Medical Billing Companies & Consultants in Lynchburg, VA

Overview

AntWorks Healthcare is a Lynchburg, Virginia company that builds healthcare software and also delivers outsourced revenue cycle work for physician practices. Its offering combines three connected pieces: a revenue cycle management service, a practice management system and a certified electronic health record. For buyers comparing medical billing vendors, the firm is an option that pairs billing support with its own software platform rather than depending on third-party tools.

Revenue cycle and billing

The revenue cycle offering spans the entire path of a patient encounter, beginning when an appointment is booked and ending once the provider receives final payment. AntWorks takes responsibility for coding, claims handling and the pursuit of balances owed by both patients and insurance carriers, then reports outcomes back to the practice.

The firm says its process achieves payment on 95% of claims in the first submission cycle, and it positions the service as a way for practices to see detailed cash-flow data, keep control of their finances and expand capacity without recruiting more billing staff. Core billing services include:

• Medical coding
• Claims submission and management
• Insurance follow-up and collections
• Patient balance collections
• Revenue and performance reporting to the client

Software products

The practice management system targets scheduling, front-desk and back-office workflows. Its stated aim is to cut errors and lift revenue while building on a practice's existing technology instead of replacing it outright, so that groups can take on more patients without adding personnel.

The electronic health record carries meaningful use certification, and AntWorks Clinical EHR version 7.1 earned 2015 Edition certification as a complete ambulatory EHR through the Drummond Group. The EHR supplies evidence-based reminders for patient care, intended to support closer ties between clinicians and patients and better clinical results.

Who they serve and track record

AntWorks reports serving more than 40 medical specialties and subspecialties. Testimonials on its site come from organizations such as Elgin Medical Center and Tazewell Family Physicians, the latter describing a relationship lasting longer than two decades, while other customers mention quicker electronic billing and responsive support staff. The company also points to a five-star rating on Software Advice and to its 2016 selection by HealthCare Tech Outlook for a list of promising RCM software vendors.

In describing how it works with clients, the company frames the relationship as a mutual partnership in which day-to-day use of its products and direct client feedback drive ongoing improvements, balancing features that suit most users with adjustments for individual practices. For a practice that wants one vendor handling billing, scheduling and clinical documentation, this integrated model, combined with long-standing client relationships and a certified EHR, is the main point of difference.

InteliX Credentialing and Billing Solutions, which operates under the Credentialing.com name, is a Lynchburg, Virginia company that handles administrative and revenue tasks for healthcare providers. It started out focused on getting providers enrolled with insurance payers, then added outsourced medical billing, also called revenue cycle management, along with services for opening a new practice. Clinicians who want a single outside partner for both payer enrollment and claims work will find both offered under one roof.

Background and Team

Physicians founded the company in 2008, and it remains owned by a group of experienced doctors and other healthcare professionals. At first it offered credentialing to only a few specialties. Since then it has expanded to work with providers across all 50 states, including clients in Alaska and Hawaii, and it reports more than 8,000 clients served.

The owners say they set it up to build on its credentialing roots in response to client requests, with the goal of becoming a full practice-solutions firm. Its staff is based in Lynchburg, is HIPAA certified, and averages over three years of experience with insurance panels.

Medical Billing Services

The billing team says it can work inside any electronic medical record system, so clients can keep their current EMR. It covers the whole claims cycle, from entering charges to recovering old balances:

• Daily charge entry and electronic or paper claim filing
• Claim correction, resubmission and ongoing follow-up
• Billing to government, commercial and private payers
• Payment posting and denial management, including appeals
• Patient statements, patient questions and collections
• Claims tracking and custom monthly reports
• Recovery of aging accounts receivable

Aging A/R recovery is a particular focus. A dedicated group of specialists goes after older unpaid insurance claims, and practices can buy this service alone if they want to keep the rest of their billing in-house. The company also checks patient insurance eligibility, since coverage and copays can change between visits.

Who They Serve

Billing clients include solo physicians, small and large practices, physician groups and hospital-owned practices. The company also works with behavioral health providers, surgery centers, urgent care clinics, in-home health agencies, durable medical equipment suppliers and laboratories. Its broader lineup covers credentialing for physicians, nurses, psychologists, counselors and behavioral health clinicians, plus negotiation of insurance contract rates.

How They Work With Clients

Every client is assigned one specialist who stays with the project and sends updates on a regular schedule. The firm gives realistic time estimates but does not promise turnaround times. It charges no setup fees or hidden fees, and credentialing clients can get volume discounts based on how many payers are involved.

Its advice to small and mid-sized practices is to outsource billing. It suggests bringing billing in-house only once a practice brings in enough revenue to pay for a team of roughly seven or eight full-time billers.