Medical Billing Companies & Consultants in Yuma, AZ

Based in Yuma, Arizona, this firm handles revenue cycle management for physician practices and other medical providers. The bulk of its clients are located in Yuma, Somerton and San Luis, but its reach extends to offices in Lake Havasu, Phoenix and Scottsdale as well. Owner Mary Alice Lopez leads the operation, and her team of coding and billing professionals brings a combined track record of more than 25 years in the field.

Billing and Revenue Cycle Services

The firm's primary offering is outsourced claims management. Its specialists take the care a provider delivers, translate it into claims, and send those claims to payers so the practice gets paid. Once an office becomes a client, the firm takes ownership of the full claims workflow, including:

• Preparing and submitting every claim
• Following up with payers until each claim is resolved
• Sending statements to patients
• Writing and filing appeals for denied claims
• Managing accounts receivable
• Reviewing receivables trends for the client

Consulting, Auditing and Compliance

Beyond day-to-day claims work, the firm offers guidance to practices that want a clearer picture of their finances. Its accounts receivable review identifies balances from payers or patients that are slipping through the cracks, pinpoints weak spots in operations, and confirms which workflows are functioning well.

The team also provides training on HIPAA privacy requirements and on the Medicare-required curriculum covering fraud, waste and abuse. Drawing on her auditor certification, Lopez reviews whether providers meet CMS requirements, follow Medicare and Medicaid rules, and keep their credentialing and payer contracts up to date.

The firm states that its methods follow guidance from the federal Office of Inspector General, Medicare and Medicaid.

Practices just opening their doors, along with providers joining an established group, have the option of a startup package. It covers credentialing, negotiation and setup of payer contracts, electronic health record implementation, compliance training, creation of a compliance plan, an introduction to Medicare and Medicaid requirements, and HIPAA training.

Training and Education

Lopez holds approval from the AAPC to teach. She runs AAPC courses that prepare students to sit for the Certified Professional Biller (CPB) and Certified Professional Coder (CPC) credentials. Classes can be held on site at a client's location or online through Zoom, which may suit offices that prefer to build expertise among the employees they already have.

Team and Credentials

Lopez holds the CPC, CPB, CPMA, CPC-I, CEHRS and CEMA credentials and has earned the title of AAPC Fellow. She has been recognized with awards from the AAPC, the National Healthcareer Association and NAMAS. With more than 25 years spent in coding and billing, she also once served as an officer of the Southwest Coders of Yuma chapter.

Sujey Lopez, CPC, CPB, handles claims for radiology, surgical, ENT, children's health and internal medicine practices. Daniel Lopez oversees accounts for rehabilitation therapists, children's health providers, and surgeons who treat conditions of the jaw, mouth and face.

The firm places weight on honesty, ongoing training for its staff and strict compliance, and it notes experience with a wide range of practice management software.

Prospective clients may find value in its local Yuma roots, its specialty-focused billing staff, and its combination of auditing and training services in a single firm, setting it apart from companies that only submit claims.

Medical Coding & Billing Services, Inc., often shortened to MCBS, is a Yuma, Arizona company that handles medical coding and billing for physician practices. Its main clients are busy medical offices that rely heavily on technology and want to hand off claims work without losing sight of their own data.

Instead of taking over billing in a closed system, MCBS puts its clients on the same hosted software its own staff uses. Both sides work from one shared set of records.

Billing and Revenue Cycle Services

MCBS sets up each account around the way a particular practice already runs. It covers the usual billing chores and some related administrative work, including:

• Coding of procedures and diagnoses, plus preparation of insurance claims
• Review of newly entered charges in a queue before they post
• A tracking number for each visit that appears on the claim and comes back on the EOB, which makes posting payments easier
• Help with provider credentialing
• Monthly reports that clients can open online at any hour

Hosted Practice Management Platform

The firm's software runs in a web browser, so a practice doesn't have to buy servers, build its own network, pay for upgrades or run backups. Patient demographics, insurance details and appointments sit on tabbed screens, and staff move between them by pointing and clicking. The system flags possible duplicate patient records as they are entered.

Offices can also add their own custom fields. MCBS builds electronic charge slips that look like a practice's paper superbill. Staff can fill them out on office computers, tablets or handheld devices. The charges show up at the front desk right away, so the patient's share is already worked out at checkout.

A color-coded scheduler can handle several physicians, block times, appointment types and locations, including one provider working at more than one site. The company says its platform is HIPAA secure and compliant with the federal EHR Final Rule.

Consulting Beyond Billing

MCBS also advises on the technology side of billing. It can recommend computer hardware, packaged networking, remote access setups and the use of notebooks or handheld devices in exam rooms. For a practice that wants billing and office IT advice from one vendor, this support goes beyond what a claims-only service usually offers.

Background and Team

Philip Gladney, the CEO, founded the company and directs sales and technology. He also owns LeveL-2, Inc., which gives client offices a second tier of technical support. Co-founder Clenda Sursky is the administrator and personnel director. She brings 27 years of experience in healthcare and stresses careful attention to each office's claims.

The wider staff includes a customer service supervisor, a Colorado State University graduate who speaks German and Spanish and works on both client support and data processing, and a team member who has explored European markets for medical services. The company describes its approach as personal, hands-on attention to each account.

Medical Management Associates of Yuma, LLC is a medical billing company based in Yuma, Arizona. It handles the revenue side of physician practices so that doctors and their staff can spend their time on patient care. The firm processes professional medical claims for practices in both Arizona and California. That makes it a fit for providers in the Yuma area and in practices across the nearby state line in Southern California.

Background and Credentials

The company traces its roots to 1994, which gives it a long history in the local healthcare market. It is a small, staff-based operation with an in-house team that handles client accounts directly. The company describes that team as committed to high standards of quality.

Its website shows Better Business Bureau accreditation, which some buyers look for when they check a vendor's reputation. The firm also says it uses modern billing technology, with the goal of getting reimbursements to its physician clients without needless delay.

Claims Management Services

The firm's main offering is a full insurance claims service that covers each claim from start to finish. Instead of handling only electronic submission, the team manages the work that comes before and after it. They also deal with the administrative tasks that usually fall on a practice's front office. Its claims work includes:

• Preparing and sending claims to all insurance carriers
• Tracking unpaid claims and following up with payers
• Posting payments once reimbursements arrive
• Contesting claims that payers reject or pay at the wrong amount
• Answering patient phone calls about their bills
• Sending physicians a report every month

Taking over patient billing calls can matter for small offices, where reception staff often have to explain statements while also checking in patients. The monthly reports keep physicians informed about how their accounts are doing, even though the day-to-day billing work happens outside the practice.

Credentialing and Contracting

Besides claims processing, the company helps Arizona providers with credentialing, the process of enrolling with insurance plans. It also supports practices as they negotiate agreements with payers. New physicians, practices adding providers, and groups reviewing their payer mix may find this useful. Having one vendor handle both enrollment and billing can mean fewer handoffs between outside firms.

Working With the Firm

Practices that are considering the company can ask for a free, no-obligation billing estimate through its website. The estimate form asks how many practitioners work in the office and roughly how many billings the practice produces each month, so pricing is based on the size of the practice.

The firm says it puts a priority on regular communication with its clients. It invites prospects to get in touch with questions about its billing practices or about whether its services suit their needs.

For physician offices in Yuma and the surrounding region, the company offers a locally based option with decades of history and a focused set of claims and credentialing services.