Medical Billing Companies & Consultants in Huntington Beach, CA

Optimal Billing Solutions, Inc. is an outsourced revenue cycle management firm based in Huntington Beach, in Orange County, California. The company was founded in 2004. It focuses on rehabilitation therapy practices, handling claims and reimbursement for physical therapists, occupational therapists and speech therapists. Its clients are clinics in California, Nevada and Idaho, from newly opened private practices to established ones that hand over their existing billing.

Background and Leadership

Stacy Bevington, the President and Founder, started the business after 17 years working in an outpatient physical therapy clinic. She started in filing and front-desk work, moved into billing and later ran the clinic as administrator. That gave her direct experience of how therapy practices run day to day.

She began by helping therapists open their own clinics and by taking over billing for existing practices, and referrals from early clients grew the company from there. The firm is a member of the American Medical Billing Association (AMBA) and hires staff who hold the Certified Medical Reimbursement Specialist (CMRS) credential.

It has also added a physical therapist who previously did therapy chart review and authorization work for an insurer.

Services

Practices can hand over the whole billing cycle or choose individual pieces. Services include:

• Complete revenue cycle management
• Entry of patient demographics and daily charges, including review of data from a practice's own EMR or billing platform
• Daily electronic claim scrubbing and submission
• Ongoing claim follow-up, denial management and appeals
• Insurance payment posting, plus ERA and EFT enrollment
• Patient statements, balance follow-up and payment plans
• Help with eligibility and benefits verification
• Credentialing for new providers
• Chart audit services and documentation guidance
• Staff training, specialty in-services and practice management consulting

How They Work With Clients

Work usually starts with an on-site practice evaluation. The team watches office workflows and gathers information, then recommends which services fit. Claims are checked for errors and sent electronically every day, and payments and denials are also posted daily. Staff review explanations of benefits continuously and keep profiles of individual payers.

This lets them tell providers quickly when a treatment is denied and spot denial patterns early. Practices get monthly performance reports at no extra charge and remote access to the billing software, so they can see account status in real time. The team stays in daily contact with clients by phone, email and Skype.

Payers, Patients and Compliance

The staff keep up with Medicare, Medicaid, HMO and PPO plans, workers' compensation and lien cases. They also coach providers on documentation requirements to reduce medical necessity denials and audit risk. Bilingual English and Spanish staff handle patient billing, sending statements after insurance has processed a claim and setting up payment plans when needed.

The firm does not do credit reporting itself but works with outside collection agencies, and no account is referred without the practice's approval. The company runs a customized HIPAA compliance program, and every employee completes HIPAA training each year.