Medical Billing Companies & Consultants in Edison, NJ

Overview

Akshar MediSolutions is a revenue cycle firm based in Edison, New Jersey. It runs the financial back office for healthcare organizations. Its clients include hospitals, clinics large and small, laboratories and solo physicians. The company says it works with practices across the United States and pays particular attention to small, independent offices. Its leaders have more than ten years of background in IT, consulting and billing, and the team includes certified coders.

Core Services

The firm offers a full outsourcing model. Its work starts before a patient arrives and continues until each account is settled. The main service lines are:

• Medical billing, including charge entry with claim scrubbing and payment posting
• Coding and compliance audits covering ICD-10, CPT, HCPCS, modifiers and NCCI edits
• Checks on insurance eligibility and benefits
• Requests for prior authorization, with follow-up
• Electronic and paper claim filing, plus fixes for clearinghouse rejections
• Denial analysis, correction and appeals
• Follow-up on receivables and recovery of aged balances
• Payer enrollment, credentialing and help obtaining NPIs
• Medical scribe documentation
• Help moving to an EMR, and custom performance reports

How They Work

Akshar sets defined turnaround targets for its work. Payments are posted within a day of arrival, and bank deposits are checked against the practice management system. Secondary claims are sent according to coordination of benefits. Denied claims are reviewed and resent within two business days after the EOB comes in. Transmission errors are fixed within 24 hours. When a new client signs on, the team first reviews older unpaid receivables. It works on high-dollar claims and claims close to timely filing deadlines first, and it flags payments below contracted rates. The company aims to keep days in AR under 25. Each client gets a dedicated account manager, and an IT team offers technical help around the clock.

Analysis and Compliance

Besides routine billing, the firm offers revenue recovery reviews. These look at documentation quality, coding patterns such as under-coding of E/M visits, unbilled charges, denial trends and dead AR. They also compare collections with contracted amounts, including drug profitability and out-of-network payment negotiation. The firm can help practices enroll underinsured and uninsured patients in foundation and patient assistance programs. It also enters new patient demographics with built-in accuracy checks. All of this work follows HIPAA-compliant procedures.

What Sets Them Apart

Akshar combines its outsourced services with cloud-based EHR, RCM and practice management tools that it offers clients free of charge. The company says it covers all medical specialties and quotes a 7 to 14 day turnaround. It also sells SEO and website development to healthcare clients. This may suit buyers who want one New Jersey vendor for credentialing, coding, claims and collections, plus the software to run them.

HealthQuist USA Inc is an Edison, New Jersey company that runs the financial back end of medical offices on a contract basis. Doctors and office administrators hand it their reimbursement tasks so they don't have to keep that function in-house. According to the firm, it has offered these services since 2003, and its customers are spread nationwide, ranging from solo doctors to sizable group practices with many clinicians. Its central argument is that physicians should be free of the time-consuming job of pursuing payment. Handing that job to a specialized outside staff, it says, frees front-desk and clinical personnel to concentrate on the people they treat.

What the firm provides

HealthQuist presents its main offering as one contracted bundle that follows a claim from start to finish. A number of supporting services surround that central product:

• Full-cycle claims handling for private insurers as well as Medicare, Medicaid and other public programs
• Oversight of money owed by insurance carriers
• Claims work for on-the-job injury, employee health and accident-related legal matters
• Collection and tracking of amounts patients owe directly
• Audits of code assignment that flag mistakes and services left off the bill
• Enrollment of clinicians with health plans
• Advisory work on missed payments and the terms of insurer agreements
• Dedicated teams for quality assurance and regulatory compliance

The company's involvement with insurers begins ahead of the appointment itself. When a patient books and registers, HealthQuist personnel confirm eligibility and plan benefits directly with the insurer and secure approval for the encounter. Once the patient has been seen, the team records services and incoming payments, then checks clinical documentation against what appears on the claim. Software reviews each claim for errors before it is transmitted electronically. Outstanding balances are pursued, and rejected claims are contested through formal appeals. The firm also studies financial reports to gauge how well a practice is performing, and it recommends ways to reduce the errors at check-in and in administrative processing that delay incoming revenue.

Working with clients

Every client is paired with its own Account Manager, who oversees the transition period. That individual studies the practice's workflow and afterward acts as the primary go-between connecting the office with the specialists processing its claims. HealthQuist avoids guaranteeing any specific percentage gain in revenue. It frames its aim instead as capturing the maximum possible income while lightening the paperwork and personnel load the practice carries. The firm also acknowledges that handing off this function is not right for everyone, and it provides a cost review so offices can judge whether the arrangement makes sense for them.

Fields served and track record

HealthQuist reports familiarity with many areas of medicine. Among them are outpatient surgical facilities, pain-control services delivered around procedures, heart care, skin care, adult primary care, women's health covering pregnancy and reproductive care, cancer treatment, eye care, bone and joint care, chronic pain treatment, children's health, rehabilitation medicine, hands-on therapy services, mental health, medical imaging, treatment of autoimmune and joint disorders, and walk-in clinics. Its online materials include client stories featuring a mental health organization and a walk-in clinic company, along with a page addressing patient privacy rules under HIPAA.

Organizations evaluating outside billing partners may find several points about HealthQuist worth weighing. The company has more than twenty years in the business. Each client receives one designated point person. Its scope also extends past routine claim submission, bundling insurer enrollment, code audits, injury-related and legal-case billing, and consulting under one roof at a single firm based in New Jersey.

iSolve RCM is a revenue cycle management firm based in Edison, New Jersey. It handles billing and collections work for physicians, clinics and other healthcare organizations. The company operates as iSolve RCM LLC and says it has supported providers throughout the United States for more than six years. It markets its work to multi-specialty groups and also to smaller practices that lack the staff to run a full billing cycle in-house.

The firm's main offering is outsourced medical billing for professional as well as facility claims, which it prepares on CMS-1500 and UB-04 forms. Its team of certified billers and coders handles the work from front-end patient data through to reporting. The stated goals are cleaner submissions, fewer rejections and quicker payment from payers. Its main service lines include:

• Medical billing and electronic claims submission
• Medical coding using ICD-10, CPT and HCPCS
• Denial management and appeals
• Accounts receivable management and AR aging analysis
• Payment posting from ERAs and EOBs
• Insurance eligibility verification
• Medical billing audits
• Provider credentialing and payer enrollment

How They Work

For outsourced billing clients, iSolve RCM describes a five-stage workflow. Staff first record patient demographics and insurance history. Next they confirm coverage and explain to patients what they will owe. Coders then turn physician documentation into standard codes. Claims are checked for errors before they go to payers. When payments arrive, staff record them in the receivables system and chase anything left unpaid. For receivables, the company outlines a ten-step routine. It includes building aging reports, finding out why claims are stalled, checking payer filing deadlines, phoning insurers for status updates, correcting and resubmitting denied claims, escalating difficult cases and contacting patients about balances they owe. Denial specialists review remittance data every day and track patterns to prevent repeat problems. The company also lists AI-assisted claim scrubbing and experience with Medicare and Medicaid claims among its capabilities.

Specialties Served

Specialty coverage is a large part of the company's pitch, and it reports serving more than 45 specialties. Named areas include behavioral and mental health, cardiology, radiology, endocrinology, neurosurgery, pathology, neonatology, nephrology, ENT, urgent care, oncology and family practice. Its behavioral health offering is the most detailed. It covers psychiatry and psychology billing, collaborative care model (CoCM) billing, integrated care management, therapy and counseling claims, and substance use disorder services. It also includes charge capture so that no session types are missed.

The company stresses HIPAA-compliant data handling, around-the-clock access and a fee based on a share of monthly collections. Prospective clients can ask for a free consultation, a demo or a no-cost assessment of their revenue cycle meant to find gaps in current collections. The website also has a calculator that compares outsourced billing with the cost of in-house staff. iSolve RCM lists its office in Edison, NJ, and says it works with providers in more than 45 states, with dedicated pages for markets such as Texas, Illinois, Ohio, Michigan and Arizona. It also offers healthcare digital marketing as a related service.