Medical Billing Companies & Consultants in Everett, MA

Certitude Healthcare Solutions is a medical revenue management firm based in Everett, Massachusetts. It works mainly with private medical practices that want outside help with the business side of patient care. The company belongs to a national network of offices that focus on revenue cycle work, practice operations and support for independent physicians across the United States. It presents itself as a partner for practices that want to improve cash flow and spend less time on paperwork.

Approach to Working With Practices

The firm calls its model full-service consulting. It says it can fit into a practice's existing operations, so a client can hand over billing completely or get help improving the processes it already runs. Prospective clients are offered a free practice analysis. This uses a proprietary tool to produce a detailed report with recommendations covering most areas of a practice's operations. Certitude says it aims to raise a practice's net yield and cut overhead. Because its platforms are web-based, clients do not need to buy costly hardware, software or network equipment.

Billing and Revenue Cycle Services

The core offering is iClaim, an outsourced billing service. Physicians keep control of their patient records and can follow the status of each claim online at any hour. Client testimonials on the site say the main benefits are claim follow-up by a dedicated billing team, better reimbursement and more time with patients. Other services support the wider revenue cycle:

• CodeRite: coding review to help capture appropriate reimbursement for each encounter
• AuditGuard: an in-depth audit of coding, billing and reimbursement workflows
• ChoicePay: calculating, processing and collecting patient payments
• QuickCollect: early, gentle outreach to patients with unpaid balances before stronger collection steps
• CredentialsNOW: credentialing support for healthcare organizations of any size
• Cost Reduction Consulting: finding savings without cutting service levels

Technology and Compliance Tools

Besides billing, Certitude provides a set of software and patient engagement products. EMRx is an electronic medical records solution set up to match how a practice already works. VirtualCare is a secure telehealth platform that runs on any device with an internet connection. AutoCard sends postcards, greeting cards and brochures to a practice's patient list. Doctible adds patient communication features meant to improve satisfaction. For dental offices, the firm resells DentiMax practice management software. CompliancyGuard tracks compliance with HIPAA, HITECH risk assessment and Omnibus requirements.

What Distinguishes the Firm

Certitude says its electronic solutions are certified for CMS, HIPAA and Meaningful Use. It also says its system helps practices track incentives under MACRA, MIPS and alternative payment models. Its combination of outsourced claims management, coding audits, credentialing, telehealth and compliance tracking suits practices that want to bring several administrative functions under one vendor. It also promises personal attention from a local office backed by a larger national organization. Buyers comparing billing partners may find the free practice analysis a low-commitment way to judge whether the firm is a good fit.