Medical Billing Companies & Consultants in Dayton, OH

A & A Medical Billing Service is a small, independent billing firm based in the Dayton area of southwest Ohio, serving physicians and their office staff who would rather hand off claims work than manage it in-house. The company positions itself as an outsourced billing partner for practices frustrated by slow or inconsistent reimbursement, and it draws on more than two decades of hands-on experience in medical billing.

Who they work with

The firm works with both general practitioners and specialists, stating familiarity with the coding conventions used across a broad range of specialties. That makes it a fit for solo doctors and smaller group practices that need someone to keep track of payer-specific modifiers, shifting Medicare policies and Medicaid billing questions without adding staff of their own.

Services offered

• Electronic claim submission to Medicare, Medicaid and the large majority of commercial insurers
• Procedure coding and modifier selection for general and specialty practices
• Tracking of Medicare and Medicaid rule changes
• Identification and pursuit of underpaid claims
• Follow-up on unpaid balances with insurers and patients
• Handling of patient billing inquiries on the practice's behalf
• Management reporting for the practice

How the process works

Claims are transmitted electronically, and the company reports direct connections with Medicare, Medicaid and roughly nine in ten or more private carriers. Because submissions flow straight into the payers' own processing systems rather than through manual handling, the firm says practices can expect faster payment turnaround.

Its billing system automatically flags reimbursements that come in below expected levels, and staff then take those cases up with the carrier. Patients with questions about their statements speak with A & A directly, which keeps those calls off the front desk.

Outstanding accounts are actively worked for the first 90 days following the date of service. Once an account reaches 120 days, the decision about what happens next, such as further collection efforts or a write-off, is returned to the physician, so the practice keeps control over how older balances are treated.

Pricing model and what sets them apart

Rather than charging setup costs or flat monthly fees, A & A bases its compensation entirely on the money it actually collects for the client, and it does not charge anything to get started. For buyers, that arrangement ties the billing company's earnings directly to collection results and lowers the up-front risk of switching vendors.

Combined with its long tenure, its emphasis on consistent follow-up and its reporting for management, the firm presents itself as a straightforward, collections-focused option for local practices.

The office keeps weekday business hours, Monday through Friday, and is closed on weekends. Practices comparing billing vendors in Kettering, Centerville and the greater Dayton region may find it a practical choice when they want a nearby, personally managed service rather than a large national revenue cycle company.

Healthcare Claims Solutions, Inc. (HCS) is a billing and revenue cycle firm in Moraine, just south of Dayton, Ohio. It works with physician practices, provider groups and larger healthcare organizations that want a clearer view of their reimbursement and a more reliable way to get paid for the care they provide. Its work is built around fee-for-service reimbursement. It supports clients in independent practices as well as in hospital-based clinical settings.

HCS says it has more than twenty years of experience with practice reimbursement. Its staff have supported providers in many parts of the United States, from small groups to large ones and from remote frontier settings to urban tertiary care centers. The firm says it uses proven, repeatable processes on every engagement but adjusts how it delivers them to each client. The goal is to let providers spend less time on administration and more time with patients.

Billing and coding services

Clients can hand off the whole billing function or pick individual parts of it. The firm's main offerings include:

• Complete physician billing: code assignment, charge entry, claim submission, payment posting, denial follow-up and collection of patient balances
• Stand-alone ICD-10-CM diagnostic and CPT-4 procedure coding, done by certified coders who follow clinical and regulatory guidelines
• Billing for mental health and therapy providers
• Revenue analytics, including a review of difficult charts sent in by prospective clients
• Help responding to payer audits, recoupments, take-backs, denials and rejections, using evidence-based protocols
• Provider credentialing aimed at faster payer approvals

Coding can be part of a full billing engagement. It can also be bought on its own, on a contract or episodic basis, by organizations that want to keep the rest of their billing in house.

Documentation, review and consulting

HCS also offers clinical documentation improvement. In these engagements, staff observe clinicians at work, review the documentation they produce and check it against the services actually provided. Providers get feedback individually and as a group, and HCS follows up later to measure progress toward agreed goals.

Chart audits are part of this service, and the aim is consistent documentation standards across every provider in an organization. The firm also works as an Independent Review Organization (IRO), a service it says its customers value highly, and it offers broader reimbursement consulting.

What distinguishes the firm

HCS sees its advantage as pairing analysis with hands-on work. It studies a practice's reimbursement, handles the billing and coding, and focuses on results that benefit the physician or group directly. It offers credentialing at a modest cost to take that paperwork off practice staff. For buyers in the Dayton area, HCS combines a local office with experience serving providers nationwide. Clients can hire it for full billing, coding only, documentation improvement or independent review.

Provider's Choice Medical Billing Services LLC is an Ohio-based firm with an office in Kettering. It handles billing and the business side of medical practices. The company has supported healthcare providers with software applications, billing work and related assistance since 1990. Most of its clients are in the Dayton region, and it also works with practices in Cincinnati and Columbus. Buyers who want a regional partner rather than a national outsourcing operation may want to consider it.

Who They Serve

The firm works with practices of very different sizes. Its clients range from a solo physician working out of one office to larger groups with several sites and facilities across various settings of patient care. Provider's Choice says its resources can handle both the information management and the revenue cycle needs of these organizations. This makes it a possible fit for a practice that expects to grow or add locations without changing billing partners.

Services Offered

Provider's Choice covers the full billing workflow, from the moment a claim is created through final payment and reporting. Its listed services include:

• Medical billing
• Electronic submission of claims to payers
• Fixing and resubmitting claims that contain errors
• Processing remittances and posting payments
• Following up on unpaid or delayed claims
• Collections
• Monthly reports on practice performance
• Hosted software
• Provider credentialing
• Help moving a practice from one setup to another

How They Work With Clients

Practices can choose from two ways of working with the company. In the first, Provider's Choice supplies the software applications and also runs the revenue cycle, giving the practice one source for both technology and billing staff. In the second, the practice keeps its current system and the firm provides revenue cycle management and support on top of it.

In both cases, the company describes its team as working like part of the client's own office staff rather than as a distant vendor. This lets each practice decide how much of its operation to hand off.

Approach and Background

Before taking on an engagement, Provider's Choice looks at two basic questions with practice leaders. The first is whether the practice is collecting everything it should for the care it delivers. The second is how much it is spending to run its operations compared with what it brings in.

The firm then works with the client to design a workflow meant to raise collections while keeping costs reasonable. It describes its staff as approachable, well informed and focused on the practices they support.

Its long history, which goes back more than three decades, and its focus on southwestern and central Ohio set it apart from newer or out-of-state billing vendors.

Worth Healthcare is a medical billing and revenue cycle firm based in the Dayton, Ohio area. Its office is on West Elmwood Drive. The company works with healthcare providers in Dayton and across Ohio. Its clients range from single providers to large physician groups. Besides billing, it offers provider credentialing and healthcare staffing. That makes it an option for practices that want help with more than claims alone.

Services offered

The firm's services cover most of the revenue cycle, along with some practical extras for a practice's office:

• Medical billing and revenue cycle management (RCM)
• Provider credentialing
• Accounts receivable management
• Claim processing and denial follow-up
• Soft-approach medical collections
• Healthcare staffing support
• Training on current software platforms
• Lockbox mail handling
• Conference room rentals

A practice can use the firm's own EMR and billing software. If it prefers, Worth Healthcare's staff will work remotely inside the practice's existing system. The team says it is trained or certified on several common platforms, including EPIC, Kareo, Allscripts, Cerner, Greenway and eCW. That can make the switch easier for a practice that doesn't want to change systems.

How the firm works with clients

Every client gets its own Billing Specialist. Larger accounts also get a dedicated manager. The specialists work from home offices and connect to client systems over secure, HIPAA-compliant links. The company presents this as protection against interruptions like the staffing problems many practices faced during COVID-19. It also helps when a practice loses billing staff.

All patient and insurer payments go straight into the provider's own bank account, not through the firm's accounts. The company says its goal is to protect revenue from undercharging, missed charges, denials nobody worked and claims that were never collected.

It aims to work as an extension of the practice's staff and to support practice managers and physicians, especially managers who have ended up handling billing on top of everything else.

Collections approach

For overdue patient balances, Worth Healthcare uses a soft collection process. Staff contact the patient directly, introduce themselves and ask for a promise to pay by a set date. They then confirm the agreement by email and send the patient a draft. Staff keep in touch as the payment date gets closer.

Once the money arrives, it is sent to the provider quickly. If the patient doesn't pay as agreed, the firm sends a registered demand letter, and legal action becomes possible. Clients can also get monthly or quarterly reports for bookkeeping and tax purposes.

For buyers comparing billing vendors, the main differences here are the dedicated billing contact for each account, the option to keep existing software or use the firm's, and payments going directly to the provider's bank account. The extra office services, such as lockbox handling and software training, may also appeal to practices in the Dayton region.