Medical Billing Companies & Consultants in Syracuse, NY

Kopp Billing is a revenue cycle management firm in downtown Syracuse, New York. It has worked with healthcare providers since 1963. Its clients include hospitals, physician practices, surgeons, ambulatory surgery centers and mental health professionals. It handles outsourced billing, coding, self-pay recovery and collections. Its message to buyers rests on three ideas that run through all its materials: being open about results, using modern tools and taking personal responsibility for the work.

Medical billing services

Kopp has been doing billing work since Medicare and Medicaid were introduced. Practices can choose from several setups. Kopp can run billing and receivables on its own proprietary platform, or work inside the practice management software a client already uses. Practices without a system can license software from Kopp, including the Medent® Practice Management System, which gives client staff access to features such as appointment scheduling. Billing staff handle claims and compliance for Medicare, Medicaid, HMOs, commercial and traditional insurance, self-pay, workers' compensation and no-fault cases. Daily work ranges from sending claims and posting deposits to following up on unpaid receivables and building custom management reports. The firm also helps clients decide how much effort to put on old claims versus new ones.

Coding, auditing and self-pay recovery

Kopp's coders hold AAPC or AHIMA credentials, and several also have specialty certifications. Kopp is a corporate member of the AAPC and has its own coders' work audited independently. Clients can sign up for ongoing work or one-off projects, paying on retainer or at hourly or monthly rates. Services include:

• Reviews of coding accuracy and supporting documentation
• E/M audits of professional claims
• Coding, audits and provider education for mental health
• ICD-10 reviews and training for clinicians
• Full reviews of surgeon and first-assistant coding
• Coding and documentation reviews for ambulatory surgery centers
• Template reviews, peer benchmarking and documentation improvement programs
• Help catching up on backlogs of professional coding

For hospitals, Kopp has run early-out self-pay programs since 1998. It doesn't wait for patients to report their coverage. Instead, it uses proprietary data scrubs and eligibility algorithms to find third-party payers, which it says make up about a quarter of its early-out recoveries. Accounts are checked for bankruptcies and deceased patients when they are placed and at regular intervals after that. They are also grouped by propensity-to-pay scores, and automated skip tracing plus staff outreach help reach patients. Older unpaid balances go to a separate collections service, which aims to recover more while keeping contact with patients courteous.

How Kopp works with clients

Kopp's extended business office service picks up work an in-house team can't get to. Examples include unreviewed receivables, system conversions, difficult payers, small insurance balances and workers' compensation claims. New clients meet with a principal to design their arrangement, and contracts include measurable benchmarks. Each client gets a daily activity feed, a dedicated account manager and a support team that knows its policies. Unlike bigger national competitors, Kopp fits its service to each client's current software, staff and procedures. It has experience connecting with most major healthcare systems and puts weight on keeping data secure.

Founded in 1996, MedBest Medical Management, Inc. is a Syracuse-based administrative services firm affiliated with SUNY Upstate Medical University. It handles the non-clinical operations behind the physician practices of this academic medical center, including professional fee billing, coding oversight, payer enrollment, financial accounting and workforce leasing. Prospective clients should understand that MedBest's customer base consists mainly of Upstate's Medical Service Groups (MSGs) rather than independent practices in the broader market. The company functions as an internal revenue and operations partner within the Upstate network.

Revenue cycle and billing

MedBest assigns a separate billing staff to every Upstate MSG, so each department works with a consistent set of contacts when monitoring its collections. These teams manage reimbursement from the moment a charge is entered until the balance is resolved, and most essential activities happen on a daily schedule:

• Assigning ICD-10 codes to physician services
• Verifying patient coverage with certain insurers
• Sending primary and secondary claims every day, both electronically and on paper, and reviewing payer rejections and acknowledgment reports
• Recording payments each day and examining explanations of benefits to make sure amounts paid are accurate
• Monitoring denied claims by procedure code and insurer, and pursuing appeals for denials and short payments
• Depositing funds into each group's accounts and sending patient bills on a daily basis
• Balancing accounts receivable every day, week and month, and producing end-of-month summaries that show trends

Compliance auditing and provider education

MedBest maintains a specialized audit unit that educates both newly hired and veteran clinicians about coding, billing and regulatory requirements. Instruction is customized to reflect each physician's subspecialty and experience. Recently hired providers undergo early reviews so they receive prompt guidance on how they code. Reviewers access charts and billing information remotely within Epic, which means clinic operations continue without disruption while an audit is underway. The unit relies on Intelicode software for its reviews. Its documentation assessments apply standards particular to academic practice, such as teaching physician requirements, the primary care exception, telemedicine billing and subspecialty taxonomy, as well as charting issues unique to Epic. The auditors additionally benchmark evaluation and management coding against a nationwide dataset drawn from academic medical centers. The resulting CPT utilization reports show how Upstate clinicians compare with counterparts at other teaching hospitals. Reviewers also identify billable services that physicians may be overlooking and describe the documentation needed to justify them.

Enrollment, accounting and staffing

In addition to its billing work, MedBest assists with provider credentialing and insurer enrollment and delivers accounting services designed for healthcare organizations. Acting as a Professional Employer Organization in partnership with Upstate, it also leases staff, and it includes consulting among its offerings.

Background and leadership

The organization's workforce has grown beyond 800 people. Key members of its management group are:

• Michael Lashway, who oversees the company's HR function as its director
• Sadia Duquette, Director of Audit and Compliance, an RHIA- and CPC-credentialed professional with over a decade of experience reviewing professional services
• Nicolas Bonfardice, Director of Administration, who brings upward of 14 years in healthcare operations and holds membership in the MGMA, a national professional body for medical practice managers
• Michael Mulcahey, Director of Finance, who directs the company's financial reporting and serves the accounting needs of six clients

For organizations evaluating the firm, its main distinctions are a deep orientation toward academic medicine, direct access to Epic and the assignment of a dedicated billing team to every group it supports.

O'Brien's Billing is a medical billing firm in Syracuse that works mainly with private practices in behavioral health and related fields. Most of its clients are mental health professionals such as psychotherapists, licensed clinical social workers and psychologists. It also bills for chiropractors and acupuncturists. The company is built for solo clinicians and small group practices rather than large health systems. It suits providers who would rather spend their time with patients than on insurance paperwork.

Background and Experience

The company was started more than thirty years ago and is now run by the second generation of the founding family. Over that time it says it has worked with hundreds of practices, most of them in the central and western regions of New York State, with some clients farther away. It works from an office on East Genesee Street in Syracuse. Client testimonials on its website, from a social worker, a psychologist and a wellness practice, praise the staff's persistence with insurer mistakes, their knowledge of payer rules and how kindly they treat patients.

Core Billing Services

The firm's main offering is revenue cycle management for practices that accept insurance. Claims are filed electronically, and staff check each payer's explanation of benefits to make sure the amounts are correct. When a claim is rejected or paid wrong, the team follows up without waiting to be asked. Insurance reimbursements go straight to the practice, not through the billing company. The firm's services include:

• Electronic claim filing with detailed reports for the provider
• Review of explanations of benefits and resolution of denials and errors
• Checking new patients' copays, deductibles, visit caps and referral or authorization rules before the first session
• Tracking authorizations and annual visit limits, with alerts when a treatment plan is due
• Insurance credentialing and updates to practice demographic details with payers
• Regular updates on insurer requirements and government rules that affect compliance and payment

How They Work With Practices

The firm does not use a single standard setup for every client. It designs billing workflows around each practice's existing routines and how comfortable the clinician is with technology. Staff can work directly inside several common practice platforms, including SimplePractice, TherapyAppointment, Practice Fusion and Tebra. Practices that do not use an electronic health record can still get a workable process that fits how they operate. This flexibility helps clinicians who are opening a new therapy practice, moving from part-time to full-time work, or simply trying to cut down on evening and weekend admin.

Additional Support

The company also offers help beyond claims. It handles electronic health record implementation and staff training, and it can set up electronic funds transfer so insurer payments arrive faster. Through a partnership with Practiscapes, it helps clinicians build and host websites where prospective clients can find them, read answers to common questions, follow a blog or request appointments. Taken together, these services make O'Brien's Billing a single administrative partner for small mental health, chiropractic and acupuncture practices that want experienced, personal service from a long-established local firm.

Based in Syracuse, New York, SpectraMedi MSO operates as a medical service organization that handles the administrative side of healthcare so that doctors and their teams can focus on treating patients. It works with hospitals, clinics and private practices of all sizes. According to the company, a central part of its purpose is helping independent practitioners keep their independence by raising productivity, strengthening financial outcomes and smoothing the movement of patients through a practice.

Medical Billing and Revenue Cycle Services

Billing forms the core of what the organization provides. When a practice hands its claims over to SpectraMedi, that work goes to staff the firm identifies as certified billing specialists. The practice is relieved of the expense and oversight of an in-house billing department and its systems, yet it keeps full visibility into its money. Clients can view reports at any hour, choosing from both built-in and tailored formats, and can reach them wherever they happen to be. SpectraMedi names the following objectives for practices that use its billing service:

• Cutting the total expense of operating a practice
• Bringing down the rate of claim denials from insurers
• Strengthening cash flow and reducing how long balances remain outstanding
• Capturing the fullest possible payment on each claim filed
• Supplying in-depth data analysis on financial results

Billing is not the only service available. The organization also handles collections, transcription that meets HIPAA requirements, staffing assistance and medical coding. As a result, a practice can consolidate multiple administrative tasks with a single provider rather than contracting different companies for claims, records and the recovery of unpaid balances.

Software Included With Service

Technology built in-house accompanies SpectraMedi's services. Practices that use its billing receive tools for both the front desk and the exam room, among them scheduling, practice management and an EHR/PHR system that comes with a patient portal. These programs help staff arrange appointments and manage patient arrivals and departures. For documentation, the company provides an iPhone app for dictation, the option to dictate by telephone, a product called iMedDictate and a client sign-in known as EasyFlow. SpectraMedi states that its software took shape through close collaboration with doctors across a wide range of practice types, which allows the tools to be configured around a given practice's routines, medical specialty and geographic setting.

Pricing Approach and Background

There is no standalone charge for the software. Instead, clients are billed solely for the services SpectraMedi has carried out. For organizations weighing different vendors, the practical result is that the technology adds no cost on its own and charges are tied to completed tasks. A billing rate calculator is also available so practices can project what they might spend.

SpectraMedi has been active in the healthcare field since 1999. The company reports having worked with over 8,000 providers and employing roughly 700 people, a workforce that includes IT specialists, transcriptionists, coders, billers and collection staff. The technology itself comes from Spectrum Software Solutions Inc., which also keeps it running on its own servers. The organization emphasizes lasting partnerships with its clients and a steady standard of quality throughout its full range of services.