Medical Billing Companies & Consultants in Metuchen, NJ

Headquartered in Metuchen, New Jersey, only minutes from Edison, K&D Medical Billing and Services Inc provides coding and billing support to healthcare providers across a range of specialties and practice sizes. Although the office sits in Middlesex County, the firm accepts clients from every part of the country. Its central goal is helping practices collect more of what they are owed by reducing errors on claims and speeding up payer turnaround.

Services

Three service lines make up most of the firm's business: end-to-end revenue cycle management, Medicare Advantage billing, and audits of the revenue cycle. The revenue cycle package spans every step between a patient's first registration and final payment on the account, including:

• Patient intake and verification of insurance eligibility
• Charge entry and coding aligned with up-to-date guidelines
• Claim submission and follow-up on anything that stalls or gets rejected
• Denial management, appeals and oversight of receivables
• Payment posting and account reconciliation
• Provider credentialing and enrollment with insurers
• Standard monthly financial statements along with tailored reporting
• Internal audits, post-payment reviews, examination of clinical documentation, and in-person coding and billing training

Claims for Medicare, Medicaid and commercial payers all fall within the firm's scope, and staff also field billing inquiries from patients. For Medicare Advantage clients, the team confirms eligibility and benefits for every patient, applies the coding requirements specific to those plans, files and reconciles claims, and tracks shifts in regulation to lower a practice's risk of audits and penalties. A notable emphasis is making sure practices receive complete payment under HCC risk adjustment.

How They Work With Clients

Rather than using a fixed rate card, K&D quotes each client based on that practice's specific requirements, and it characterizes its agreements as flexible. The company commits to replying to client emails within a single business day. Onboarding a new practice generally runs three to four weeks. On the technology side, the firm can bill in Elation and route claims through the Claim MD and Availity clearinghouses, and it will also operate within whatever system a practice already uses.

Background and Team

The founder, Kelita Martelly, CPC, CMRS, began her career as a physician in Haiti, where she treated patients before relocating to the United States in 2009. She later joined a large South Florida medical group and took charge of risk adjustment, coding, billing, auditing, compliance and provider education across upwards of 30 clinics. Her partner in the business, Dienna Fileus, holds CPA licenses in both New Jersey and Maryland and brings more than fourteen years spent in tax, audit and accounting roles at Big 4 firms, a state government agency and private-sector companies. Coders on staff carry CPC, CRC and CMRS certifications.

What most distinguishes K&D for prospective clients is the pairing of a medically trained coder with deep Medicare Advantage risk adjustment experience and a CPA rooted in auditing. As a result, the firm suits practices that serve large numbers of Medicare Advantage patients, as well as those looking for audit expertise in addition to day-to-day claims work.