Medical Billing Companies & Consultants in Reston, VA

HMS USA Inc. is a healthcare revenue company based in Reston, Virginia, with a second office in New York City. It works for healthcare providers in Virginia and across the country. Its main business is outsourced medical billing and coding, and it also offers several related administrative and growth services. Practices can hand off most of their financial back office to one vendor instead of hiring several.

Who They Serve

The company works with healthcare organizations of all sizes, from one-provider offices to large multi-site systems. The client types it lists include:

• Solo and independent practices
• Physician groups and hospitals
• In-home medical service providers
• Urgent care systems, emergency centers and non-emergency treatment providers
• Laboratories
• Other billing companies that need help clearing backlogged work

It also offers billing for many specialties, including cardiology, ophthalmology, internal medicine, OB/GYN, geriatrics, oncology, urology, ENT, wound care, mental health and psychiatry, dental, ambulatory care and laboratory billing.

Services and Process

HMS USA handles the whole claims cycle in eight steps. It starts by setting up patient demographic records. Next, staff call or email payers to check each patient's coverage, premium status and expected copay. Coders then assign ICD and CPT codes, and the team enters charges, submits claims and follows up with payers.

The company says it holds AAPC certification as a practice revenue manager. Its goal is to send clean claims the first time and to keep chasing payments until they come in.

Beyond core billing, the firm offers revenue cycle management that covers coding, claims and collections together. Its credentialing specialists check provider qualifications and enroll providers with insurance networks. Its billing audits look for coding errors such as upcoding, downcoding and outdated procedure codes, check regulatory compliance and help recover lost revenue. Audit clients get written reports with suggested fixes.

The company also offers remote front office staff for scheduling and patient intake, chronic care management, remote patient monitoring, and a digital marketing service for medical practices.

How They Work With Clients

New clients usually start with a free consultation or revenue review. A specialist looks at problems like denials, aging accounts receivable, credentialing delays or staffing gaps. After that, HMS USA tailors its support to the practice. That support can include data analysis, aging reports that can be customized, claims handling and ongoing advice on performance. The company says it treats every client as having different needs rather than using one standard package.

Background and Differentiators

The company says its mission is to make the business side of medicine simpler. It describes its core values as transparency, compliance, mutual respect, teamwork and willingness to adopt new technology. HMS USA says its services are fully HIPAA compliant.

It shows client testimonials on its site, including one from a plastic surgery practice in Florida, and Google reviews that praise individual staff members for responsive follow-up on credentialing and billing. Buyers looking for one partner to handle billing, credentialing, audits and front office support may find this broad range of services useful.