Medical Billing Companies & Consultants in Warwick, RI

American Billing & Credentialing is a revenue cycle and provider enrollment firm with an office in Warwick, Rhode Island. The company concentrates on behavioral health and mental health practices, including solo clinicians such as licensed professional counselors, marriage and family therapists and psychiatrists, as well as larger groups. Its site lists Rhode Island, Connecticut and Massachusetts as areas it serves, and it says its client roster includes more than 200 providers across the country.

Background and approach

The firm was founded by people who had previously worked hands-on in billing and credentialing. According to the company, that experience showed them that many billing vendors handle only routine tasks and fail to give practices the fuller, client-focused support they need, and the business was set up to close that gap.

All work is performed by staff in the United States, and nothing is sent offshore. Its team includes certified billers and credentialing specialists, one of whom is presented as a senior specialist with twelve years in the field.

Services

The company takes responsibility for the complete revenue cycle along with enrollment work, so clinicians can spend their time on patients instead of administration. Its main offerings are:

• Behavioral health and mental health billing
• Claim submission and follow-up across the revenue cycle
• Denial management and insurance appeals
• Medical insurance credentialing and medical credentialing
• Credentialing for therapists
• Payer enrollment and contract negotiation
• Expedited credentialing options
• A free revenue analysis for prospective clients

The firm reports that it handles enrollment and contracting with Aetna, Cigna, UnitedHealthcare, Blue Cross, Medicare and Medicaid, plus hundreds of regional health plans. It estimates that initial credentialing usually takes 45 to 90 days, and it pursues denied claims through appeals in an effort to recover revenue owed to the practice.

How engagements work

Onboarding follows four steps. First, the practice securely uploads its claims, payer contracts and credentialing records, which the team commits to reviewing within 24 hours. Next, the specialists clean up outstanding receivables and begin enrollment and appeal work. Once that is in place, the firm keeps credentials current with insurance panels and works to cut down on rejected claims.

Each client is assigned a dedicated account manager and gets a report every month. The company describes its fees as transparent, with no hidden charges.

Software experience

Because the firm specializes in behavioral health, its staff are used to the practice management and EHR systems common in that field. The site names Psyquel, TherapyNotes, Valant, Ensora Mental Health, previously called TheraNest, and SimplePractice. This can shorten onboarding for practices already running one of these platforms. For buyers comparing vendors, the firm's main distinguishing points are its focus on mental health, its domestic staff, and the fact that it combines billing, credentialing and payer contracting under one provider.