Medical Billing Companies & Consultants in Anaheim, CA

DoctorMGT, also known as Doctor Management Services, is an outsourced revenue cycle firm headquartered in Anaheim, California. It takes over the financial and administrative back office for healthcare providers so clinical teams can spend less time on paperwork. The company reports more than ten years of experience and says it has supported over 1,000 providers and clinics.

Its clients include independent physicians, specialty clinics, multi-specialty groups and hospitals, both in California and in other parts of the country. It describes its staff as certified billing experts.

Core Billing and Revenue Services

Most of the firm's work involves claims-based reimbursement. Its teams code patient encounters, prepare and submit claims, pursue unpaid accounts receivable and appeal denied claims. It also handles collections and bills patients directly. Its main offerings include:

• Medical billing and coding, plus full revenue cycle management
• Denial management, A/R follow-up and collection services
• Prior authorization support
• Telehealth, out-of-network and primary care billing
• Virtual medical assistants and virtual scribes
• Medical and legal interpreter services

Credentialing and payer enrollment make up a substantial part of the business. In addition to general provider credentialing, DoctorMGT runs a dedicated Texas program and offers credentialing for TMS and Spravato treatment. It also lists credentialing support for behavioral health, dental, locum tenens, nurse practitioner and hospital settings, along with rural and FQHC providers and DME and ancillary suppliers.

Personal Injury, Liens and Med-Legal Work

Compared with many general billing vendors, DoctorMGT places unusual emphasis on non-traditional reimbursement. It maintains separate service lines for personal injury billing, workers' compensation claims, lien negotiation and med-legal billing. The company says it focuses on getting paid for complex and lien-based claims and takes on aged and previously denied accounts that other billers may have set aside.

That focus may appeal to pain management, orthopedic, surgical and chiropractic practices that treat a large number of accident and injury patients.

Specialties and Facility Types

The firm lists billing programs for more than twenty specialties. These include anesthesia, cardiology, chiropractic, dermatology, emergency medicine, family practice, general surgery, internal medicine, laboratory, mental health, neurology, orthopedics, pain management, physical therapy, podiatry, radiology, urgent care and urology, as well as durable medical equipment and ambulatory surgery centers. It works with solo and group practices, surgical centers, urgent care centers, emergency rooms, labs and imaging centers, nursing facilities, home health agencies, FQHCs and hospitals.

Working Approach and Added Services

DoctorMGT says it does not pass client work to outside contractors and instead deals with payers directly on each practice's behalf. It emphasizes transparent pricing and accurate claims, and its website includes HIPAA guidance, case studies, testimonials, industry articles and a breakdown of the states it covers.

Beyond billing, the company provides front office management, staffing support, practice assessments, billing consulting and help with the Quality Payment Program. A marketing division adds search engine optimization, social media management and healthcare content writing, so a practice can rely on one vendor for both administrative operations and growth efforts.

MedBillPartner, Inc. is a revenue cycle firm in Anaheim that does medical billing for safety-net providers across Southern California. Its clients are mainly federally qualified health centers (FQHCs), community and nonprofit clinics (including look-alikes and grant-funded organizations), and hospital medicine physician groups. The company chooses to work in only seven counties: Orange, Los Angeles, Riverside, San Bernardino, San Diego, Ventura and Imperial. Long Beach appears on its list of Los Angeles County communities it serves.

Background

The business began in 1988 as Medi-Syn, Inc., which billed for local providers. Ten years later, the team built its own billing system, called Medi-Net, instead of licensing outside software. That system still processes every claim the firm submits. MedBillPartner, Inc. was incorporated in 2014 and is the surviving entity of this continuous operation. Medi-Syn is now inactive. The company says clients usually stay with it for seven to ten years or more.

Services

The firm has three main lines of work, each supported by related revenue cycle functions:

• FQHC billing, including Medi-Cal prospective payment system encounters, wrap-around reconciliation and California's alternative payment methodology
• Community clinic billing covering sliding-fee schedules, county programs for uninsured patients and reporting that meets grant requirements
• Hospitalist billing that captures charges throughout a patient's stay and checks them against the hospital census
• Inpatient and observation evaluation-and-management coding, plus capture of critical care time and bedside procedures
• Denial work that fixes the underlying causes instead of simply resubmitting claims
• Follow-up on aged receivables before filing deadlines pass
• Enrollment of physicians in Medicare, Medi-Cal and commercial HMO and PPO carriers
• Productivity and RVU reporting for each provider

For surgical and complex procedure coding, the company brings in certified coders and checks claims for valid ICD-10 and CPT pairings. Its hospitalist practice supports many inpatient models, including nocturnist shifts, skilled-nursing and post-acute rounding physicians, academic teaching services, locum groups and hospital-based specialty consult teams.

Payer and regional expertise

The firm emphasizes that it knows how Medi-Cal managed care differs from county to county. It works with plans such as L.A. Care, Health Net, CalOptima Health, IEHP, Molina, Gold Coast Health Plan, Community Health Group and the Community Health Plan of Imperial Valley.

In Los Angeles County, it also bills the subcontracted plan partners, including Blue Shield of California Promise and Anthem Blue Cross. The company says it has direct relationships with Medi-Cal, Medicare and major IPAs. It also says it signs a business associate agreement with each client and follows HIPAA requirements.

Organizations with sites in several counties get combined reporting for leadership.

Working with clients

New clients start with a free review of their denied and unpaid claims to find lost revenue. MedBillPartner then works alongside the existing billing setup so no claims are dropped during the switch. After that, it takes over completely, works through the backlog of old receivables and sends monthly reports.

The firm says most cleanup work is done in the initial 60 to 90 days. Clients can use Medi-Net to see billed, paid and outstanding amounts in real time, and the company stresses keeping records organized and ready for audits.

Meridian RCM is a revenue cycle management firm based in Anaheim, California. It handles outsourced medical billing for healthcare providers of all sizes, from single-physician offices to groups with several locations. According to the company, it was started in 2015 by people from the healthcare field who had dealt with billing problems themselves.

Its aim was to make the revenue process easier to follow and more effective for practices. The company says it began as a small billing team and now works with providers across the country in many specialties.

Services Offered

The firm covers the whole revenue cycle, from the time a patient books a visit until the provider is paid. Its main services are:

• Claims management, focused on sending complete and accurate claims the first time
• Denial management, finding why a claim was rejected, fixing it and sending it again
• Medical coding done by certified coders, with attention to compliance and audit protection
• Accounts receivable follow-up to reduce old unpaid balances
• Prior authorization handling to cut down on approval delays
• Checking patient insurance coverage before appointments
• Provider credentialing
• Virtual assistant support for practice administration

Specialties and Clients

Meridian RCM changes its approach for each client's specialty, mix of insurers and daily routines rather than using one fixed process. It names primary care, orthopedics, pediatrics, pain management and behavioral health as fields it works in, along with others. Client comments on its site come from a medical group and a spine and pain center. They mention fewer denials, faster authorizations and useful monthly reports on rejected claims.

How Engagements Work

New clients go through four stages. First comes a free review of the practice's current billing, its denial trends and where revenue is being lost. Next is onboarding: the team connects to the practice's systems, which the company says usually takes a few days with no downtime. Then Meridian RCM takes over the daily work of claims, coding, authorizations and follow-up. Finally, monthly reports show the most common denial reasons, collection trends and where results could improve.

Technology and Differentiators

Practices don't have to change software to work with Meridian RCM. The company says it connects through APIs to more than 60 EHR and practice management platforms, including in-house and custom-built systems. Data syncs in real time, so staff can keep their current tools without retraining.

The firm points to a decade of experience with insurer rules and coding changes, and says it can grow with a practice as its volume increases. It also stresses open communication, with regular reports and updates so clients can follow their revenue without having to ask.

For buyers comparing billing vendors, the main points are its coverage of every step of the cycle, its specialty-specific setup and its ability to work with existing systems.