Services we offer
Your job is to take care of your patients, not worry about the right billing processes.
Denied claims, slow collections, and credentialing gaps do not happen only because healthcare billing is complicated. They happen because managing it correctly requires full-time attention that most in-house teams cannot maintain while running a practice.
MedHeave handles billing, coding, and end-to-end revenue cycle operations so providers can stay focused on patient care.
You cannot fix a revenue problem you do not have time to audit.
Most practices do not lose revenue to a single identifiable problem. They lose it to several smaller issues that run simultaneously. Individually, they seem too minor to prioritize, and collectively, they compound, resulting in massive revenue leaks.
- An authorization that keeps getting delayed.
- A denial that nobody on your team has time to appeal.
- A credentialing gap that freezes billing for a provider.
MedHeave was built to handle your entire RCM under one roof, so every part of your billing cycle has someone accountable for it.
Revenue cycle management isn’t your job. It’s ours.
Whether you run a single-provider practice or a multi-specialty group, our end-to-end RCM services are designed to reduce the administrative burden on your staff, accelerate your collections, reduce denials, and give you full visibility into where your revenue stands.
Revenue cycle management
MedHeave manages your entire revenue cycle as one integrated system, covering eligibility, charge capture, coding, claim submission, and AR follow-up until fully paid.
Medical billing
We run your complete billing cycle, from charge entry through denial appeals, with a dedicated team accountable at every stage, so you generate revenue on every claim.
Medical coding
We review every diagnosis, procedure, and modifier against your documentation and payer-specific edits, so a coding error is never the reason you lose revenue overall.
Medical credentialing
We manage your credentialing cycle, from primary source verification to CAQH maintenance and PECOS enrollment, so lapsed credentials never cause a claim denial.
Prior authorization
We handle every prior authorization request with the exact documentation each payer needs, follow it through to approval, and appeal every denial so care never stalls.
Denial management
Denial management runs as a dedicated function on our end, with the payer knowledge and the root-cause discipline to recover every dollar that belongs to the practice.
Patient billing
We confirm patient responsibility from EOBs, send up to three statements, make follow-up calls, and coordinate payment plans before escalating accounts to collections.
Workers' compensation and no-fault billing
We verify claims, submit correct codes and documents within 24-48 hours, follow up with adjusters on delays, and manage denials & appeals until you get paid in full.
AR recovery
Aging accounts receivable is losing revenue every day it goes unworked. We follow up on outstanding balances systematically and have consistently kept client AR under 40 days.
In-network billing
In-network billing pays what it should only when every claim aligns with your contracted rates. We manage provider enrollment, fee schedule compliance, PCP assignments, bundled payments, capitated rates, and incident-to billing, so nothing is underpaid.
Out-of-network billing
OON billing requires negotiation, documentation, and follow-through that in-house teams rarely have the capacity for. We manage the full process and maximize your revenue.
Reporting and analytics
Your billing data tells a story about where revenue is leaking. We surface that data in a clear format so you can make decisions based on numbers rather than instinct.
Virtual medical assistant
A trained virtual assistant handles appointment scheduling, patient follow-ups, and administrative intake without the overhead of adding full-time staff to your payroll.
Insurance eligibility verification
We verify patient coverage before every visit, eliminating the billing surprises that create disputes, write-offs, and strained patient relationships after the fact.
No-surprise act & IDR
We handle full NSA compliance, including good faith estimates, open negotiation, and IDR filing through the CMS portal with QPA analysis. Our IDR success rate runs 75 to 85%.
Referral management
We verify every referral for matching NPI, visit count, CPT codes, and diagnosis before services are rendered. Auth requirements are confirmed during benefits verification, and renewals are submitted before expiration to prevent denials.
Secondary billing
We determine primary and secondary payer responsibility, bill primary first, and submit remaining balances to secondary after adjudication. If both payers refuse primary responsibility, we coordinate with the patient and insurers to resolve COB before claims are filed.
Incident-to billing
We verify supervision requirements, apply correct rendering and billing NPIs, and cross-check documentation against payer-specific incident-to criteria to prevent denials and audit flags.
Single case agreement
When no in-network provider is available within the required radius, we submit single-case agreement requests, handle documentation, and secure payer approval before services are rendered.
Quality payment programs
We align coding, documentation, and claims data with MIPS, MACRA, and APM reporting requirements. Our billing workflows are structured to support accurate measure reporting so providers avoid negative payment adjustments from CMS.
Coordination of benefits
We determine primary and secondary payer responsibility, resolve COB disputes between insurers, and ensure claims are billed in the correct order so nothing is delayed or denied.
Who works with us
You don’t need more patients.
You need better billing.
High patient volume and busy clinical operations do not automatically translate into predictable cash flow. As payer rules tighten and documentation requirements increase, even well-performing practices see revenue loss through preventable denials, missed charges, lack of prior authorization, and inconsistent follow-through.
MedHeave is built for specialties that are experiencing revenue loss from billing gaps, not from a lack of patient volume.
Specialty practices
We manage billing cycles of practices with multiple specialties where differences in coding, documentation, and payer expectations can lead to uneven billing outcomes if not managed consistently.
Primary care groups
We work with primary care groups where high patient volume requires precise billing processes to maintain steady and predictable cash flow.
Emergency departments
We assist emergency care settings where incomplete intake information and high denial rates require structured billing workflows and consistent follow-up.
Hospital systems
We support hospital systems that manage both facility and professional billing, helping maintain alignment across departments and reduce delays in reimbursement.
Multi-specialty practices
Multi-specialty practices require billing workflows that can handle different coding standards, payer rules, and documentation requirements across departments. From podiatry to oncology, our specialty-focused billers and coders manage RCM across every service line accurately.
FAQs
Questions providers ask us before changing their billing set-up.
These are the questions our operations team gets asked on every discovery call by providers that want to know exactly how their revenue cycle will be managed before they partner with us.
How does MedHeave handle denied claims?
90% of denials are caught through ERAs. 70% are resolved with modifier corrections and resubmitted. The rest are sent to the provider for clinical input. If the corrected claim is denied again, we appeal. Write-offs only happen with provider approval.
What happens to our existing AR when we transition to Medheave?
We build a full aging sheet and identify claims still within rework windows. Commercial payers allow approximately 90 days; Medicare allows up to 1 year. Claims in the 60 to 120 day bucket are prioritized first. Write-offs are only recommended with your approval.
How do you handle underpayments on in-network claims?
Every EOB is compared against the contracted fee schedule. If the payment is below the contracted rate, we contact the payer for reprocessing. We bill at 150% to 300% of the allowable to prevent charge-level underpayments. Consistent underpayers are flagged for contract renegotiation through credentialing.
Do you handle prior authorizations or just claims?
We handle both. Auth requirements are verified by specialty and payer, requests are submitted with clinical documentation, and status is tracked centrally. If a claim is denied for missing auth, we check retro auth first, then file a medical necessity appeal. Appeal approval rate runs 70 to 85%.
Who works on our account, and what happens if someone leaves?
A dedicated team handles charges, AR, and payment posting, each with a supervisor running daily audits. Resigning staff serve a 30-day notice for SOP handover. Supervisors are a real-time backup on every account. Your revenue cycle does not pause for staffing changes.
How quickly do you submit claims after the provider signs the encounter?
Within 24 hours of signed notes. Missing CPT or diagnosis codes are flagged to the provider the same day. All submissions are tracked through the clearinghouse to confirm successful transmission.
Not sure where to start?
Tell us which part of your revenue cycle is causing the most friction, and we will show you exactly where MedHeave fits in. No sales pitch, just a direct conversation about what is not working and how we can fix it.
