Medical Billing Companies & Consultants in Henrico, VA

Medical Billing Solutions LLC, often shortened to MBS, is a Richmond, Virginia firm that handles billing, coding and collections work for healthcare providers. Its clients range from solo physicians to hospital-affiliated physician groups, and also include hospitals and diagnostic imaging centers. The company says it has done this work for more than two decades. It has since become part of Zrlka Inc., which has announced it acquired the business.

The firm presents itself as a single outsourced partner for the whole claim lifecycle. It doesn't take on just one piece of the process. Instead, it aims to manage reimbursement from the first patient contact until each account is settled, so clinicians can focus on care instead of payer disputes and patient balances.

Clients get monthly reports on transactions and financial statistics. The company also says it pays clearinghouse enrollment and transaction costs itself instead of charging them to the practice.

Services across the revenue cycle

Before the visit, MBS helps with scheduling, patient registration, insurance eligibility checks, referrals and prior authorizations. After the encounter, it handles coding and coding audits, charge entry and charge review, and claim submission. It also posts payments and denials, both manually and electronically. Its other tasks include:

• Denial management and appeals, with individual follow-up on delayed claims
• Scrubber edits, claim conversion and resubmission after corrections
• Reconciliation of insurer explanation of benefits documents
• Insurance, patient and small-balance adjustments
• Monthly patient statements and answers to patient billing questions
• Electronic billing enrollment with Medicare and commercial insurers

Specialty services

Beyond core billing, the company runs a separate billing service for medical imaging centers that focuses on workflow and staff productivity. Its credentialing team helps providers of any specialty across the country join health plan networks and keep their CAQH profiles current.

For practices covered by Medicare's Quality Payment Program, MBS helps with MACRA measures and sends reports to CMS through approved channels. The firm says it supports more than 25 major specialties. Its published client testimonials come from cardiology and electrophysiology practices.

On the technology side, MBS supplies and maintains practice management software installed at the client's office, which gives real-time access to account data. It trains both physicians and office staff on the software and can also install electronic medical record systems. Diagnosis and procedure codes are checked for compliance before claims are sent.

Operating model and stated results

The company describes a global delivery model, a database of payer rules used to predict reimbursement patterns, redundant IT infrastructure, and senior managers who work directly with clients. It stresses clear accountability at every level of the organization and tailored processes meant to limit disruption when a practice switches over.

Its published targets include first-pass clean claim rates of 80 to 90 percent, claim turnaround of 14 to 21 days, a collection ratio above 95 percent, less than 10 percent of receivables older than 120 days, and customer support around the clock. Buyers should treat these figures as company-reported benchmarks and check them during due diligence.

Trustegic Medical Billing Services, LLC, often shortened to TMBS, is an outsourced billing and revenue cycle firm based in Henrico, Virginia, just outside Richmond. The company works with healthcare providers who would rather hand off claims, coding and payer paperwork to a dedicated team than manage those tasks in-house. Its stated priorities are transparency, dependability and responsiveness, and its tagline encourages clients to trust the strategy it applies to their revenue.

Specialty Focus

Although TMBS can support a range of practices, it concentrates on behavioral health. Its core clients include mental health practitioners, addiction treatment programs and similar professional practices, and the testimonials on its site come from a licensed social worker and a licensed professional counselor. Buyers in these fields may value a vendor that already knows the payer rules and coding patterns common to therapy and counseling work.

Billing and Revenue Cycle Services

The firm's revenue cycle work starts with patient flow and continues through remittance posting, denial handling and patient collections. Its coding team works with the large CPT and ICD-10 code sets, using reference resources and set workflows with an emphasis on compliance. TMBS also bills for remote visits, which reflects how many behavioral health providers now see clients virtually.

A separate receivables function chases overdue insurance balances so that money owed to the practice is collected promptly. The company says its approach aims to prevent delayed or denied reimbursement and reports having raised client revenue by as much as 25 percent.

• End-to-end revenue cycle management
• Medical billing and CPT/ICD-10 coding
• Telehealth billing and coding
• Denial follow-up and patient collections
• Accounts receivable recovery from insurance carriers

Credentialing and Enrollment

Credentialing is a second major part of the business. For Medicaid, TMBS manages the full process from the first application through approval, including primary source verification, payer enrollment, ongoing monitoring and renewals. For Medicare, it helps providers get an NPI, completes the enrollment application, communicates with Medicare Administrative Contractors, keeps provider records current and advises on application fees.

For commercial insurers, it collects and verifies provider data, processes applications and works on getting providers onto payer panels. It also sets up CAQH ProView accounts, handling registration, data entry, document uploads, authorizations and ongoing upkeep so that a provider's credentials are kept in one central profile.

Working With the Firm

New clients begin with a consultation or appointment, then complete provider intake and practice information forms through the website, which also publishes plans and pricing. Because TMBS combines billing, coding, receivables follow-up and payer enrollment in one firm, a new or growing behavioral health practice can use it for both getting credentialed with insurers and getting paid by them afterward.