Medical Billing Companies & Consultants in Hayward, CA

HealthCombine Solutions Inc., which also goes by HCS, is a billing and practice administration firm in Hayward, in the East Bay part of the San Francisco Bay Area. It works with physicians in solo practice, with group practices and with professionals who practice in hospitals or other facilities. Its main offering is an outsourced revenue cycle and administrative package. The practice keeps its clinical work, and HCS handles the paperwork and payer side of the business.

Core billing services

HCS covers the full claims process, from coding to collecting payment. Its staff assign procedure and diagnosis codes using the CPT and ICD-10 code sets and send claims to payers electronically. The firm says it normally finishes entering incoming billing data within about one business day. Its published service list includes:

• Coding of procedures and diagnoses, with electronic claim filing
• Superbill and charge slip forms designed around each practice
• Persistent follow-up on unpaid balances owed by insurers and by patients
• Practice performance reports, monthly and yearly
• Scanning and imaging of documents
• Electronic Remittance Advice handling
• Setting up Electronic Funds Transfer with the larger payers
• Enrolling providers and credentialing them with Medicare, Medicaid, PPO and HMO plans

How the firm works with clients

Each client practice gets its own account manager, who oversees the whole account and is backed by a support team. This group is responsible for increasing reimbursement, keeping daily operations running smoothly, preparing financial reports, pointing out problems early and directing attention toward the most profitable parts of the practice.

HCS also offers advice on choosing a clearinghouse for electronic data interchange. It notes that clearinghouses vary in cost and ease of use, and it helps each office pick one that fits its software. The firm leaves the choice of an EMR and billing platform to the physician.

Commitments and pricing model

HCS backs its service with a set of written commitments. It promises to protect physician and patient data in line with HIPAA rules, to prevent data loss and keep service running without interruption, and to confirm that the practice always owns its data. It also says there are no setup fees and that physician references are available.

Fees are a negotiated percentage of a practice's net collections. The rate depends on factors such as specialty, monthly claim volume, the procedures performed and the mix of payers. The firm also charges a separate per-piece fee for patient statement mailings, which come with return envelopes printed for each practice.

Background and leadership

The firm presents itself as more than a claims processor, combining billing with credentialing, reporting and administrative support. It credits its staying power to keeping up with changing industry rules and payer requirements. HCS states that all of its transactions and services meet HIPAA standards for electronic healthcare transactions, code sets, security and privacy.

The company website lists Kristine James as Chief Executive Officer and Matthew Steffen as Chief Financial Officer. For practices in and around Fremont, HCS is a nearby East Bay option that pairs a single point of contact with a broad set of administrative services.