before They Are Sent

We review each claim for the details payers commonly reject: demographic and subscriber mismatches, missing or invalid NPIs, place-of-service errors, modifier issues and diagnosis codes that do not support the billed procedure.

Claims are submitted electronically through your clearinghouse on an agreed schedule. Rejections are addressed quickly so they do not age into timely filing problems.

  • Professional (CMS-1500 / 837P) and institutional claim formats as applicable
  • Payer-specific edits and documentation requirements
  • Secondary and tertiary claim submission
  • Timely filing deadlines tracked by payer
More on Claims Management

Insurance Verification

Eligibility and Benefits Verification

Many avoidable denials trace back to coverage details that were not confirmed at the start. We help close that gap.

Active coverage

Confirm the plan is active on the date of service and the subscriber details match.

Benefits detail

Copays, coinsurance, deductibles and visit limits relevant to the planned service.

Prior authorization support

Identify when authorization or referral is required and help gather what the payer requests.

Coordination of benefits

Determine primary and secondary payers so claims are sent in the correct order.

Billing team posting insurance payments on computers

Payment Posting

Accurate Posting and Reconciliation

Payment posting is where underpayments and incorrect adjustments are either caught or missed. We post electronic remittances (ERA/835) and paper EOBs, compare what was paid to what was expected, and flag variances for follow-up.

Posted payments are reconciled to deposits, and patient balances are moved to responsibility promptly so statements go out on time.

  • ERA auto-posting review and manual EOB posting
  • Adjustment and write-off review against contracts
  • Underpayment and zero-pay flagging
  • Deposit reconciliation support

Denial Management

Work Denials, Then Prevent the Next One

Every denial is reviewed, categorized and routed. Patterns are reported back so the upstream cause can be fixed.

Categorize by root cause

Eligibility, authorization, coding, credentialing, timely filing and documentation denials are tracked separately.

Correct or appeal

Correctable claims are fixed and resubmitted; others receive a written appeal with supporting documentation.

Feed back into prevention

Recurring issues are shared with your team, with suggested changes to front-end or coding steps.

Denial Management Details
Stethoscope beside a phone used for payer follow-up calls

A/R Follow-Up

Accounts Receivable That Does Not Get Left Behind

Unpaid claims become harder to collect the longer they sit. We work aging reports on a regular schedule, prioritizing by balance, payer and filing deadline, and contact payers by portal or phone to move claims forward.

If you have an existing backlog, we can take on an A/R cleanup project alongside ongoing billing.

  • Aging reviewed by payer and age bucket
  • Payer portal and phone follow-up
  • No-response and underpayment follow-up
  • Credit balance and refund review

Revenue Cycle

Billing as Part of the Full Revenue Cycle

Billing performs best when the steps before and after it are aligned. We can support the rest of the cycle too.

Revenue Cycle Support

Front end

Registration accuracy, eligibility checks and authorization tracking.

Mid cycle

Charge capture, coding review and claim preparation.

Back end

Posting, denials, A/R follow-up, patient balances and reporting.

Why Choose Us

In-House Billing vs. Working With Getwell Healthcare Solutions

Many practices use a mix of both. Here is how the approaches generally compare.

  • Coverage and continuityA team-based approach helps avoid backlogs when a staff member is out or leaves.
  • VisibilityRegular reports on aging, denials and collections, reviewed with you.
  • Credentialing connectionBilling and enrollment issues handled by one partner.
FactorTypical in-house setupWith Getwell Healthcare Solutions
Staffing Hire, train and cover absences yourself Team-based coverage for billing tasks
Denial follow-up Often worked as time allows Worked on a defined schedule by root cause
Payer rule changes Tracked by individual staff Monitored as part of daily work
Reporting Depends on staff time and system skills Regular practice-level reports
Credentialing issues Often handled separately Coordinated with billing
Control Full direct control You keep access to your systems and data

Every practice is different. We will discuss which tasks make sense to keep in-house during your consultation.

FAQs

Medical Billing FAQs

Answers to questions practices often ask before outsourcing billing.

Still have questions?

Talk with a licensed insurance professional.

(445) 300-7597 Mon–Fri 8am–8pm ET

Getwell Healthcare Solutions helps healthcare providers manage the revenue cycle, including charge entry, claim submission, payment posting, denial management, and accounts receivable follow-up. We tailor our services to your practice’s specialty and workflow. Our goal is to help you get paid accurately while reducing administrative burden.

We work with a range of healthcare providers, including independent physicians, group practices, and specialty clinics. Each practice has unique billing needs, so we begin by understanding your specialty, payer mix, and current processes. Contact us to discuss whether our services are a good fit.

We review denied claims to identify the cause, correct errors, and resubmit or appeal when appropriate. We also look for patterns in denials so that recurring issues can be addressed at the source. This helps reduce future denials and improve cash flow.

Yes. We provide regular reporting so you can see claim status, collections, and outstanding balances. Transparency is central to how we work, and we are available to walk you through reports and answer questions.

In many cases, yes. We can often work within your current practice management or EHR system. During your consultation, we will review your technology setup and discuss the best approach.

We follow HIPAA requirements and use secure processes to handle protected health information. Access is limited to the team members who need it to perform their work. We are happy to discuss our privacy and security practices and sign a Business Associate Agreement.

Start by scheduling a free consultation. We will learn about your practice, review your current billing challenges, and explain how we can help. There is no obligation to move forward.

Consultation

Talk With Us About Your Billing

Tell us about your practice and what you would like to improve.

We will review your current billing workflow, open A/R and denial patterns, then recommend a scope that fits. Please do not include any patient health information in this form.

  • No-obligation discovery call
  • Review of current billing challenges
  • Clear proposal and onboarding plan

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