01
Eligibility & benefits verification
We confirm coverage, copays, deductibles and prior authorization requirements before the patient arrives, so claims are not denied for problems the front desk could have caught.
Austin-based medical billing company serving all 50 states
Medical Billing Services Nationwide That Get You Paid in Full
Provider Concerns handles your entire medical billing cycle — eligibility checks, certified coding, clean claim submission, payment posting, denial management and A/R follow-up — for physicians, labs, ASCs and hospitals billing Medicare, Medicaid and commercial payers in every state.
- No upfront fees
- Certified coders
- HIPAA compliant
- Works with your EHR
Claim status
PaidClaim journey
Verified → Coded → Scrubbed → Paid
Industry clean-claim benchmark98%+
No-response follow-up
30 days
Report cadence
Monthly
Billing every major payer, in every state
MedicareState Medicaid ProgramsMedicaid Managed CareBlue Cross Blue Shield plansUnitedHealthcareAetnaCignaHumana
MedicareTexas MedicaidMedicaid Managed CareBlue Cross Blue Shield plansUnitedHealthcareAetnaCignaHumana
End-to-end medical billing
What our medical billing service covers
Outsourced medical billing works only when every step of the revenue cycle is handled by people who know payer rules. Our team takes ownership of each stage below, from the moment a patient books until the claim is paid or properly closed.
02
Charge entry & coding review
Certified coders assign CPT, ICD-10-CM and HCPCS codes and modifiers, then check them against your documentation to support medical necessity.
03
Claim scrubbing & submission
Every claim is checked against payer rules and NCCI edits before it goes out electronically as an 837P (CMS-1500) or 837I (UB-04).
04
Payment posting
ERA/835 and paper EOB payments are posted and compared with your contracted rates, so underpayments are flagged instead of written off.
05
Denial management & appeals
Every denial is categorized by reason code, then corrected and resubmitted or appealed within the payer’s deadline.
06
A/R follow-up
Aging claims are worked by dollar value and age, with payer calls and escalation until they are paid or properly closed.
07
Monthly reporting
A clear monthly report on collections, denial rate, days in A/R and anything that needs your attention.
Need one piece, not the whole cycle?
Each service is also available on its own.
How we get you paid faster
Most lost revenue comes from a few predictable problems
Missed eligibility checks, coding errors, claims that are never resubmitted and denials nobody has time to appeal. We fix them at the source, so every claim follows the same path to payment.
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1
Verify
Coverage & prior auth
-
2
Code
CPT, ICD-10, HCPCS
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3
Scrub
Payer rules & NCCI
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4
Submit
837P / 837I
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5
Post
ERA/835 vs. contract
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6
Paid
Denials worked to close
Clean claims first
Every claim is scrubbed before it is sent. We aim for claims that are accepted the first time they are sent, and we track your first-pass clean claim rate every month.
No claim left unworked
Every denial, and every claim with no payer response after 30 days, gets a documented follow-up.
Root causes are reported
If one payer keeps denying the same code, or one location keeps missing authorizations, you hear about it with a specific fix.
Timely filing, tracked by payer
Deadlines are tracked, so nothing ages out
Timely filing windows differ by payer. A claim filed one day late is usually unpayable, so we track every payer's window and file well inside it. Pick a payer to see its window.
Filing window from date of service
95 days
Each state Medicaid program sets its own limit (Texas allows 95 days, for example), and managed care plans can set their own rules, so we track each plan separately.
Who we work with
Billing built for every type of provider
From a solo physician to a hospital billing department, we match your setting's claim forms, payer mix and workflows.
Full billing support without hiring in-house staff.
Multi-provider groups
Consistent coding and reporting across every provider and location.
Specialty clinics
Coders who know your specialty’s codes, modifiers and payer policies.
Lab-specific coding, medical necessity and payer coverage checks.
Ambulatory surgery centers
Facility claims, implants and multiple-procedure rules handled correctly.
Institutional 837I / UB-04 billing and A/R support.
Switching to Provider Concerns
Change billing companies without interrupting cash flow
01
Free billing review
We review your current collections, denials and aging A/R and show you where revenue is being lost.
02
Setup
We get access to your practice management system and clearinghouse and handle any payer enrollment changes.
03
Backlog cleanup
We start on your existing aged A/R and open denials alongside new claims.
04
Steady state
Your dedicated team takes over daily billing and you receive your first monthly report.
Pricing
You pay only when we collect
Our fee is based on what we actually collect for you, with no upfront fees. Your rate depends on your specialty, claim volume and the services you need. Our medical billing pricing guide explains how outsourcing costs compare with running billing in-house.
Pricing model
Pay only on collections
Written quote based on your volume
- ✓ No setup or upfront fees
- ✓ Dedicated billing team
- ✓ Monthly performance report
- ✓ Works in your current EHR
FAQ
Medical billing questions from providers
What does a medical billing company do?+
A medical billing company manages the steps between a patient visit and payment: verifying insurance, coding the visit, submitting clean claims, posting payments, appealing denials and following up on unpaid claims. Provider Concerns handles all of these for practices across the United States so your staff can focus on patients.
Which payers do you bill?+
We bill Medicare and Medicare Advantage, state Medicaid programs and their managed care plans, and the major commercial payers, including Blue Cross Blue Shield plans, UnitedHealthcare, Aetna, Cigna and Humana.
How much do outsourced medical billing services cost?+
Our fee is based on what we actually collect, with no upfront fees. Your rate depends on your specialty, claim volume and the services you need. See our medical billing pricing guide for how outsourcing compares with in-house billing.
What is a clean claim rate, and what should mine be?+
A clean claim rate is the share of claims accepted on first submission without errors. A high first-pass rate means faster payment and less rework. We scrub every claim before submission and report your rate every month.
What are the timely filing limits for Medicare and Medicaid?+
Medicare allows 12 months from the date of service. Medicaid limits are set by each state and are often much shorter (Texas Medicaid, for example, allows 95 days), and commercial plans vary by contract. We track every payer’s window so no claim ages out.
Will switching billing companies disrupt my cash flow?+
It should not. Our four-step onboarding runs backlog cleanup on your aged A/R and open denials alongside new claims, so payments keep coming in while your new team takes over.
Do you work with practices outside Texas?+
Yes. We are based in Austin, Texas, and bill for practices in all 50 states. All billing work is done securely online, so your location makes no difference.
Is your medical billing service HIPAA compliant?+
Yes. We sign a Business Associate Agreement with every client, and our staff are trained on HIPAA privacy and security rules.
Will we lose access to our billing data?+
No. We work inside your practice management system, so your data stays yours and you can see everything we do.
How do I know your billing service is working?+
You get a monthly report showing collections, denial rate, days in A/R and first-pass claim acceptance, compared with the month before.
Do you work with my practice management system?+
Almost certainly. We work in 100+ EHR and practice management systems, including Epic, Oracle Health (Cerner), athenahealth, eClinicalWorks, NextGen, AdvancedMD, Tebra (Kareo), DrChrono, Practice Fusion and CareCloud. Claims go out through your existing clearinghouse, with no software purchase, migration or retraining.
See where your practice is losing revenue
Our free billing review looks at your current collections, denials and aging A/R and shows you exactly where money is being left on the table — no obligation. A billing specialist replies within one business day.
Free billing review includes
- Denial rate by payer
- A/R over 90 days
- Clean claim rate
- Missed charges