Medical Billing Companies & Consultants in State College, PA

Complete Medical Billing Solutions, Inc. (CMBS Inc.), a family-owned revenue-cycle firm, operates from an office on South Atherton Street in State College, Pennsylvania. It works with physician practices and provider groups that want to hand off the administrative side of running a practice, from claim submission and payment posting through payer follow-up and financial reporting, so clinicians can keep their attention on patients.

Background and credentials

The business traces its roots to 2003, when founder Randy Hulek launched it as Medical Billing Solutions LLC. Growth led to a reincorporation in 2011 under the current corporate name. Hulek, who serves as President and owner, holds a business management degree with an insurance minor from Penn State and has roughly three decades of experience in billing and practice operations. The company reports that its leadership group collectively brings more than 70 years of experience, and it says it has assisted hundreds of doctors since opening. CMBS Inc. holds BBB accreditation with an A+ rating and offers diagnosis and procedure coding backed by AAPC certification.

Services

Practices can engage the firm for a full outsourced arrangement or select individual pieces from a menu. Core offerings for established practices include:

• Medical billing with electronic and paper claim submission
• Accounts receivable and accounts payable management
• Appeals of underpaid or incorrectly paid claims and denial follow-up
• Certified ICD-10 and CPT coding
• Provider credentialing and help with insurer contract negotiations
• External collections and staffed telephone support
• Monthly report review, payroll assistance, consulting, and electronic data backup

For new practices, the company also handles launch tasks such as obtaining an employer tax ID, arranging banking and credit lines, setting up payer contracts, building a fee schedule, registering group and individual NPI numbers, securing malpractice and workers compensation coverage, and building a website.

Specialties served

CMBS Inc. supports a range of disciplines, with stated experience in anesthesia, OB/GYN, pain management, chiropractic, primary care, surgical practices, and durable medical equipment billing. Its intake questionnaire also lists family and internal medicine, pediatrics, cardiology, dermatology, mental health, physical therapy, and hospital or facility clients. While its community ties are centered in Pennsylvania, the firm notes that its billing platform supports specialties nationwide.

How it works with clients

Prospective clients can request a complimentary practice-level review covering provider count, claim volume, current billing setup, and problem areas such as aging receivables, denials, or credentialing gaps; the company asks that no patient data be submitted through the website. A practice does not necessarily need to change its existing software, and cleaning up old receivables is a frequent first project. CMBS Inc. emphasizes transparency through customizable, real-time reporting and cites a 98.5 percent clean claim rate. Buyers looking for a locally owned partner with long tenure, start-up support, and a broad mix of administrative services beyond claims processing may find it a good fit.

Keystone Medical Management Solutions Inc., known as KMMS, is a firm in State College, Pennsylvania that combines outsourced medical billing with practice software. It works for solo physicians, group practices and larger institutions in Pennsylvania, and it says it has also worked with providers in other parts of the country. Buyers who want one partner for both claims work and the software behind it may want to look at KMMS, since it offers both under one roof.

Who They Serve

The company says it is not tied to any one specialty or modality. It says its team can handle both common specialties and unusual areas of medicine with special requirements. Besides physician practices, it lists the following types of organizations as a good fit:

• Individual providers and medical groups
• Hospitals
• Ambulatory surgery centers
• Clinical laboratories
• Oncology centers
• Office-based labs (OBLs) and other free-standing facilities

Services and Technology

Billing is the core of the business. KMMS presents it as full revenue cycle management, set up around each client's situation rather than delivered as a fixed package. The stated goals are fewer days in accounts receivable and more of the reimbursement a practice has earned. For software, KMMS works with AdvancedMD, which lets a practice move its whole operation onto the platform or adopt only selected parts. The firm also helps practices connect their electronic medical records and offers several ways to handle that move. Separately from its healthcare work, KMMS builds secure websites and provides a range of marketing services.

How They Work With Clients

KMMS calls its billing model results-driven. Its pitch is that the value of the service should show up in a practice's numbers, measured mainly by higher profitability and a shorter collection cycle. To support that, clients get regular reporting and billing analytics on their financial performance. Prospective clients can call to talk through their billing needs or book a demo of the software. The company also encourages practices to judge it on its track record and says references and testimonials are available.

Background and Differentiators

The firm says its billing staff has decades of combined experience across many specialties, and it reports serving hundreds of clients. Security and compliance are a recurring theme. KMMS describes its software, safeguards and billing processes as built with HIPAA and HITECH requirements in mind, and it says it uses newer technology than more traditional billing outfits. It also stresses close attention to customer service, both with practice staff and in how patients are treated. On cost, the company says openly that it aims to be competitive but may not be the lowest-priced choice, and that it puts performance ahead of being the cheapest. Directory listings describe it as an operating business with an office on South Atherton Street in State College.

The Podiatric Billing Specialists (TPBS) is a State College, Pennsylvania company that handles revenue cycle and practice administration work exclusively for podiatrists. It markets itself nationwide, so foot and ankle clinics anywhere in the country can hire it to manage insurance claims, coding and the other paperwork that comes with running a practice. Buyers looking for a vendor that knows podiatry coding in depth, rather than a general medical billing outsourcer, will find that this narrow focus is the main thing that sets the firm apart.

Background and Team

A podiatrist founded the company in 2004. The idea was that physicians often struggle to treat patients well while also keeping an office running smoothly, and many leave earned revenue uncollected as a result. The firm says it works with insurance specialists, physicians and accountants. Its contact page lists Robin L. Garman as Vice President and Sarah Belgin as Account Manager, and the site also features a monthly billing tip from Dr. Solar. The office is on South Allen Street in State College, and staff are available on weekdays from early morning into the evening, Eastern time.

Billing and Practice Services

The core offering is full outsourced billing. TPBS takes over the entire claims cycle, from submission to answering questions from payers and patients, and adds reporting and claim posting within a day or two. Clients also get software at no charge so they can view their records and reports at any hour. Fees are a percentage of collections and depend on the practice's size, location and needs. Other services include:

• Coding instruction for in-house office staff, billed on retainer
• Insurance enrollment applications and provider credentialing
• Audits of an existing billing vendor or internal billing team
• Practice appraisals, help with acquisitions, and arranging financing and escrow
• Pay-per-question answers to urgent insurance billing questions, usually within one business day
• Office management and technology consulting

Software and Hardware

On the product side, the company's own PodiatryTemplates add podiatry-specific content to electronic health record systems. The firm has released versions for Aprima, ehrThomas and MIE, and it has also sold and supported Medinotes EMR software. According to TPBS, the templates let clinicians document a visit, choose codes and link modifiers with a single click, and they generate an optimized superbill. The firm also promotes them for e-prescribing and quality-reporting incentive programs. Through a partnership with Seneca Data, it configures office computer systems, including Motion Computing tablets, for podiatry offices. Installation, training and continuing support are offered for everything it sells.

How Engagements Begin

A new relationship usually starts with a free on-site evaluation. TPBS meets with the doctor, reviews recent claims, and checks the office's workflows, systems and equipment. If the firm doesn't think it can raise revenue by more than ten percent, it says it will tell the practice so. For practices that do sign on, its pitch is that outsourcing removes the cost of billing employees, protects against gaps when staff are sick or on vacation, and gives the practice access to experienced billers who focus only on podiatry.