Stop Leaving 8% to 15% of Practice Cash Trapped in Payer Clearinghouses.
Engineered for US Medical Practice Managers, Clinic Directors, and Physicians. We handle full-lifecycle RCM, AAPC-certified CPT/ICD-10 coding, and contingency-based aged AR (>90 days) recovery with $0 upfront fees.
98.4%
Clearinghouse verified
<28 Days
Rapid payment posting
$0 Upfront
Zero practice risk
48 Hours
Level 1 & 2 appeals
Who We Serve Across the US Healthcare System
Whether you operate an independent private clinic or oversee a multi-specialty surgical center, our billing workflows match your clinical scale.
Independent Physicians
Solo & small partner practices needing maximized cash flow without the high overhead of in-house billing salaries.
Specialty Surgical Clinics
High-dollar operative cases, 90-day global surgery periods, assistant surgeon modifiers, and implant reconciliation.
Hospitals & Health Systems
Complex split professional/technical billing (26/TC), facility credentialing, and multi-facility clearinghouse batching.
Ambulatory Surgery Centers
ASC facility fees, Medicare pass-through biologics, pre-certifications, and specialized surgical tray reimbursement.
Urgent Care & Emergency
Rapid high-volume eligibility verification, STAT appeals, in-office lab billing (Modifier-QW), and patient copay posting.
Multi-Specialty Networks
Centralized RCM for combined cardiology, podiatry, orthopedics, and internal medicine under unified tax IDs.
How Much Revenue Is Your Practice Leaving in Payer Clearinghouses?
Most independent US clinics lose 8% to 15% of gross collections to unworked rejections, timely filing lapses, and unappealed downcodes. Use our financial model below to project your practice’s recoverable cash.
Lost Revenue & Aged AR Leakage Estimator
Adjust your practice metrics to model how much cash is trapped in payer clearinghouses, unappealed write-offs, and aging AR buckets.
Languishing in unworked clearinghouse rejections, unappealed downcodes, and timely filing write-offs.
No software migration required. Non-disclosure HIPAA agreement signed prior to audit.
Real Healthcare Professionals, Not an AI Black Box
Healthcare revenue cycle management cannot be left to automated scrapers that blindly resubmit bad claims. Our seasoned medical billing directors and AAPC-certified coders work inside your EHR to protect every rightful dollar.
(Tap or hover on any card below to flip and inspect our operational protocol)
Senior AAPC Coder & Doctor Defense
Every claim is inspected by certified medical coders who understand physician documentation, not opaque automated scrapers.
AAPC Certified Defense Protocol
- CPC & CPMA credentialed coders review clinical charts
- Modifier-25 & unbundling audits prevent clawbacks
- Direct peer-to-peer prep for physician insurance hearings
- 48-hour SLA on high-dollar claim appeals
Radiology, Surgery & Complex Coding
Doctors reviewing complex imaging and operative notes to capture legitimate CPT codes without triggering payer audits.
Surgical & Diagnostic Coding Protocol
- Operative note analysis for missed billable CPT codes
- NCCI edit scrubbing prior to clearinghouse submission
- 26/TC component split billing verification
- 99.1% verified coding accuracy across all specialties
Aged AR Liquidation (>90 Days)
Our forensic recovery directors investigate stale claims older than 90, 120, or 365 days on a strict 100% contingency basis.
Contingency AR Liquidation Protocol
- $0 Upfront cost — we only get paid when you collect
- Clearinghouse proof-of-timely-filing retrieval
- Direct payer claims supervisor escalations
- Historical 81% timely-filing denial overturn rate
Your Richmond VA In-House Extension
Meet the dedicated billing team standing behind your practice. Real people who answer the phone when your clinic calls.
Practice Integration Protocol
- Direct phone line to your assigned billing supervisor
- 100% inside your existing EHR (Epic, Athena, Kareo, etc.)
- Mutual HIPAA BAA executed before any PHI access
- Zero employee turnover disruption to your cash flow
“Physicians train for a decade to care for patients, not to fight insurance clearinghouses over technicalities or suffer arbitrary payer downcoding. We built Provider Billers so doctors can practice medicine with absolute financial security.”
Built Strictly for High-Complexity Medical Billing & Revenue Recovery
We are not a generic tech vendor or IT outsourcer. Provider Billers is a dedicated US Revenue Cycle Management agency focused on clinical coding accuracy, aggressive appeals, and zero-risk aging AR liquidation.
Stop Algorithmic Downcoding
Commercial payers deploy automated AI algorithms to downcode level 4/5 E/M visits and reject Modifier-25 claims. Our certified auditors enforce AMA CPT rules to safeguard your earned fees.
Liquidate Old AR (>90 Days)
Our aged AR liquidation team operates on a 100% contingency model. Zero upfront retainer. If we do not recover money from your aging AR ledger, you pay nothing.
End Staffing Turnover Chaos
Never let in-house biller resignations disrupt cash flow or cause timely filing deadlines to lapse. You gain an entire department of credentialed specialists for less than the cost of one full-time salary.
Test Before You Commit
Submit 10 rejected or aged claims for our Free 10-Claim Denial Audit. We provide a comprehensive forensic report identifying CPT/ICD-10 breakdown and actionable revenue steps in 48 hours.
Operational Comparison: Provider Billers vs. Conventional Alternatives
Evaluating true cost, clinical coding depth, and collection outcomes.
| Evaluation Criteria | Provider Billers LLC | In-House Staff Only | Generic Offshore BPO |
|---|---|---|---|
| Denial Resolution Model | Daily CARC/RARC triage by AAPC coders; 48-hr SLA | Often ignored due to time crunch; only simple claims reworked | Bulk automated resubmission without clinical appeal letters |
| Aged AR (>90 Days) Stance | 100% Contingency basis ($0 upfront, we only win when you collect) | Deprioritized as staff focus on current week charges | Hourly billing regardless of whether money is recovered |
| Coder Certification | AAPC / AHIMA certified CPC, CPMA & specialty coders | Rarely certified; billing taught informally by past staff | Non-certified data entry clerks using generic software |
| EHR Data Ownership | 100% inside your EHR. Zero third-party proprietary lock-in | Inside your EHR | Forces migration to proprietary foreign platforms |
| Initial Engagement Risk | Free 10-Claim Denial Audit before any contract commitment | Fixed salary, taxes, benefits, and paid PTO overhead | Long-term lock-in contracts with hidden onboarding fees |
Comprehensive RCM Solutions for Healthcare Practices
From front-office patient eligibility verification to aggressive aged AR recovery, our specialized teams operate as a seamless extension of your practice.
End-to-End Revenue Cycle Management
Provider Billers delivers full-lifecycle RCM engineered for independent practices and specialty surgical groups. We eliminate administrative drag, scrub claims to a 98%+ first-pass clean rate, and drive days in AR below 28 days.
Contingency-Based Aged AR Recovery (>90 Days)
Stale accounts receivable older than 90, 120, or 365 days represent massive lost profit for private practices. Our dedicated SWAT team of aged AR recovery specialists investigates, appeals, and liquidates aging balances on a strict contingency basis.
Denial Management & Root-Cause Appeals
Over 65% of medical claim denials are never appealed by practices, leading to catastrophic revenue loss. Provider Billers deploys forensic CARC/RARC denial analytics and aggressive multi-level appeals to turn denials into paid remits.
Medical Billing & Certified Coding Audits
Coding errors cause both under-reimbursement (lost money) and audit liability (clawback risks). Our certified coders (CPC, COC, CPMA) review clinical charts to maximize legitimate revenue capture while ensuring strict OIG and CMS compliance.
Provider Credentialing & Payer Contracting
Every month a new provider waits for commercial insurance or Medicare/Medicaid enrollment costs your practice an estimated $60,000 to $90,000 in unbillable revenue. Provider Billers speeds up enrollment and re-credentialing through relentless payer follow-up.
Front-Office Intake, Prior Auth & Healthcare BPO
Over 80% of claim denials originate at the front desk: invalid policy IDs, unverified deductibles, expired coverage, and unobtained prior authorizations. Our specialized healthcare front-office team secures pre-authorizations and verifies benefits before patients walk through the door.
Specialty-Specific Billing Protocols
Generalist billing companies treat every claim identically, resulting in chronic Modifier-25 rejections, LCD denials, and lost revenue. We configure scrubbers specifically for each medical specialty.
Podiatry & Foot Surgery
Eliminate Routine Foot Care Denials & Modifier-25 Audits
Podiatric billing is fraught with strict Medicare Local Coverage Determinations (LCDs), routine foot care statutory exclusions, and aggressive clawbacks on Modifier-25 and Q-modifiers. Provider Billers eliminates non-covered denials and accelerates surgical procedure reimbursements.
Cardiology & Interventional Care
Overcome Echo, Stress Test & Imaging Denials with Prior Auth Precision
Cardiology billing demands flawless handling of professional vs. technical split billing (Modifiers 26/TC), strict medical necessity algorithms for diagnostic imaging, and rapid prior authorization turnaround for invasive catheterization and cardiac PET/SPECT.
Mental & Behavioral Health
Master Time-Based Psychotherapy Billing & Session Unit Guardrails
Psychiatry and behavioral health clinics struggle with strict time-based psychotherapy coding rules, session frequency caps, interactive complexity billing, and evolving telehealth parity laws across commercial payers and Medicaid.
Orthopedic Surgery & Sports Medicine
Protect High-Value Surgical Claims & Master Global Period Billing
Orthopedic surgery accounts for some of the highest-dollar claims in outpatient and inpatient medicine. Denials commonly stem from misunderstood 90-day global surgical packages, assistant surgeon modifiers, multiple procedure discounts, and unbundled DME supplies.
Family Practice & Internal Medicine
Master Preventive vs. Problem-Oriented Splitting & Medicare AWVs
Primary care clinics balance high patient volumes with razor-thin margins. The number one source of lost revenue is failure to properly bill same-day problem visits during preventive physicals, missed Chronic Care Management (CCM), and unbilled Medicare Annual Wellness Visits (AWV).
Neurology & Neuromuscular Medicine
Optimize EEG, EMG/NCS & Complex Chronic Neurological Care
Neurology practices face complex billing challenges encompassing prolonged EEG monitoring, nerve conduction studies (NCS) combined with needle electromyography (EMG), and high-cost botulinum toxin injections for chronic migraine or spasticity.
Ready to Uncover Where Your Revenue Is Leaking?
Send us 10 redacted explanation of benefits (EOBs) or let us audit 10 aging claims inside your clearinghouse. We pinpoint the exact root cause of your denials within 48 business hours.
Line-by-Line CPT Forensic Report
Detailed breakdown of modifier mismatches, missing clinical data, and medical necessity triggers.
Recoverable Cash Quantification
Concrete dollar amount of trapped revenue recoverable within standard payer appeal windows.
100% Free & No Long-Term Obligation
Zero software switch. You review our findings and decide whether to partner.
(209)-671-6993
Request Your Free 10-Claim Denial Audit
Zero upfront cost. Send us 10 redacted explanation-of-benefits (EOBs) or let us audit 10 aging claims inside your clearinghouse. Our AAPC-certified auditors pinpoint root-cause leakage within 48 hours.
Frequently Asked Questions
Transparent answers regarding our BAA compliance, EHR integration, and contingency models.
How does the Free 10-Claim Denial Audit work?
You provide 10 sample denied or aged explanation-of-benefits (EOBs) or granting read-only access to a test batch inside your clearinghouse. Before any data is exchanged, we sign a mutual HIPAA Business Associate Agreement (BAA). Within 48 business hours, our AAPC-certified billing directors generate an audit report identifying exact CPT/ICD-10 root causes, missed modifiers, and actionable recovery steps—with zero obligation.
How does your Contingency-Based Aged AR (>90 Days) recovery work?
Our aged AR service requires $0 upfront. We work claims older than 90, 120, or 365 days that your internal team has written off or lacks the bandwidth to pursue. If we do not recover cash that is deposited into your bank account, you pay $0. You only pay a predetermined contingency percentage on recovered dollars.
Do we have to change our current EHR or practice management software?
No. We work directly inside your existing EHR—including Epic, AthenaHealth, eClinicalWorks, Kareo/Tebra, AdvancedMD, ModMed, and NextGen. You retain full data ownership, real-time visibility, and patient chart control.
How do your coders ensure compliance against OIG and Medicare audits?
Every member of our coding department is certified by AAPC (CPC, CPMA, specialty credentials) or AHIMA (CCS). We cross-reference charges against the latest CMS National Correct Coding Initiative (NCCI) edits, local coverage determinations (LCDs), and AMA CPT documentation guidelines before submission.
What is your average timeline to begin billing for a new practice?
Because we connect directly to your existing EHR without requiring a painful software migration, standard onboarding takes between 5 to 10 business days. For urgent aged AR recovery or denial triage, our team can begin forensic analysis within 48 hours of BAA execution.
Have a question specific to your practice’s payer mix or EHR?
Our Richmond, VA revenue cycle directors are available to speak directly with clinic owners and practice managers.