Who we serve
A solo practice and a fifteen-provider group have the same payer rules and completely different problems. These pages are about the second part.
Solo practices
You are the provider, the owner, and often the billing department. Every hour on claims is an hour not seeing patients.
See how we work with solo practicesGroup practices
Multiple providers, multiple payer contracts, multiple credentialing timelines, and revenue attribution per provider.
See how we work with group practicesNew and startup practices
You can't bill a payer you aren't enrolled with, and enrollment takes months. Getting this wrong delays revenue past opening day.
See how we work with new and startup practicesAmbulatory surgery centers
Facility billing differs fundamentally from professional billing — ASC payment groupings, implant and device carve-outs, multiple-procedure reduction, and separate facility credentialing.
See how we work with ambulatory surgery centersWhy structure changes the problem
Payer rules do not care how a practice is organised. The denial codes, the filing deadlines and the coding requirements are identical for a single provider and for a fifteen-provider group. What changes completely is where the work fails.
In a solo practice the constraint is hours. There is nobody whose job it is to watch the ageing report, so denials accumulate and claims cross filing deadlines while everyone is busy doing clinical work. Nothing dramatic happens on any single day.
In a group the constraint is visibility. There are enough people to do the work, but a practice-level denial rate averages five good providers and one bad one into a number that looks acceptable and hides the actual problem. Credentialing turns from an event into a permanent operation, and one lapsed revalidation can invalidate months of claims.
In a new practice the constraint is time itself. Enrolment takes 60 to 180 days, and revenue cannot start before an effective date exists. Get the sequence wrong and the practice opens to patients it cannot bill for, at exactly the moment its cash reserves are thinnest.
In an ambulatory surgery center the constraint is that facility reimbursement is a different discipline. Payment groupings, implant carve-outs, multiple-procedure reduction and separate facility credentialing are not variations on professional billing — they are their own rule set, with claim values high enough that one unworked denial matters.
What stays the same
Whatever the structure, the engagement works the same way:
- A free A/R analysis first, which you keep whether or not you hire us
- Month-to-month terms with 30 days notice, and no setup fee
- A named account lead who knows your payers and your specialty
- Coders assigned by specialty rather than pooled
- Weekly operational reporting and monthly financial reporting
- Work done inside your existing EHR or practice management system
If you are not sure which page applies
Most practices recognise themselves in one of the four immediately. If yours does not — a hospital-employed group moving to independence, a practice merging with another, a group adding a surgery center — the answer is usually a combination, and the A/R analysis is still the right first step.
Send 90 days of claims data and we will tell you what we find, including when the honest answer is that your current arrangement is working and you do not need us.