Medical Billing Companies & Consultants in Lakewood, CA

Overview

ProSurg Medical Billing is an outsourced billing firm based in Lakewood, California, just north of Long Beach. It handles revenue cycle work for surgeons, physicians and other healthcare providers in Long Beach and nearby Southern California counties. Its work has three main parts: sending claims, assigning codes, and following up to collect unpaid balances. The firm presents this support as a way for practices to bring in more revenue while spending less on running billing inside the office.

Background and Approach

The company started in 2008 and describes itself as faith based. Its founders wanted a choice between two common options. One is keeping billing in-house, which can be expensive. The other is sending claims to a large-volume vendor, where individual doctors may get little attention or say.

ProSurg takes a middle path built on direct communication and hands-on involvement with each account, so the billing team and the physician work as partners rather than at arm's length. The firm judges its success mainly by growth in clients' monthly collections, and it also gives advice meant to help practices grow.

Two founders lead the company. One has more than 25 years in practice management with multi-specialty groups and ambulatory surgery centers. That includes over a dozen years as vice president of operations at a national management services organization, where she ran billing and collections for many practices in several states.

Her expertise covers billing regulations, coding principles, documentation requirements, front-desk procedures and appeals. The other founder has more than 33 years in insurance, customer service and running businesses. He settles unresolved workers' compensation matters by negotiating with claims adjusters and defense counsel, steps in when commercial claims stall, and oversees claim tracking for every client.

Together the team says it has about 58 years of experience in billing, coding, collections and practice operations.

Services

ProSurg focuses on California workers' compensation and commercial insurance claims, and it puts weight on chasing hard or aged bills that would otherwise stay unpaid. Its services include:

• Medical and surgical claim billing, from setup through payment and resolution
• CPT and ICD coding review to cut revenue lost to wrong codes
• Collections on outstanding accounts and follow-up on problem claims
• Negotiating and resolving workers' compensation claims
• Preparing appeals for denied or underpaid claims
• A free review of explanation of benefits (EOB) and explanation of review (EOR) documents
• Patient account support, including phone payments and installment plans

For patients, the firm's staff answer calls on behalf of the practice, explain how much of a bill the patient owes, take payments by phone, and set up payment plans when needed. The firm stresses polite, respectful service in these calls.

Specialties Served

• Orthopaedics
• Pain management
• Neurology
• General surgery
• Anesthesiology
• Radiology
• Ambulatory surgery centers

This mix of specialties makes ProSurg most relevant to surgical facilities and practices that do a lot of procedures. Buyers will likely find it best suited to surgeons and specialty groups in the Long Beach area that handle many workers' compensation or commercial insurance claims and want a smaller billing partner that stays closely involved. The company says a reference from a Los Angeles orthopaedic surgeon is available on request.