Medical Billing Companies & Consultants in Seabrook, NH

Optima Billing Services LLC is a medical billing and collections company based in Seabrook, New Hampshire. Healthcare organizations hand it their outsourced revenue cycle work so clinical staff can stay focused on care. The firm concentrates on provider types whose claims tend to be complicated or tightly regulated.

Specialties Served

• Home health agencies
• Hospice and palliative care organizations
• Behavioral health and mental health providers, from solo clinicians to larger facilities
• Nursing homes, skilled nursing facilities and rehab centers
• Physician practices
• Physical therapy providers

How the Work Is Handled

Optima adjusts its billing cadence to each client. Depending on an organization's size and cash requirements, claims go out every day or every second day. Before submission, each claim passes through an audit meant to catch errors so payers accept it on the first pass.

Claims to Medicare, Medicaid and commercial insurers are filed electronically through channels such as FISS DDE, state portals, ZirMed and individual payer portals. Outstanding receivables are worked on a daily schedule. Staff contact payers by phone, pursue claims electronically and review denials so they can be corrected and resubmitted. Collection efforts cover government programs, private insurance, copays and self-pay balances.

Optima does not move clients onto a new platform. It operates inside each client's existing EMR and follows the client's own policies, so the client keeps control of medical records and billing history. For home health and hospice clients, the systems it supports include WellSky (Kinnser), Axxess AgencyCore, MatrixCare, KanTime, Homecare Homebase, Netsmart DeVero, HealthWyse (Casamba), Alora, ClearCare, firstHOMECARE, Thornberry NDoc and HAS IGEA. For behavioral health practices, it lists SimplePractice, TherapyNotes, Kareo and Waystar/ZirMed.

Reporting and Compliance

Payments and adjustments are posted directly into the client's system. This keeps accounts receivable aging accurate and lets the provider see the current state of its receivables at any time. Clients receive reports on billing activity, reimbursement and cash collections, organized either by batch or by individual patient. Home health agencies must file quarterly Medicare credit balance reports even when they owe nothing. Optima prepares these reports and sends them to the agency ready to submit.

Additional Services and Background

The company also handles credentialing. This includes enrolling clients with new insurers, adding clinicians to existing payer contracts and supporting contract renewals. Its consulting work starts with reviewing a client's workflow and procedures. Through its sister firm, Tortolano & Company LLC, Optima can also arrange accounting, bookkeeping, operational support and tax assistance. Clients have access to a provider portal.

The firm publishes regular updates on regulatory changes, including CMS hospice wage index and payment rates, home health payment rules and the HOPE assessment tool for hospices.

Optima may suit agencies and practices that want an outside billing team to work in their current software. It also fits organizations that need specialized post-acute billing knowledge, with services that go beyond claims into credentialing and back-office support.