Medical Billing Companies & Consultants in Buffalo, NY

Assertive Medical Practice Management Services, Inc., which operates under the shorter name AM-PM, is a Western New York firm that handles the business side of healthcare for physician groups and other providers. Its work centers on three linked disciplines: claims and receivables management, professional coding, and provider enrollment. The company is based in West Seneca, a suburb just southeast of Buffalo, and reports that its clients have ranged from independent doctors' offices to several of the region's larger medical centers.

Billing and revenue cycle work

On the billing side, AM-PM offers an end-to-end outsourced service. Staff answer patient questions about their accounts, key in charges, check clinical notes against the codes each provider selected, and run edits before claims go out. Claims and patient statements are transmitted electronically, and payments from insurers and patients are posted from electronic remittances. The firm also handles:

• Denial follow-up and insurance appeals
• ERA/EFT enrollment with payers
• Loading 837 and 835 transaction files into a database
• Identifying and reporting overpayments
• Pre-collection work on aging patient balances
• Annual refreshes of CPT, ICD-10 and HCPCS codes and fee schedules
• Reports delivered each month

Beyond routine claims, the company watches charges and fee schedules so that practices are reimbursed for every service rendered, and it runs cash recovery projects aimed at older insurance receivables, including balances a practice may already have written off. For patients who owe overdue amounts, AM-PM describes a respectful collections approach that looks for workable payment arrangements. The team says it tracks payer rule changes at the local, state and federal level by attending meetings and seminars and keeping ties with major insurers, then passes relevant updates along to clients.

Coding, audits and credentialing

AM-PM's certified coding service provides on-demand help to physicians and office staff, research when a practice faces an insurance audit or adds new services or employees, and provider education. Audits can be requested to review modifier use, level of service, whether documentation supports what was billed, and legibility and signatures. Findings are summarized in a written report covering background, scope, objectives, methodology, results and recommendations; it is reviewed with providers and administrators and may lead to further training or follow-up audits focused on risk areas. For credentialing, the firm uses an electronic system to file and maintain participation with insurance carriers, hospitals and facilities, keep CAQH attestations current, and monitor licenses, DEA registrations, education, training and malpractice coverage. It will also review payer contracts and may help negotiate them.

Approach and team

The staff includes C-suite management consultants, revenue cycle specialists, coders and credentialing support personnel who build custom plans for each client. Consulting offerings include assessments of finances and operations, revenue cycle improvement, and audits of coding and quality assurance, with stated goals of recovering lost revenue, reaching compliance, containing costs and raising productivity. Each new client receives an individualized analysis, and the firm emphasizes personal attention as a daily practice. A practice manager quoted on the site credits the team with helping her organization's HCC scores, timely billing and low outstanding receivables.

Healthcare Solutions WNY, often shortened to HCS, is a practice management company in Western New York. It takes on the administrative and financial work of running a healthcare organization so that clinicians can spend their time on patients. Its staff handle the work in-house, and the firm supports practices at every stage, from opening a new office to growing an established one. Medical billing is the core of what it does, but it also covers coding, credentialing, accounting, payroll, human resources and consulting. A provider can hand over a single function or several.

Billing and Revenue Cycle Work

The billing team covers the full claim process, starting with charge entry and running through denial follow-up. Staff look at how claims were paid and challenge underpayments to recover money owed to the provider. They also study denial patterns and teach office staff how to prevent them. Clients get management reports measured against key performance benchmarks, along with custom reports when needed. Each practice has its own contact person. HCS can supply the billing software or work in the client's current system. It also does pre-collection work on overdue accounts and reviews the client's fee schedule every year.

Coding, Audits and Credentialing

The coding staff hold AHIMA and AAPC credentials and work across many specialties. They code both surgical procedures and office visits using CPT and ICD-10. Their work includes:

• Audits that check compliance and look for lost revenue
• Coding that follows NCCI edits
• Coaching providers on documentation and keeping them current with yearly code updates
• Reviewing and appealing denied claims, and explaining the causes to the practice
• Enrolling providers with insurance payers, keeping CAQH profiles up to date and getting NPI numbers

Facility Types Served

Besides physician practices, HCS bills for several kinds of institutions. For hospitals, it handles inpatient, outpatient, emergency department and observation claims. It also aims to get claims in on time when cases need closer review. For nursing homes, the team works with long-term care coding, skilled nursing facility claims, and Medicare and Medicaid rules. It also serves Rural Health Clinics, which must follow specific CMS rules and bill per encounter, as well as critical care hospitals.

Back-Office Support Beyond Billing

Practices that want to outsource more can use HCS for accounting. This covers weekly bills, bank reconciliations, cash monitoring, monthly financial statements, budgets and productivity reports. The firm also works with the client's tax accountant at year end. Payroll includes a time and attendance system, W-2s, deductions and time-off tracking under New York State and federal rules. On the HR side, HCS can help with hiring, onboarding, leave paperwork such as FMLA and PFL, benefits renewals, COBRA, employee handbooks and compliance training. Its consultants also help with starting a new practice, checking profitability, reviewing physician pay and finding bottlenecks in workflow. For buyers, the main draw is having billing, credentialing and other back-office work handled by one local partner.

HealthTec Solutions, Inc. is a medical billing and practice support firm in the Buffalo area. It works from an office in the Northwoods Medical Center in West Amherst, New York. The company takes over the revenue-cycle and back-office work of physician practices so that clinicians and their staff can spend more time with patients. It works with independent physicians running a practice alone as well as with multi-provider groups. Its pitch to these practices is a cheaper option than keeping a billing team on the payroll.

Core Services

The firm groups its work into three main service lines, and practices can pick the support they need:

• Comprehensive medical billing: handling both patient and payer billing from start to finish, from preparing and sending claims through to collecting payment, with a focus on accuracy and revenue
• Practice management: taking care of the administrative, financial and operational side of a practice so the office runs consistently
• Customized reports: financial and operational reports built around what each client wants to track

Client testimonials on the site mention other work as well. This includes reconciling receivables, fixing billing errors, dealing with insurers on a practice's behalf, and monthly bookkeeping and accounting. The firm also runs a central billing line that patients of client practices can call to talk with a billing specialist about their accounts.

How They Work With Practices

HealthTec gives each insurance payer its own billing specialist, so the staff working a practice's claims know that payer's rules and processes. The company says its claim denial rate is below the national average and its collection rate is above it. It presents this as a way for practices to get steadier cash flow and run their offices more efficiently. The site also says the firm uses artificial intelligence in its operations. Certified coders keep billing information current, and the in-house accounting staff prepare detailed monthly reports that show practice owners where they stand financially.

Background and Track Record

The firm's client relationships go back a long way. Village Pediatrics & Rheumatology says it has used HealthTec for more than twenty years for billing, insurance work and reporting. Amherst Medical Associates says it began working with the company in 2008 for patient billing and collections, and later added bookkeeping and accounting. Both clients say outsourcing to HealthTec has saved them time and money. Their testimonials suggest the firm works especially well for pediatric, rheumatology and internal medicine practices, though it does not limit itself to any one specialty.

For Western New York practices comparing billing vendors, HealthTec offers a local office, payer-dedicated staff and certified coders. It can also combine billing with accounting and custom reporting under one provider. That combination may suit practices that want one outside partner to handle both their claims and their financial records.

Company Snapshot

Headquartered in Cheektowaga, a suburb within greater Buffalo, New York, Maxim Management Services takes on the nonclinical workload that comes with operating a doctor's office, acting as an outsourced management partner for physicians. The scope of each relationship varies. A practice might call on the firm for advice on a single issue, or it might turn over almost every administrative task behind the scenes. Arrangements are built individually rather than drawn from a fixed package.

The firm's client base consists largely of physician groups and specialty offices across Western New York. Among the organizations it identifies as clients are a regional urology group and a local oncology practice, suggesting familiarity with the reimbursement complexities found in both specialties.

Billing at the Core

Revenue cycle management forms the backbone of what Maxim does. On a daily basis, its team transmits claims electronically to every large insurer and records incoming remittances through electronic posting as well. A current-generation practice management system supports this process. By shortening the time between service and payment, the firm aims to give practices more predictable income. Clients retain full visibility into their records and may look at their practice information at any time. Coding is available as a companion service, allowing a practice to delegate the assignment of codes in addition to claim filing and payment entry.

Range of Offerings

Maxim's capabilities reach well beyond reimbursement work, covering a broad mix of office and technology functions. According to the company, its lineup consists of:

• Billing for medical services, with claims filed electronically each day
• Coding of medical claims
• Dictation and transcription, entered straight into a practice's electronic records or supplied in a standard document format
• Advisory services for Medent users
• Network setup and information systems assistance
• Systems for managing practice operations
• Broad consulting on running a practice
• Research into patient outcomes

For transcription, Maxim's staff can enter dictated material inside a client's electronic health record or prepare conventional written transcripts instead. The company emphasizes that the final deliverable is tailored to suit how each office prefers to operate. Its technology services span the full spectrum of office IT, with the intent of minimizing downtime and safeguarding sensitive information. Solutions are configured to match the particular environment of each client. Practices that rely on Medent software can draw on the firm's specialized advisory support for that platform.

Working Style

Maxim frames its client relationships as collaborative, with its own experts supplementing rather than replacing the people a practice already employs. Precision, productivity and measurable outcomes are the priorities it highlights. The company also deliberately limits how many clients it serves. Rather than pursuing expansion for its own sake, it chooses to maintain a smaller roster of closely managed, enduring relationships. That philosophy positions it as a specialized, personalized provider instead of a large-scale processing shop.

For medical offices around Buffalo seeking a single nearby resource to handle reimbursement, coding, transcription, advisory work and technology support, Maxim brings these functions together under one roof. This spares practices the effort of juggling multiple independent contractors and keeps accountability in one place.

Medical Management Services, often shortened to MMS, is a billing and revenue firm based in Amherst, New York, in the Buffalo suburbs. It works mainly with physician practices that want to hand off coding, claims and receivables. The company's stated goal is to help doctors collect everything they are legally owed for the care they give, while keeping ethics, compliance and integrity at the center of that work.

Background

MMS traces its roots to 1979. That year Charles Tirone M.D., a Buffalo radiologist, started PAC-DATA Systems, which the company describes as the region's first billing service. PAC-DATA ran on IBM Series One mainframes with its own software and helped make it practical for physicians to bill separately. It was incorporated under the MMS name in April 1982. In 1995 the firm launched a second-generation in-house billing platform built on the Ingres relational database and Sun Microsystems hardware. In September 2010 the business changed hands through a management buyout. Since then it has moved to GE software and works with technology partners in several countries. The company says its staff are the main reason for its success.

Services

MMS offers a broad set of services, so a practice can outsource its whole revenue cycle or pick only the parts it needs:

• Complete billing outsourcing, in which MMS codes encounters, submits claims and manages accounts receivable while keeping the practice compliant
• Chart review and coding done only by Certified Professional Coders
• Insurance enrollment and ongoing physician re-credentialing with payers
• Web-based scheduling and practice management on GE Centricity, with on-demand custom reports
• Consulting that compares a practice's in-house billing against industry benchmarks
• Help setting up monthly key performance indicators and tracking trends over time
• Accounting support and payroll processing for medical offices

How it works with clients

Under the full outsourcing model, physicians focus on patient care and MMS takes over the administrative side. The firm presents this as a way to raise practice revenue while cutting staffing and overhead costs. For practices that do their own billing, MMS offers specific services, such as keeping up with payer re-credentialing or reviewing how well their in-house process performs. Its hosted practice management option lets offices manage schedules over the internet without buying an expensive software system up front.

What sets it apart

The firm's coders do more than process claims. Some of them also teach coding at colleges in Western New York and prepare students for certification exams. MMS also works directly with providers to improve their clinical documentation. Its credentialing team uses IntelliApp software and says it manages credentials for close to 1,000 physicians. For buyers comparing billing vendors, MMS offers a long history in the Buffalo market, a staff of certified coders, and a range of services that runs from coding and claims through credentialing, consulting, accounting and payroll.

Practicefirst Medical Management Solutions is an outsourced revenue cycle firm based in Amherst, New York, a suburb just north of Buffalo. The company traces its roots to 1960 and now works with physician groups, specialty practices and other healthcare organizations across the United States. It combines claim submission and accounts receivable work with certified coding, credentialing, compliance support and broader practice oversight. A client can hand off one function or the whole revenue cycle.

Billing and A/R Services

The billing work starts before any claim is filed. The team first reviews a practice's patient financial policies, including its collection, small-balance and refund rules. Each year it checks fee schedules against carrier arrangements and against federal surprise-billing requirements for patients with out-of-network coverage. Practicefirst also helps set up patient payment plans. It sends final notices before an account goes to an outside collection agency or attorney.

Before claims go to the clearinghouse, the team scrubs them. It checks place-of-service codes, CPT-4, ICD-10, HCPCS and modifier usage, and payer bundling rules. Payments are usually posted within two days, mostly through electronic auto-posting, and each remittance is checked for accuracy. Denied or underpaid claims are pursued through calls to carriers or written appeals. Clients get tailored reports every month, quarter and year. The firm also reviews encounter notes to find legitimate services that went unbilled, confirms authorizations and referrals, and bills secondary payers.

Coding, Audits and Practice Support

Coding staff are certified through AAPC or AHIMA and take ongoing education courses. The company says its coders are audited every month and must reach at least 95 percent accuracy. Specialties supported include:

• Anesthesiology, cardiology and neurology
• Emergency medicine and hospitalist groups
• Gastroenterology, orthopedics and urology
• OB/GYN, radiology and surgical practices
• Urgent care

Practicefirst also offers independent chart audits. These flag undercoding, overcoding and documentation gaps before a payer or government review finds them. Its credentialing group uses an electronic system to monitor applications, catch errors and track renewal deadlines. One orthopedic group with more than 70 providers mentions getting weekly status reports. Other offerings include compliance resources, customized practice management oversight, and documentation training for emergency department and hospitalist clinicians. The firm also helps physicians open a new practice, from entity paperwork and tax ID setup to payer enrollment.

What Sets It Apart

Practicefirst highlights fast onboarding with links to most EMR platforms, flexible rates for startup practices that are still building cash flow, and reporting tied to key performance indicators. It is a MEDENT preferred provider. Several client testimonials on its site come from Western New York organizations. They include a Buffalo practice, a WNY hospitalist group that has used the firm for its full revenue cycle since 2014, and a pediatric cardiology practice served since 2011. For buyers in the Buffalo area, the firm combines a nearby office, more than six decades in business and credentialed coders. That makes it worth considering for practices that want coding accuracy and billing handled by the same partner.

Preferred Systems and Services, Inc. is a Buffalo-area company that supports physician practices and other professional offices with revenue cycle work and office supplies. It has worked with healthcare providers across Western New York for more than four decades. Over that time its client base has grown beyond New York into several nearby states. Practices that want to hand off billing and collections, while also buying office supplies from the same vendor, may find the combination useful.

Billing and Receivables Services

The firm's main offering is complete outsourced billing paired with accounts receivable management. It works with practices at different stages. Some are moving away from an in-house billing department for the first time. Others want to leave a billing vendor they already use. In both cases the company says it adapts its approach to each office's goals rather than using a fixed package. The stated aim is to improve a practice's revenue so that clinicians and staff can spend more of their time on patients.

• Full-service medical claims billing
• Accounts receivable management
• Insurance claim follow-up handled by assigned specialists
• Work to lower claim denials and keep cash flow steady
• Help moving from an in-house billing setup
• Takeover from an existing outside billing service

Dedicated Insurance Follow-Up

Preferred Systems and Services also offers insurance follow-up as a separate service. A practice can have a team of specialists assigned to chase open claims and push for full payment from insurers. The company presents this as a cost-effective option, noting that it usually costs less than adding a full-time staff member to do the same work. It offers both short-term and longer-term contracts. That suits practices clearing an old backlog of unpaid claims as well as those wanting ongoing outsourced support.

Forms and Office Products

Besides billing, the company sells forms, paper goods and related business supplies to medical and professional offices. Buyers can ask for quotes on these items. Prospective billing clients can also request a billing assessment at no charge before signing on, which lets a practice review its current performance and see what the firm proposes.

Background and Approach

The company stresses customer service as a core part of how it works. Over its long history in the region it has built relationships with many physicians, who rely on it for services, products or both to keep their offices running smoothly. It serves medical offices in particular, and its site also names dental offices, laboratories and other professional practices as customers. For buyers comparing billing vendors, its main strengths are its long local track record, flexible contract terms, the option of dedicated follow-up staff, and the ability to supply both billing services and office products.

Overview

Professional Ambulance Billing LLC, known as PAB, is a Western New York firm based in Williamsville, a suburb just northeast of Buffalo. It works only on getting emergency medical services paid. It doesn't serve doctors' offices or hospitals. Instead, it built its business around the coding, paperwork and payer rules that apply to ambulance transports. PAB was set up to give EMS agencies a cheaper way to handle their billing, and it now works with agencies across the Northeast.

The company's pitch to new clients is about money agencies never collect. PAB says many nonprofit squads don't file claims for the transports they provide. That leaves insurer money unclaimed and puts the cost of emergency coverage on local taxpayers. By recovering that money, PAB aims to help agencies strengthen their budgets, lean less on tax support and put more back into patient care.

Who PAB Serves

PAB's clients cover the range of organizations that run ambulances, including:

• Volunteer ambulance corps
• Not-for-profit EMS agencies
• Municipal and town-operated services
• Privately owned ambulance companies
• Air medical operators

Services and Payers

The firm handles claims for both ground and air transport. On the ground side, it bills Basic Life Support calls, both emergency and scheduled non-emergency, plus emergency Advanced Life Support transports at the ALS1 and ALS2 levels. It also bills treat-and-release calls, where a crew assesses and treats a patient but doesn't take them to a hospital. For air medical clients, PAB handles claims for helicopter and airplane flights. It collects from a wide mix of payers: Medicare, Medicaid, commercial health plans, no-fault auto insurers, workers' compensation carriers and patients paying out of pocket. Patients can use an online portal to pay bills and send in their insurance details, which helps agencies get the information they need to file claims.

How PAB Works With Clients

PAB stresses a hands-on, one-to-one relationship with each client. The company believes no two EMS agencies work the same way, so it builds each collection plan around the client's goals and operations rather than using one standard template. Its staff have long experience with ambulance services and understand the day-to-day pressures agencies face. The firm promises close teamwork, prompt turnaround and fair fees, so crews and managers can focus on patient care while the billing is handled elsewhere.

Technology and Compliance

PAB backs its billing knowledge with up-to-date billing and field data software, which helps clients record call details and move claims along quickly. What it calls the PAB Advantage rests on five points: performance, low costs, HIPAA compliance, client service and support for patient care. For buyers comparing vendors, PAB is a regional firm that does only EMS billing. It has an office near Buffalo and works with volunteer, municipal, private and air ambulance clients.

Overview

TMC Data Services is a privately owned medical billing firm in Williamsville, New York, in the Buffalo area. It takes on billing and claims work for healthcare practices that would rather not do it in house. The company says it has three goals for clients: help providers collect more of what they are owed, cut what they spend chasing payments, and show clearly how their billing is being handled. For Western New York practices deciding whether to keep billing in house or outsource it, TMC presents itself as a local firm that covers the whole billing cycle.

Who They Serve

The firm says its clients cover a wide range of practices and medical specialties rather than one niche. Its website does not name specific specialties, so buyers in a particular field should ask TMC directly about its experience there. TMC stresses that it tailors its work to each practice. It also says clients can choose which tasks to hand over and which to keep.

Services Offered

TMC's published service list covers the main parts of the billing cycle for a physician or provider office:

• Electronic claim filing through current billing software and a clearinghouse, used whenever a claim can be sent electronically
• Paper claim filing for claims that cannot be sent electronically, with forms printed and mailed first class
• Payment posting to practice accounts
• Accounts receivable management for outstanding balances
• Monthly patient statements
• Financial reporting so providers can track performance
• Full practice management of claims and receivables as a combined package

The company says this list is not complete and that its services can be adjusted to fit each practice.

How They Work With Clients

TMC's main pitch is that it takes paperwork and admin tasks off a practice's hands. A practice that outsources does not have to buy and maintain its own billing equipment and software. It also avoids the staffing costs of an in-house billing team, such as paid leave, benefits and workers' compensation coverage. The firm says it handles billing conversations so that providers do not have to discuss payment with patients. It expects this to reduce the number of calls the front desk gets about bills and errors. TMC also keeps up with changing government and insurer rules for its clients, since missing those changes can cost a practice income. It promises faster payment than the 60 to 90 days some offices wait, fewer outdated or error-filled claims, and less need for practice staff to deal with insurance companies.

What Sets Them Apart

Practices can download and complete TMC's cost analysis survey, a form that collects details about the practice so the company can estimate how much it might save before work begins. The firm points to its experienced staff, its focus on accurate claims and its customer service as reasons to choose it. Its private ownership and Williamsville office make it a local option for Buffalo-area practices that want a billing partner nearby.