Revenue Cycle Infrastructure for Medical & Behavioral Health Providers
We help healthcare leaders strengthen the full revenue cycle with AI-enhanced revenue intelligence, operational oversight, payer expertise, denial prevention, and workflow infrastructure designed to identify opportunities faster and support revenue growth.
Full Claim Lifecycle
Eligibility, VOB, authorization & more
End-to-end revenue cycle support
Clean Claim Performance
98%+ First-Pass Clean Claim Rate
Denial Prevention & Recovery
Protecting revenue before and after claim submission
Custom Revenue Reporting
Financial insights tailored to your organization
Denials Are a Symptom. Workflow Is the Cause.
Most denials begin upstream: weak eligibility, incomplete VOB, expired authorizations, claim-field errors, documentation gaps, or payer rules missed inside the EHR workflow.
- Revenue Cycle Challenges
- Revenue Lost to Repeat Denials
- Denials tracked as totals instead of root causes.
- Recurring payer issues remain unresolved.
- Revenue recovery begins after payment delays occur.
- Coverage & Network Visibility Gaps
- Coverage changes often go unnoticed until claims are denied.
- Out-of-network issues create unexpected revenue and patient balance challenges.
- Teams lack a consistent process for identifying and resolving coverage risks.
- Hidden Revenue Risks
- Owners see summaries, not true performance trends.
- Revenue data remains fragmented across systems.
- Payment and A/R risks surface too late.
- How The Hamill Group Solves These
- Denial Prevention Intelligence
- Root causes identified by payer, CPT, and provider.
- Trends drive workflow improvements.
- Prevention occurs before resubmission.
- Coverage & Network Visibility
- Eligibility and benefits verified at key points in the patient journey.
- Network status issues identified and escalated for resolution.
- Clear workflows for patient communication, cash-pay options, and provider reassignment when needed.
- Real-Time Revenue Visibility
- 837, 270/271, and 835 data connected.
- KPI views by payer, provider, CPT, and A/R age.
- Risk alerts for stalled claims and payment gaps.
Full-Spectrum Healthcare Billing Services & Revenue Cycle Operations
THG supports every stage of the revenue cycle, from patient access and claims management to denial prevention, analytics, and executive reporting.
Behavioral Health Billing Services
Deep expertise supporting therapy, psychiatry, SUD, IOP/PHP, telehealth, payer-specific workflows, and complex behavioral health reimbursement models.
Revenue Cycle Management (RCM)
Strengthen financial performance with end-to-end revenue cycle oversight, proactive issue resolution, and clear executive visibility.
Medical Billing & Claims Management
Improve claim acceptance, reduce payment delays, and maximize reimbursement through proactive claims management.
Medical Coding (CPB / RHIA-Aligned)
Accurate coding and documentation review designed to improve claim quality and reduce preventable denials.
Credentialing & Provider Enrollment
Help providers gain and maintain payer participation with streamlined enrollment and credentialing support.
Denial Management & AR Recovery
Identify hidden revenue opportunities, workflow breakdowns, and reimbursement risks before they impact growth.
RCM Audit
Identify hidden revenue opportunities, workflow breakdowns, and reimbursement risks before they impact growth.
The Hamill Group: A Revenue Cycle Operations Partner
The difference between billing and revenue operations is visibility, accountability, and control.
Revenue Cycle Operations. Not Just Billing.
Most healthcare organizations don't struggle because of a single denial, claim, or billing error. Revenue challenges occur when critical functions like patient access, eligibility, claims, payments, denials, and reporting operate independently instead of as a connected system.
The Hamill Group helps healthcare organizations build stronger revenue cycle infrastructure by connecting workflows, improving visibility, and creating accountability across the entire revenue cycle. We don't just manage billing tasks. We help organizations understand where revenue slows down, why it happens, and what actions drive improvement.
By combining operational oversight, revenue analytics, payer expertise, and proven workflows, we help healthcare leaders strengthen financial performance, reduce revenue leakage, and build revenue operations that scale with growth.
Revenue problems rarely begin with a denial.
Most healthcare organizations treat eligibility, claims, denials, follow-up, and reporting as separate tasks instead of connected workflows. As visibility decreases, reimbursement slows, A/R ages, and the same revenue issues repeat month after month. Without operational oversight, organizations often see the symptoms of revenue leakage long before they identify the cause.
The Hamill Group approaches revenue cycle management as a connected operational system, not a collection of billing tasks.
By aligning patient access, eligibility, claims, denials, payments, and reporting into a unified workflow, we help healthcare organizations improve visibility, strengthen accountability, and identify revenue risks before they impact financial performance. The result is a more controlled revenue cycle, stronger payer performance, and revenue operations built to support long-term growth.
Security & Compliance
The Hamill Group is committed to protecting patient information through HIPAA-compliant workflows, role-based access controls, secure technology, Business Associate Agreements where applicable, and industry best practices for safeguarding healthcare data throughout the revenue cycle.
Why Healthcare Organizations Choose The Hamill Group
Partnering with The Hamill Group is more than outsourcing billing. It’s a strategic investment in stronger workflows, greater visibility, and improved revenue performance. Here’s what healthcare organizations gain:
Accelerated Cash Flow & Reduced AR Days
Clean claim submission architecture, including pre-scrubbing against payer-specific edits, reduces first-pass denial rates and accelerates payment timelines. Our Accounts Managers monitor AR aging in real time and initiate follow-up on unpaid claims before they enter the 90-day bucket.
Denial Prevention, Not Just Denial Processing
Most billing agencies track denials. We classify them by CARC/RARC, identify the workflow or documentation failure that caused them, and apply systemic corrections at the front end of the revenue cycle. The goal is to reduce denial volume, not to build a better appeals queue.
Behavioral Health Payer Expertise
Commercial payers, Blue Cross Blue Shield plans, Medicaid managed care organizations (MCOs), and federal programs each apply different coverage, authorization, and documentation rules to behavioral health services. Our behavioral health billing consultants know those rules by payer and manage them proactively on your behalf.
Compliance Risk Reduction
Billing and coding errors create audit exposure. Our coding reviews, documentation audits, and payer-specific compliance monitoring reduce the risk of recoupment, OIG referral, and payer fraud designation, protecting your organization operationally and financially.
Executive Reporting & Revenue Transparency
Your leadership team should not have to request data to understand revenue performance. The Hamill Group provides structured monthly KPI reports covering clean claim rate, denial rate by category, collections ratio, AR aging distribution, and payer-level reimbursement performance, formatted for Physicians, administrators, and billing leadership.
Operational Capacity for Scaling Practices
Growing medical practices and behavioral health organizations face a specific challenge: billing volume scales with patient volume, but internal billing infrastructure rarely keeps pace. Outsourcing to a billing agency with operational depth allows you to grow without rebuilding your back office.
Schedule Your Custom Revenue Performance Review
Meet directly with THG Founder & COO Kira Hamill to review revenue performance, identify operational risks, and uncover opportunities for improvement.
- Revenue Risk Assessment
- Workflow Improvement
- Denial & A/R Analysis
- Actionable Recommendations
How The Hamill Group Manages Your Revenue Cycle?
Practice Discovery & Revenue Cycle Baseline Assessment
Before we touch a single claim, we conduct a structured intake review of your EHR/PM configuration, payer contracts, credentialing status, current denial categories, and AR aging profile. This baseline eliminates the assumption-driven onboarding that causes early billing errors.
Front-End Revenue Cycle Controls
We install front-end controls at the point of scheduling and registration: real-time 270/271 eligibility verification, payer-specific authorization requirement checks, and demographic validation protocols. Front-end error prevention is the highest-ROI intervention in the revenue cycle; it eliminates downstream denials before claims are built.
Claim Preparation, Coding, & Clean Submission
Charges are reviewed by billing teams with CPB-aligned and specialty-specific coding standards. Claims are scrubbed against payer-specific edits and CMS logic before 837 electronic transmission. Medical transcription and documentation reviews are performed where required for E&M and behavioral health CPT accuracy.
Payment Posting, Denial Management & AR Resolution
835 ERA remittances are posted and reconciled against expected reimbursement benchmarks. Denials are classified by CARC/RARC, routed to the appropriate resolution workflow, and tracked through appeals and resubmission. AR aging is monitored in real time with escalation protocols for payer-level outliers.
Reporting, Optimization & Leadership Accountability
Monthly performance reports are delivered to your Accounts Manager and reviewed with practice leadership. KPI trending identifies payer reimbursement erosion, coding drift, and denial pattern changes. Quarterly strategy reviews are conducted for multi-site and behavioral health organizations to align billing operations with organizational growth objectives.
Which Revenue Challenges Are Impacting Your Organization?
Tell us where you’re experiencing revenue challenges, and we’ll help identify the root cause and opportunities for improvement.
Trusted by Healthcare Teams That Need More Than Basic Medical Billing
Medical practices and behavioral health organizations work with The Hamill Group because they need revenue cycle control, not just claim submission. Our team helps improve billing visibility, payer follow-up, denial accountability, and AR workflow support through hands-on account management and technical RCM expertise.
“They were in our EMR within 24 hours, fixed our billing crisis, and claims started paying. Attentive, fast, and highly recommended.”
Cornelia S. Franz
MD @ The Franz Center
The Hamill Group helped connect our eligibility, authorization, claim submission, denial follow-up, and payment posting processes into a more controlled workflow. Their account support feels hands-on and operational.
Graham Johnson
@ Denova Collaborative Health
“They don’t just identify problems, they solve them. THG is, without question, among the very best I’ve worked with in my career.”
Victoria Conditt
@ Touchstone Health Services
Flexible Pricing Built Around Your Organization
Every practice is different. That’s why every THG engagement is customized to your organization’s goals, workflows, and operational needs.
Transparent Pricing
Most practices invest between
3%-7% of collections.
Implementation fees typically range from $1,000-$5,000, depending on implementation complexity.
Monthly collections
Practice size
Number of providers
Existing staffing & internal resources
Revenue cycle complexity
Required scope of services
Specialty Medical Billing Services for Complex Reimbursement Workflows
The Hamill Group supports medical practices and behavioral health organizations with specialty-focused billing workflows. Each specialty has different CPT codes, payer rules, documentation standards, authorization needs, and denial risks. Our billing teams manage those details so claims move more cleanly from intake to reimbursement.
Counseling & Therapy
RCM support for therapy practices handling session-based billing, authorizations, documentation requirements, and recurring payer follow-up.
Psychiatry & Medication Management
Billing support for psychiatric evaluations, medication management visits, behavioral health coding, and payer-specific authorization rules.
Primary Care / Family Medicine
Complete revenue cycle support for high-volume primary care practices managing preventive visits, chronic care, procedures, and routine claims.
Pediatrics
Specialized billing support for pediatric practices, including wellness visits, vaccines, developmental screenings, and family insurance coordination.
Gastroenterology
RCM services for GI practices handling consultations, procedures, endoscopy billing, pathology coordination, and payer documentation requirements.
Orthopedics
Billing support for orthopedic care, including office visits, imaging, injections, surgical claims, modifiers, and post-operative billing rules.
Neurology
Revenue cycle support for neurology practices managing diagnostic testing, chronic condition visits, procedures, and complex payer requirements.
Oncology
RCM support for oncology practices managing chemotherapy billing, infusion services, complex treatment plans, prior authorizations, drug administration, and ongoing payer follow-up.
Ophthalmology / Optometry
RCM support for eye care practices managing medical visits, vision-related services, diagnostics, procedures, and payer-specific coverage rules.
ENT / Otolaryngology
Billing support for ENT practices covering office procedures, diagnostics, surgical services, allergy care, and documentation-based claim accuracy.
Urgent Care
Fast-paced billing support for urgent care centers managing walk-in visits, procedures, labs, payer edits, and high-volume claim submission.
Pain Management
RCM support for pain management providers handling injections, procedures, imaging guidance, authorizations, and strict medical necessity requirements.
- Behavioral & Mental Health Billing Services
Built for behavioral health, psychiatry, therapy, SUD, IOP, PHP, and group practices. THG supports VOB, recurring authorizations, telehealth POS/modifier review, session-level billing, H-code workflows, payer documentation, and denial prevention.
Pick your specialty | Book a free demo
Payer Expertise Across Medicare, Medicaid & Commercial Plans
The Hamill Group manages payer-specific billing workflows across government and commercial plans, helping practices control enrollment, claim rules, prior authorizations, reimbursement checks, denials, and AR follow-up with technical payer-level visibility.
Medicare
THG supports Medicare Part A/B and Medicare Advantage workflows, including MAC portal follow-up, PECOS enrollment checks, CMS-1500/UB-04 claim review, LCD/NCD documentation awareness, AWV billing, secondary coordination, and 835 ERA reconciliation.
Medicaid
Medicaid billing changes by state, MCO, waiver program, and covered service rule. THG manages Medicaid eligibility, prior authorization, state portal workflows, behavioral health carve-outs, revalidation tracking, COB, and payer-specific denial follow-up.
Commercial Payer
THG manages commercial payer workflows across Blue Cross Blue Shield, UnitedHealthcare, Aetna, Cigna, Humana, and regional plans. Our billing teams track authorization rules, timely filing limits, underpayments, contract variance, appeal windows, and patient responsibility transfer.
Medical Billing Services for Healthcare Organizations Across All 50 U.S. States
Medical practices and behavioral health organizations work with The Hamill Group because they need revenue cycle control, not just claim submission. Our team helps improve billing visibility, payer follow-up, denial accountability, and AR workflow support through hands-on account management and technical RCM expertise.
- Multi-state payer rule awareness for Medicare, Medicaid, and commercial plans.
- State-specific Medicaid and managed-care workflow coordination.
- Provider, location, NPI, taxonomy, and payer-enrollment alignment.
- Reporting by payer, state, location, provider, and service line.
Practice Billing Saver Guide:
In-House Cost vs. Managed RCM Infrastructure
The cost of billing is not only staff salaries. It includes supervision, recruiting, training, software, clearinghouse fees, rework, delayed cash, denials, underpayments, and management time.
See How In-House Billing or Your Current Company Stacks Up
Whether you bill in-house or outsource to a company that only submits claims, the outcome is often the same: denials go unworked, AR ages past 90 days, and underpayments slip through uncaught. Basic billing keeps claims moving. It doesn’t protect your revenue.
The Hamill Group replaces submission-only billing with full revenue cycle control, denial accountability, active payer follow-up, and managed AR workflows built to recover what your current setup is leaving behind. Enter your numbers to compare your billing today against The Hamill Group in real dollars.
Revenue Cycle Control
Instead of one or two billers juggling everything, a dedicated team owns your revenue from charge capture to final payment.
Payer Follow-up & Denial Support
No denials left sitting in a queue: persistent follow-up and root-cause appeals recover what stretched in-house teams never get to.
AR Workflow Management
Daily AR work-down with no coverage gaps, so claims don't age out while a biller is on leave.
PRICING IS BASED ON:
See How Much You Could Save With The Hamill Group
EHR-Agnostic Billing Support Without Changing Your System
THG works inside your existing EHR, EMR, practice management, clearinghouse, and payer portal environment. We improve billing workflow design, claim movement, reporting visibility, and payer response management without forcing a platform change.
Why We Provide the Best Behavioral Health RCM Services in the USA
Behavioral health billing breaks when authorizations, VOB, payer rules, and documentation are not managed together. The Hamill Group gives health centers a structured billing workflow built for recurring visits, telehealth claims, payer-specific requirements, and denial prevention.
Behavioral Health RCM Case Studies Built Around Denials, Authorizations, and AR Control
Explore real behavioral health RCM case studies showing how The Hamill Group helps reduce denials, improve authorization workflows, and bring aging AR back under control with hands-on operational support.
Authorization Denial Control for Recurring Therapy Claims
THG helped a behavioral health group control recurring therapy and psychiatry claim denials by connecting VOB notes, approved units, CPT codes, authorization dates, provider details, and reauthorization deadlines into one payer-specific billing workflow.
Fixing POS, Modifier, and Payer Rule Errors in Telehealth Claims
THG helped a behavioral health provider reduce telehealth billing errors by reviewing payer-specific POS rules, modifier requirements, documentation, authorization links, and claim setup before submission.
Authorization Denial Control for Recurring Therapy Claims
THG helped a behavioral health group control recurring therapy and psychiatry claim denials by connecting VOB notes, approved units, CPT codes, authorization dates, provider details, and reauthorization deadlines into one payer-specific billing workflow.
Ready to Trace Denials Back to the Workflow That Caused Them?
If clean-looking claims are still denied or AR is aging past 60 days, the issue is likely workflow control. Get a no-commitment RCM review to identify denial causes, authorization gaps, and recovery opportunities.
- Claim-Level Review
- Payer-Specific Controls
Frequently Asked Questions
What is included in The Hamill Group’s medical billing services?
Our medical billing services cover eligibility checks, VOB, charge review, CPT/ICD-10/HCPCS validation, 837 claim submission, clearinghouse rejection correction, 835 ERA posting, denial management, AR follow-up, secondary billing, and KPI reporting.
How is THG different from a generic medical billing company?
Most billing companies submit claims and follow up after problems happen. THG manages the revenue cycle workflow behind the claim, including front-end controls, payer-specific edits, denial root-cause analysis, AR segmentation, and executive reporting.
Does THG support both professional and institutional claim workflows?
Yes. THG can support professional and institutional billing workflows where applicable, including 837P/837I claim submission, payer edits, payment posting, denial routing, and AR follow-up.
How does THG reduce preventable claim rejections?
We review claims before submission for NPI, taxonomy, POS, modifiers, diagnosis pointers, subscriber details, COB sequencing, authorization linkage, payer edits, and documentation gaps.
Can THG work with our internal billing team?
Yes. THG can work with internal billing teams, Physicians, Coders, front-desk staff, Accounts Managers, administrators, and leadership to improve claim ownership, payer follow-up, and revenue visibility.
Why does behavioral health billing require specialized workflows?
Behavioral health billing includes recurring visits, VOB, prior authorizations, telehealth rules, session-level CPT coding, H-code workflows, medical necessity documentation, and payer-specific carve-outs. These workflows need tighter control than standard billing.
When browsing the offering of rich royal casino australia, the thoughtful structure of the platform becomes apparent quickly. Assistance offerings for gambling addiction prevention are made available directly in the account. Player leaderboards in tournaments provide healthy competition within the community. An official contact address for legal enquiries is provided in the imprint. Play sessions can be seamlessly continued between desktop and smartphone. Personal game lists and favourites ease quick access to preferred titles. Players can configure their own daily, weekly and monthly limits when needed. No-deposit bonuses allow players to test the platform without financial risk. Live roulette tables offer various game variants from classic European to Lightning Roulette. The wealth of possibilities makes the casino a destination worth more than one visit.
When browsing the offering of rich royal casino australia, the thoughtful structure of the platform becomes apparent quickly. Assistance offerings for gambling addiction prevention are made available directly in the account. Player leaderboards in tournaments provide healthy competition within the community. An official contact address for legal enquiries is provided in the imprint. Play sessions can be seamlessly continued between desktop and smartphone. Personal game lists and favourites ease quick access to preferred titles. Players can configure their own daily, weekly and monthly limits when needed. No-deposit bonuses allow players to test the platform without financial risk. Live roulette tables offer various game variants from classic European to Lightning Roulette. The wealth of possibilities makes the casino a destination worth more than one visit.
When browsing the offering of rich royal casino australia, the thoughtful structure of the platform becomes apparent quickly. Assistance offerings for gambling addiction prevention are made available directly in the account. Player leaderboards in tournaments provide healthy competition within the community. An official contact address for legal enquiries is provided in the imprint. Play sessions can be seamlessly continued between desktop and smartphone. Personal game lists and favourites ease quick access to preferred titles. Players can configure their own daily, weekly and monthly limits when needed. No-deposit bonuses allow players to test the platform without financial risk. Live roulette tables offer various game variants from classic European to Lightning Roulette. The wealth of possibilities makes the casino a destination worth more than one visit.
When browsing the offering of rich royal casino australia, the thoughtful structure of the platform becomes apparent quickly. Assistance offerings for gambling addiction prevention are made available directly in the account. Player leaderboards in tournaments provide healthy competition within the community. An official contact address for legal enquiries is provided in the imprint. Play sessions can be seamlessly continued between desktop and smartphone. Personal game lists and favourites ease quick access to preferred titles. Players can configure their own daily, weekly and monthly limits when needed. No-deposit bonuses allow players to test the platform without financial risk. Live roulette tables offer various game variants from classic European to Lightning Roulette. The wealth of possibilities makes the casino a destination worth more than one visit.
When browsing the offering of rich royal casino australia, the thoughtful structure of the platform becomes apparent quickly. Assistance offerings for gambling addiction prevention are made available directly in the account. Player leaderboards in tournaments provide healthy competition within the community. An official contact address for legal enquiries is provided in the imprint. Play sessions can be seamlessly continued between desktop and smartphone. Personal game lists and favourites ease quick access to preferred titles. Players can configure their own daily, weekly and monthly limits when needed. No-deposit bonuses allow players to test the platform without financial risk. Live roulette tables offer various game variants from classic European to Lightning Roulette. The wealth of possibilities makes the casino a destination worth more than one visit.
When browsing the offering of rich royal casino australia, the thoughtful structure of the platform becomes apparent quickly. Assistance offerings for gambling addiction prevention are made available directly in the account. Player leaderboards in tournaments provide healthy competition within the community. An official contact address for legal enquiries is provided in the imprint. Play sessions can be seamlessly continued between desktop and smartphone. Personal game lists and favourites ease quick access to preferred titles. Players can configure their own daily, weekly and monthly limits when needed. No-deposit bonuses allow players to test the platform without financial risk. Live roulette tables offer various game variants from classic European to Lightning Roulette. The wealth of possibilities makes the casino a destination worth more than one visit.
When browsing the offering of rich royal casino australia, the thoughtful structure of the platform becomes apparent quickly. Assistance offerings for gambling addiction prevention are made available directly in the account. Player leaderboards in tournaments provide healthy competition within the community. An official contact address for legal enquiries is provided in the imprint. Play sessions can be seamlessly continued between desktop and smartphone. Personal game lists and favourites ease quick access to preferred titles. Players can configure their own daily, weekly and monthly limits when needed. No-deposit bonuses allow players to test the platform without financial risk. Live roulette tables offer various game variants from classic European to Lightning Roulette. The wealth of possibilities makes the casino a destination worth more than one visit.
When browsing the offering of rich royal casino australia, the thoughtful structure of the platform becomes apparent quickly. Assistance offerings for gambling addiction prevention are made available directly in the account. Player leaderboards in tournaments provide healthy competition within the community. An official contact address for legal enquiries is provided in the imprint. Play sessions can be seamlessly continued between desktop and smartphone. Personal game lists and favourites ease quick access to preferred titles. Players can configure their own daily, weekly and monthly limits when needed. No-deposit bonuses allow players to test the platform without financial risk. Live roulette tables offer various game variants from classic European to Lightning Roulette. The wealth of possibilities makes the casino a destination worth more than one visit.
When browsing the offering of rich royal casino australia, the thoughtful structure of the platform becomes apparent quickly. Assistance offerings for gambling addiction prevention are made available directly in the account. Player leaderboards in tournaments provide healthy competition within the community. An official contact address for legal enquiries is provided in the imprint. Play sessions can be seamlessly continued between desktop and smartphone. Personal game lists and favourites ease quick access to preferred titles. Players can configure their own daily, weekly and monthly limits when needed. No-deposit bonuses allow players to test the platform without financial risk. Live roulette tables offer various game variants from classic European to Lightning Roulette. The wealth of possibilities makes the casino a destination worth more than one visit.
What behavioral health services does THG support?
THG supports billing for therapy, psychiatry, counseling, group therapy, SUD, IOP, PHP, telehealth visits, and multi-provider behavioral health organizations.
How does THG manage behavioral health authorizations?
We track authorization numbers, approved units, CPT/HCPCS codes, provider details, date ranges, payer rules, documentation requests, re-authorization deadlines, and concurrent review needs.
Does THG support telehealth billing for behavioral health?
Yes. THG reviews telehealth claims for POS 02/10, modifiers 95, GT, or GQ where applicable, payer-specific rules, documentation support, authorization status, and session-level coding accuracy.
How does THG prevent repeat behavioral health denials?
We classify denials by CARC/RARC, payer, CPT, provider, authorization status, service line, documentation issue, and workflow source to identify whether the root cause is VOB, authorization, coding, documentation, or payer policy.
How is pricing for THG’s billing services determined?
Pricing depends on specialty, claim volume, payer mix, provider count, number of locations, EHR/PM setup, denial volume, AR cleanup needs, credentialing scope, reporting requirements, and service complexity.
Does behavioral health billing have different pricing?
It may, because behavioral health often requires deeper VOB, recurring authorization tracking, telehealth validation, H-code support, session-level review, and payer-specific documentation management.
Is AR cleanup included in standard pricing?
Aged AR cleanup is usually reviewed separately because old claims require denial analysis, timely filing checks, payer status review, appeal validation, underpayment review, and recoverability scoring.
Do you offer pricing based on collections?
Pricing can be structured based on the client’s scope, volume, specialty, and revenue cycle needs. Final pricing is confirmed after reviewing claim volume, payer mix, AR status, EHR setup, and workflow complexity.
What should we review before requesting a quote?
Review your claim volume, denial rate, AR over 90 days, payer mix, provider count, authorization volume, EHR limitations, credentialing gaps, and reporting needs. These factors affect the scope and pricing model.
Do we need to change our EHR to work with THG?
Our medical billing services cover eligibility checks, VOB, charge review, CPT/ICD-10/HCPCS validation, 837 claim submission, clearinghouse rejection correction, 835 ERA posting, denial management, AR follow-up, secondary billing, and KPI reporting.
What parts of the EHR workflow does THG review?
Our medical billing services cover eligibility checks, VOB, charge review, CPT/ICD-10/HCPCS validation, 837 claim submission, clearinghouse rejection correction, 835 ERA posting, denial management, AR follow-up, secondary billing, and KPI reporting.
How does THG identify EHR-to-clearinghouse issues?
Our medical billing services cover eligibility checks, VOB, charge review, CPT/ICD-10/HCPCS validation, 837 claim submission, clearinghouse rejection correction, 835 ERA posting, denial management, AR follow-up, secondary billing, and KPI reporting.
Can THG help with 835 ERA posting issues?
Our medical billing services cover eligibility checks, VOB, charge review, CPT/ICD-10/HCPCS validation, 837 claim submission, clearinghouse rejection correction, 835 ERA posting, denial management, AR follow-up, secondary billing, and KPI reporting.
Does THG support documentation or medical transcription handoff issues?
Our medical billing services cover eligibility checks, VOB, charge review, CPT/ICD-10/HCPCS validation, 837 claim submission, clearinghouse rejection correction, 835 ERA posting, denial management, AR follow-up, secondary billing, and KPI reporting.
How does THG protect PHI during billing operations?
THG follows compliance-focused workflows that support role-based access, secure documentation, PHI handling controls, payer record management, BAA requirements where applicable, and audit-ready billing notes.
Does THG work with HIPAA billing transaction standards?
Yes. THG works around HIPAA-related billing workflows, including 837 claim submission, 835 ERA posting, 270/271 eligibility, 276/277 claim status, and 278 authorization/referral workflows where applicable.
How does THG support payer audit readiness?
THG can help organize claim notes, payer communication, appeal documentation, authorization records, EOB/ERA files, denial history, and supporting documentation needed for payer audit response.
How does THG reduce compliance risk in billing workflows?
We review coding alignment, documentation support, payer requirements, authorization status, provider setup, billing notes, payment adjustments, and repeat denial patterns to reduce preventable exposure.
Can THG publish HIPAA, ISO, CPB, or RHIA certification claims?
Only if verified documentation is available. Safe website wording is HIPAA-aware processes, ISO 27001:2022-aligned controls, CPB-aligned billing workflows, and RHIA-informed documentation standards unless formal proof is confirmed.