Medical Billing Companies & Consultants in San Juan, PR

AGS Medical Billing Corp. is a family-owned company that handles medical billing for physicians and other healthcare providers in Puerto Rico. It has been in business for more than 22 years and works from an office in the Cupey area of San Juan. Its main goal is to make sure doctors get fully paid for the care they give.

Client testimonials on its website come from a dermatologist, a podiatrist who has practiced in Bayamón since 1990, and a chiropractor. Its clients are mostly independent and specialty practices that would rather not keep a full billing department in-house.

Billing and Claims Management

The firm bills every health plan operating in Puerto Rico and the United States mainland. It uses ASSERTUS, a billing platform the company describes as HIPAA-approved. Beyond sending claims, it handles data entry, checks patient eligibility and does specialized coding. Clients get direct access to the system, so they can follow their account and see how billing is moving at any time. Claims can be filed with insurers on paper or electronically, depending on what the payer requires.

Its full range of services includes:

• Billing of primary, secondary and supplemental health plans
• Follow-up with insurers on pending payments and payments already received
• Payment posting, adjustments and reconciliation against plan remittances
• Audits of medical accounts to find errors, rebill adjusted claims and prepare billing reports on request
• Liaison work with insurers, covering paperwork, password setup, authorization requests and endorsements
• Credentialing of physicians with health plans
• Office organization and staff orientation on HIPAA rules
• In-person meetings with health plans to resolve claims that are stuck or unpaid

How They Work With Practices

AGS is paid a percentage of what it collects, so its income depends on what the practice actually receives. The company presents this as a reason it works hard to recover every dollar owed. Couriers pick up claims and payments at client offices once a week, and practices can also send documents by email.

Billing staff stay in regular contact with each practice's office team to answer questions, which gives clients personal, one-on-one service. Patient billing records are kept confidential, and only the physician and authorized office staff can see them. The company also carries an insurance policy that protects its clients' claims.

Why Practices Choose Outsourcing

AGS argues that outsourcing billing saves practices money in several areas. These include billing software, clearinghouse fees, equipment, office supplies, courier costs, training and the extra costs of paying in-house billing staff. With billing handled outside, office staff can focus on their own work and doctors can spend their time on patients.

Testimonials on the site mention faster payments from health plans, fewer billing errors and quick responses from the billing team. They also credit the firm with helping new practices grow from the start.

The company says it keeps up with ongoing changes in medical billing. It also says it supports professional development and motivation among its staff. Its stated values are excellence, organization, efficiency and security. For practices in Bayamón and the San Juan metro area, AGS offers a local, Spanish-speaking billing partner with long experience dealing with Puerto Rico's health insurers.

Headquartered in San Juan, Puerto Rico, Avant-Garde specializes in recovering unpaid claims and overseeing the financial side of patient care. Its clientele spans the full spectrum of medical organizations, ranging from solo doctors to large inpatient institutions.

The firm's purpose is to ensure that providers submit accurate charges, receive the payments insurers owe them, and reclaim revenue buried in neglected or previously written-off balances. Avant-Garde states that its team brings over twenty years of hands-on experience within Puerto Rico's medical industry, giving it close familiarity with how local insurers operate.

Services

Avant-Garde handles every financial stage of an encounter, starting when an appointment is scheduled and ending when the provider is fully paid. Its core offerings include:

• End-to-end revenue oversight, such as verifying patient coverage, assigning diagnostic and procedure codes, enrolling providers with insurers and renewing those enrollments, and reviewing remittances for accuracy
• Billing for both facilities and individual clinicians, spanning code assignment, tracking submitted claims, sending statements to patients and collecting balances, handling rejections, recording incoming payments and producing reports
• Examination and recovery of overdue, rejected or outstanding claims
• Streamlining of in-house processes so that financial operations run more smoothly
• Evaluation of insurer agreements and pursuit of better fees, provisions and requirements
• Regulatory reviews confirming that practices follow applicable laws and their own procedures
• Advisory support for medical offices, such as organizing information and configuring billing software

How They Work

The firm's signature strength lies in reclaiming long-outstanding balances. Analysts examine a provider's electronic payment records and group rejected claims into categories. From there, they pursue sums that earlier contractors or a practice's own personnel had abandoned. Because Avant-Garde assigns its own specialists to this effort, a provider's workforce can stay focused on routine responsibilities.

The company pairs this recovery expertise with its experience in financial examination. Its stated aims are quicker payment, a lower rate of rejections, greater output and durable improvements in how providers handle charges. Avant-Garde describes its insurer agreement work as a means of steadying cash flow and limiting the monetary risk that providers face.

Who They Serve

Avant-Garde supports many kinds of medical organizations and care environments, among them:

• Doctors across all fields of practice
• Inpatient facilities and urgent care centers
• Independent practice associations and Section 330 community clinics
• Imaging providers
• Ambulatory surgery facilities
• Diagnostic laboratories
• Behavioral health providers

Leadership and Locations

The company was established by Carmen Ortiz, who leads it as president and chief executive. Her career in medical billing and financial review exceeds a quarter century, and she has directed patient intake, billing and collection units at multiple Puerto Rican hospitals.

In addition to a master's degree in business administration, she has earned three professional billing certifications, PMBT, PMBC and PMBA, addressing instruction, coding and auditing respectively. Earlier, she oversaw financial reviews of hospitals on behalf of Optim Business Solutions and served as an instructor for AFAMEP, Puerto Rico's professional body for billing specialists.

She has also conducted training sessions at the Ponce School of Medicine, the Pontifical Catholic University and Inter American University. Her professional ties extend to the Healthcare Financial Management Association, in whose activities she regularly takes part.

Beyond its main office in San Juan, Avant-Garde maintains sites within Hospital Buen Samaritano in Aguadilla and at a hospital in Fajardo. Together with its metropolitan headquarters, these offices give the firm reach into both the western and eastern regions of Puerto Rico.

billrMD is a cloud-based medical billing and practice management platform run by MedPharm Services LLC from offices in San Juan, Puerto Rico. Rather than outsourcing billing work, the company licenses software that lets providers handle their own revenue cycle. It is built for three main groups: independent medical practices, third-party billing companies that work for multiple providers, and laboratories and independent diagnostic testing facilities (IDTFs).

Background

The company says it has more than 25 years of experience building technology for healthcare organizations. It presents billrMD as a lower-cost, modern alternative to older billing systems. One example is accounts receivable: older tools often make staff track it through static reports, while billrMD uses visual dashboards that show balances and patient payments.

The platform runs in a web browser, so clients don't need to install or maintain software on local machines. Any computer with an internet connection can be used to log in, whether at the office, at home or while traveling.

Billing and Revenue Cycle Capabilities

The billing side of the system covers each step from charge entry to collecting payment:

• Electronic claim submission through a built-in clearinghouse, with checks that catch errors before claims go to commercial and government payers
• Electronic remittance advice, so payer payments flow straight into the software, plus batch entry and single-session forms for posting payments by hand
• Patient statements in balance or ledger format that can carry the practice's own logo
• Card payments through partner processors, posted directly to patient accounts
• Built-in and custom reports that show revenue cycle performance and key billing metrics

Practice Management Tools

Beyond billing, the platform includes a scheduler with several calendar views and drag-and-drop booking that connects to the billing workflow. Automatic email or text reminders aim to cut down on missed appointments and reduce calls from the front desk. User administration is another major feature. Practices can create as many non-provider staff accounts as they need at no added charge.

Administrators can set permissions by role, limit access to sensitive data, and review access logs for sessions that involve protected health information. The system also sends alerts about suspicious activity or failed sign-in attempts.

Security and Getting Started

billrMD states that the platform is HIPAA-compliant and that client data is backed up every day in the cloud. New clients can begin on a free introductory plan without a credit card or a long-term commitment. The company also offers training materials, demo videos, case studies, a FAQ section and a dedicated support team.

It can suit practices of different sizes, from small offices to larger multi-user groups, as well as billing companies that want one shared platform for several clients.

Factu-Med is a San Juan, Puerto Rico firm that handles the administrative and financial side of healthcare practices. Its main focus is processing and collecting medical claims. The company describes its work as a mix of management, engineering and consulting for health service providers. It encourages clients to treat its team as their own in-house billing office rather than hiring and training billing staff. The firm operates from an office in the Altamira area of San Juan.

Background and approach

According to its website, Factu-Med has been handling medical billing for more than ten years. Over that time it has added offerings for the healthcare sector, including accounting and information systems work alongside claims processing. The company says its clients usually see billed revenue rise by about 10 to 25 percent.

Buyers should treat that figure as the firm's own claim. Its stated aim is to cut paperwork and overhead for providers so physicians and staff can spend more time with patients.

Services

Factu-Med groups its work into four main areas:

• Medical billing: claims are prepared and submitted by billing specialists using dedicated billing software, process-management tools and web-based information systems.
• Consulting: help with operations, financial management and projects, carried out in close cooperation with a practice's director, manager, administrator and key employees.
• Digitization: scanning and electronic document management that captures many types of records along with their related data.
• Gestoría: follow-up and recovery work to help providers regain control over their billing, income and collection activity.

Specialties served

The firm lists experience with a wide range of provider types, which may suit groups with mixed billing needs. These include:

• Hospital emergency rooms
• Ambulance services
• Medical groups
• General practitioners
• Medical specialists
• Clinical laboratories
• Radiology and X-ray providers
• Psychologists and psychiatrists

Local regulatory knowledge

The company's FAQ shows that it knows the Puerto Rico payer environment well. It explains that enrolling as a provider with Original Medicare through First Coast Service Options can take about three to four months, depending on how complete the paperwork is. It also covers claim filing deadlines.

Traditional Medicare allows up to thirteen months, while most Advantage plans and the government health reform plan allow about ninety days from the date of service. The FAQ also refers to Puerto Rico's prompt payment law, Act 104 of 2002, which gives health plans fifty days from receipt of a claim to pay.

It notes that Original Medicare payments often arrive in about fifteen business days.

For buyers comparing billing vendors in San Juan, Factu-Med's main strengths are its local office, its knowledge of Puerto Rico insurers and rules, and its range of services beyond claims submission, including consulting, document digitization and collections follow-up. The firm offers services only and does not list any software or other products for sale.

Golden Billing Puerto Rico is a San Juan company that manages the financial and reimbursement side of healthcare for solo clinicians as well as larger medical organizations. It says it has been in the business for over thirty years and serves clients on the island and in the continental United States. Medical billing is its sole focus, and every service it sells relates to insurance claims, incoming payments or the paperwork behind them.

Services offered

Golden Billing's services span nearly the entire reimbursement process, from confirming whether a patient is covered to matching the payments that insurers eventually send. The services it lists are:

• End-to-end billing cycle management for individual clinicians and organizations
• Insurance claim handling
• Matching and reconciling incoming payments
• Confirmation of patient coverage
• Credentialing for healthcare providers
• Ongoing support and service for providers
• Management of correspondence and messages
• Conversion of paper records to digital files
• Training for employees in client offices
• Digital reports each month, plus remote assistance

Golden Billing does more than file claims. It checks a patient's insurance status before a bill goes out, which lets coverage problems surface early instead of after a denial. The firm also trains a practice's own employees. That service may suit offices that handle reception or some billing duties internally and hand the remaining work to an outside vendor. Clinicians who need to join insurance networks, or keep their participation current, can get help with credentialing as well.

How the company works with clients

Each month, clients get a digital report that shows practice owners how their billing is performing. The firm supports these reports with remote assistance, so clients can get help without scheduling face-to-face meetings. Golden Billing also turns paper documents into electronic files and handles letters and messages for the provider.

The company says it aims to help clients collect 97 to 100 percent of the amounts they bill. Practices considering the firm may want to ask during a first meeting how that number is calculated. Interested providers can ask for a cost estimate through the company's online form.

Team and credentials

Golden Billing says its billing employees have been trained and certified by a local professional organization that represents people who work in medical billing on the island. Practices comparing billing vendors in Puerto Rico may find this island-based certification a useful way to evaluate competing firms. The company describes its purpose as making billing easier for providers, and it says its staff work to meet the quality standards the healthcare sector expects.

Location and fit

The company's office is in the VIG Plaza building on Ponce de León Avenue in San Juan. Golden Billing has decades of experience, staff certified on the island, and a wide range of services that includes credentialing, coverage checks and payment reconciliation.

These qualities make it worth considering for medical practices, clinics and healthcare organizations around San Juan that want to outsource all of their billing to one firm. U.S. mainland providers looking for a billing team familiar with Puerto Rico may also find it a good match.

Group Medical Billing Services, often shortened to GMBS, is a Puerto Rican firm that handles billing and related back-office work for physicians, medical offices and other healthcare facilities across the island. Its leader, CEO Cindy M.

Soto López, brings over two decades of professional experience in the field, and the company's own social media presence states it has been operating since 2008. The firm positions itself as a hands-on partner that lets clinical staff spend less time on paperwork and more time with patients.

Core services

GMBS organizes its offering into six service lines that together cover most of the revenue cycle for a small or mid-sized practice:

• Medical billing: preparing and submitting claims based on the documentation each provider supplies
• Claims follow-up and collections: pursuing unpaid or stalled claims and outstanding balances
• Audits: reviewing claims and internal workflows to catch errors and identify areas to improve
• Credentialing: assisting providers with initial enrollment and periodic re-credentialing
• Reporting and reconciliation: matching payments to accounts and producing financial summaries
• Workshops and training: educational sessions on billing, claims and administrative topics for providers and office staff

Care settings and claim forms

Beyond the standard physician office, the company reports experience with a wide range of care environments. These include home-based services, hospitals, emergency rooms, outpatient facilities, ambulatory surgery centers, psychiatric facilities and partial hospitalization programs, vaccination centers, dialysis centers and telehealth visits.

The team works with both professional and institutional claims, including the CMS-1500 form and its electronic 837P counterpart as well as the UB-04 (CMS-1450) and the 837I transaction used by hospitals and other facilities. GMBS notes that whether it can take on a particular facility type or specialty is confirmed case by case during an initial consultation.

How engagements work

New clients move through a four-stage onboarding sequence. It begins with a conversation about the practice's needs, followed by an evaluation of which services fit, a coordination step where terms and next steps are agreed, and finally ongoing follow-up whose frequency depends on the contracted scope. Prospective clients can request a consultation through service-specific forms on the website.

Throughout each engagement, the firm emphasizes direct communication, orderly processes, close attention to pending payments and keeping current with changes in payer requirements.

What distinguishes GMBS for buyers is its combination of local market knowledge, a personally led team and an educational component. Practices that want both outsourced billing support and training for in-house personnel can obtain both from the same provider, and the company also publishes articles in an online learning center covering billing fundamentals and the benefits of outsourcing. The firm works from an office in the Santurce area of San Juan and serves clients throughout Puerto Rico.

Based in San Juan, Puerto Rico, Inmediata Health Group develops technology for the healthcare sector. Its offerings center on software and a claims clearinghouse that take on the financial side of care delivery, from billing tasks to the broader revenue cycle.

On the island, its client base spans insurance carriers, academic institutions that train physicians, clinical testing labs, hospitals, dental offices and individual practitioners. Inmediata concentrates on the technology that carries a claim through every stage, beginning when a patient is first entered into the system and ending once reimbursement arrives. There is no indication that it supplies outsourced billing personnel.

Markets served

• Hospital networks
• Physician practices and specialty clinics
• Dental offices and allied health practitioners
• Clinical testing labs
• Pharmacies
• Insurance carriers and other payers

At the core of its billing lineup sits SecureClaim, a web-hosted platform for practice administration and billing. Its functions include entering new patients, booking visits, generating reports and matching payments to accounts. Eligibility can be confirmed instantly while a user is viewing a patient's chart, the scheduling calendar or an individual claim.

Because SecureClaim ties into Inmediata's clearinghouse and its clinical charting products, information captured at the point of care can be turned into a claim ready for submission. The system processes institutional, dental and professional claim types, and it is set up for billing in general medicine, dentistry, allied health and ambulance services.

Claims are routed to payers through SecureTrack, which Inmediata promotes as the top clearinghouse on the island, with links to every payer operating there. Prior to submission, SecureTrack validates each claim against X12N formatting standards along with payer-specific edits, raising the share of claims accepted on initial submission.

The tool automatically pairs incoming remittances with their corresponding claims, and users on any device can monitor rejected or denied claims and see where each payment stands. Hard copies of claims, whether institutional, dental or professional, can be generated directly out of the tracking and aging reports.

An optional module, SecureTrack eAttachments, replaces mailed paperwork by letting providers transmit lab results and clinical documentation to payers digitally, linked to the relevant claim.

Other products in the portfolio are the SecureEMR and SecureEMR+ medical record systems, SecureInsight for data analysis, and SecureTrack Web Services for integrations between software platforms. For insurers, Inmediata provides SecureAlly, a platform for adjudicating claims. It administers benefit tiers, copayments, coinsurance and deductibles; detects upcoding, unbundling and duplicate submissions; and reports on utilization review and the age of outstanding claims.

Every Inmediata product runs in the cloud, which spares customers from maintaining in-house servers and allows staff to log in from anywhere. According to the company, its offerings satisfy the rules set by HIPAA, CMS and ONC.

Materials it published in 2019 refer to an annual Sarbanes-Oxley Section 404 audit and to accreditation by the Electronic Healthcare Network Accreditation Committee (EHNAC). Inmediata reports more than two decades of activity in Puerto Rico.

For an organization seeking billing support, the company's main advantage lies in an integrated suite covering billing, claims clearing, medical records and analytics, designed around the island's insurers.

Pro Medical Billing Services, which also operates under the name Profesional Medical Billing, is a medical billing firm with an office in San Juan, Puerto Rico. The company started in 2012. It works for healthcare providers who would rather hand off the billing side of their practice so their staff can spend more time with patients.

Its clients range from small private practices to clinics and larger healthcare facilities. That range makes it an option for both solo physicians and multi-provider groups looking for outside billing help in Puerto Rico.

Background and Ownership

The firm has been in business for more than ten years. It says it was founded to make the complicated work of getting paid for medical care easier to manage. It describes itself as a woman-owned business, which may matter to organizations that track supplier diversity in their buying decisions. The company stresses integrity and long-term relationships with clients. It presents itself as a partner in each practice's financial health rather than just a vendor that processes paperwork.

Services Offered

Pro Medical Billing Services focuses on the core tasks that turn patient visits into collected revenue. Its published services include:

• Preparing and submitting insurance claims
• Following up on unpaid or pending claims
• Reviewing coding to make sure claims are accurate before they go out
• Managing denials and resubmitting rejected claims
• Working with insurance payers on reimbursement issues
• Reducing the administrative workload of in-house staff

Together, these services cover most of the billing cycle, from the first claim through collecting payment. The firm's stated goals are to help clients get as much reimbursement as they are owed, improve cash flow, and reach steadier finances. Practices that struggle with backlogs, frequent rejections, or slow payer responses may find this kind of full-scope support useful.

How the Firm Works With Clients

The company says it adjusts its services to each client rather than offering one fixed package. Buyers can expect it to look at how a practice currently handles billing and then take over the parts that cause the most delays or lost revenue. Its experience with insurance reimbursement suggests it is used to the payer rules and paperwork providers face every day. It does not list any software products for sale or resale. It operates as a service-only billing partner.

Considerations for Buyers

For healthcare organizations comparing billing vendors in the San Juan area, Pro Medical Billing Services offers a local office, more than a decade of operating history, and a clear focus on claims, coding accuracy, and denial handling. Its woman-owned status and emphasis on personal service set it apart from larger, more automated national outsourcing firms. Prospective clients should ask the company directly about specialty experience, reporting, and onboarding, since its website does not describe those in detail.

SA Medical Billing and Consulting is a firm based in San Juan, Puerto Rico. It handles revenue-side administration for healthcare providers. The company describes itself as Puerto Rican-owned. Its stated goal is to lower the administrative costs of delivering care and to make sure providers submit the procedure and diagnosis codes the law requires. For practices that would rather not keep a full billing staff in-house, it offers outsourced billing combined with advice on running the practice.

Who the firm works with

The firm's clients are mainly physicians in private practice and independent medical offices. It also says it works in both public and private healthcare settings. That makes it an option for small, owner-run clinics as well as organizations tied to government health programs. The firm says it serves clients across all of Puerto Rico, not just the San Juan metro area.

Core services

The main service is claims billing done for the provider. The firm also manages the coding work that billing depends on. Payments are posted to accounts every day rather than in weekly or monthly batches. Daily posting can help a practice see where its receivables stand and spot denied or underpaid claims sooner. The full list of services includes:

• Outsourced medical billing
• Coordination of medical billing and coding
• Daily payment posting
• Accounts payable support
• Setup of electronic medical records (EMR)
• EMR training and support
• Medical practice consulting

Software and engagement model

The firm also offers electronic medical record software, which it says has won awards. According to its listing, installing the software, training staff and ongoing support come at no extra charge for clients who use its billing service. The billing itself is paid as a fixed monthly fee instead of a separate charge for each task.

Buyers comparing vendors may find it easier to budget for one bundled package covering both records software and billing. The firm asks practices to call so it can review their needs before they sign up.

Points for buyers to weigh

This is a small, local business focused on Puerto Rico, not a national revenue cycle company. It accepts payment by ATH Móvil, check or cash, which are common methods in Puerto Rico. Its strengths are that it combines records software with billing, posts payments daily, and focuses on coding compliance. Buyers should ask the firm directly about its staff, certifications, years in business and the specialties it supports, because public sources give little information on these points.