Medbillytics

Healthcare practices that need their back office to run reliably without adding internal headcount have a focused option in Medbillytics, a medical billing and revenue cycle management BPO company based in Burbank, California. The company handles the administrative functions that regularly pull clinical staff away from patient care, working as a domestic USA-based extension of each client's front and back office operations. Credentialing is a core part of what Medbillytics does. The team manages the complete provider and facility lifecycle: CAQH profile setup, PECOS enrollment, payer applications, follow-up, and ongoing re-credentialing cycles. They maintain active relationships with Evernorth, Blue Shield, Optum, Aetna, and other major payers, and use AI-assisted tools to track expiring credentials before they create billing gaps. Medicare credentialing averages 30 days to complete; commercial credentialing averages 45. Medical coding and billing is handled by certified coders covering CPT, ICD-10, and HCPCS codes across all specialty types. Claims go through AI verification before electronic submission via Waystar, and the company reports a 94% clean claim rate with a submission window under 48 hours. Insurance eligibility is verified before every visit, and prior authorizations are managed from initial submission through approval to cut off eligibility-based denials before they occur. Accounts receivable management here is active work, not passive reporting. Staff operate directly inside Availity, Noridian, and Waystar to locate outstanding claims, identify why they have not paid, and take corrective action. Denial patterns are tracked monthly by payer and CPT code to catch systemic issues early. The company targets AR days outstanding under 40 and files Medicare redeterminations through the Noridian portal as needed. A HIPAA-compliant domestic call center rounds out the service offering. It covers patient-facing balance collections, payment plan arrangements, prior authorization status calls, denial escalations, and after-hours overflow, supporting four languages. Monthly analytics deliverables include clean claim rates, denial rates by payer, AR aging, fee schedule reconciliation against actual reimbursements, and productivity by provider. Medbillytics works exclusively in healthcare, serving primary care groups, behavioral health practices, and specialty providers across cardiology, gastroenterology, orthopedics, neurology, OB/GYN, dermatology, oncology, urgent care, and diagnostic labs. The company operates Monday through Friday, 8am to 6pm Pacific, charges no hidden fees, and assigns a dedicated account manager to every client. Practices considering outsourcing their revenue cycle management to a healthcare-focused BPO company in the USA can connect through the Medbillytics website to discuss their needs.