Medical Billing Companies & Consultants in Roanoke, VA

Blue Ridge Billing Solutions, LLC is a medical billing firm based in Roanoke, Virginia, operating from an office suite on Bernard Drive in the southwest part of the city. The Better Business Bureau classifies the company under medical billing and records it as a limited liability company that was formed and began operating in September 2021. That makes it a fairly young firm in the regional revenue cycle market, and buyers comparing local vendors may want to weigh that.

Background and management

BBB records list Ms. Jessica Phillips as the manager and as the main point of contact for both principal and customer matters. The company's file is handled by the BBB office serving Western Virginia, which opened it in mid-2023. The firm is not a BBB Accredited Business, but it holds an A+ rating from the bureau.

The bureau also notes that billing is a field where professional licensing, bonding or registration may apply. Prospective clients should confirm any such credentials directly as part of normal vendor checks.

Patient-facing billing information

The firm's website includes a consumer notice on balance billing protections for out-of-network care. These protections took effect under Virginia law at the start of 2021. Hosting this kind of guidance suggests the company handles patient-side statements and questions for the providers it bills for, not only claims sent to insurers. The notice explains the difference between in-network and out-of-network providers. It also describes when patients can and cannot be billed beyond their normal cost-sharing amounts. Topics covered include:

• Protection for emergency care received from out-of-network hospitals or clinicians
• Protection for non-emergency surgical and ancillary services, such as anesthesiology, pathology, radiology, lab work and hospitalist care, delivered by out-of-network professionals at in-network facilities
• Which plan types the state rule covers, which may opt in, and which fall outside it
• How high-deductible plans paired with Health Savings Accounts are treated differently
• How patients can raise disputes with the Bureau of Insurance at the State Corporation Commission

Relevance for provider groups

The notice focuses on anesthesia, pathology, radiology and other facility-based professional services. These are the specialties most often affected by surprise-billing rules, so such practices may find the firm familiar with the compliance issues that shape their billing. However, the pages reviewed did not include a full service menu, a client list or details of the firm's software. Practices should ask directly about coding, claim submission, denial management, payment posting and reporting.

Considerations for buyers

For practices in the Roanoke Valley, Blue Ridge Billing Solutions offers a nearby billing partner with a physical office and a clean BBB rating. Its visible attention to Virginia's patient-protection rules is also a plus. Because the company has been in business only a few years and publishes limited detail about its services, buyers should ask for references, a description of its workflow and onboarding, and written terms before deciding.

Overview

Based in Roanoke, Virginia, Eggleston & Eggleston Medical Practice Management has worked with physician groups and hospitals throughout the state since 1995. Richard B. Eggleston, IV and Patricia E. Eggleston launched the business together, and its typical client is a medical group of moderate to large size.

Many of these groups prefer to remain physician-owned rather than be absorbed by a health system or acquired by private equity, and they turn to an outside partner for revenue cycle, accounting and operational support.

The company works with practices at every point in their life cycle, whether a group is setting up its first location or a mature practice is revisiting the terms it holds with insurers.

Anyone evaluating revenue cycle vendors should note that this firm keeps claims work in-house through its own Billing Department, which processes medical claims daily. That unit reports to a Billing System Manager who previously spent close to twenty years at Anthem in claims, customer service and quality control roles.

Certified coders are part of the billing and coding staff, and a dedicated team leader oversees credentialing and contracting, managing provider enrollment and relationships with insurers. One anesthesiologist who uses the firm says it handles a full range of tasks for the practice, from claims to supervision of the retirement plan.

Services

• Claim submission and reimbursement oversight
• Provider credentialing and assistance with insurer contracts
• Accounting, financial oversight and monthly reports for clients
• Planning and information management strategy
• Reviews of operational efficiency and reimbursement
• Support related to Recovery Audit Contractor (RAC) reviews
• Review of medical charts, coding and documentation
• Launching new practices

Regulatory compliance receives considerable attention. Through its RAC offering, the firm prepares practices for Medicare audits by creating processes that let staff meet record request deadlines, monitoring services that tend to attract audit attention, following denial trends, preparing staff who will handle responses and drafting appeal guidelines.

On the chart review side, the company performs external audits based on samples, spots documentation weaknesses before they become problems, teaches evaluation and management coding, analyzes explanation of benefits statements and examines high-volume or high-value claims for missed charges. Practices may select whichever of these components they need and assemble a tailored arrangement.

A separate area of the firm's website is devoted to PracticeSuite.

Team and Credentials

Accounting is the common thread among the firm's leaders. Rich Eggleston, a CPA, serves as President and Practice Manager; he began at KPMG and went on to oversee hospital-based physician groups for a management company operating nationally.

Patricia Eggleston holds a Master of Accountancy from Virginia Tech, likewise began her career at KPMG, and serves as a part-time instructor in accounting and taxation at Roanoke College. The financial services department is directed by Rose B. Williamson and Rebecca L. Jones, both CPAs with lengthy tenures at the firm.

A number of employees are affiliated with professional accounting associations at both the national and state levels.

Engagements generally begin with a no-cost assessment of the practice, after which the firm designs a plan that addresses the issues uncovered. Testimonials posted by the company come from physicians in urology, orthopedics and anesthesiology.

One case study outlines a lengthy partnership with Blue Ridge Urological, in which the firm assisted with recruiting and retaining physicians and advanced practice providers and also helped the group shut down and later resume operations during the COVID-19 pandemic.

For practices seeking a single regional partner to handle billing, accounting and compliance, this mix of capabilities may merit a closer look.

Expert Medical Billing Services, which also goes by EMBS, is a revenue cycle firm for physician practices, clinics and other healthcare organizations. It has physical offices in Roanoke, Virginia, and Orlando, Florida, and it works remotely with providers in every U.S. state using HIPAA-secure systems. Practices in the Roanoke Valley can get local support while also having access to a team that serves clients nationwide.

Core Services

The company covers the whole reimbursement process, from checking a patient's coverage before the visit to collecting the final payment. Its main offerings include:

• Full-service medical billing, including charge entry, claim submission, payment posting and patient statements
• CPT and ICD-10 coding to reduce avoidable rejections
• Full revenue cycle management
• Enrollment and credentialing with government and commercial payers
• Denial management, appeals and accounts receivable follow-up
• Checking insurance benefits and obtaining prior authorizations
• Medical scribing and non-clinical practice management
• Billing audits and claim scrubbing before claims go out

The firm also offers healthcare digital marketing for practices that want to attract more patients online. Its website mentions a cloud-based billing automation offering as well.

Specialties Served

EMBS says it handles billing for dozens of medical disciplines. These include neurology, urology, dermatology, cardiology, podiatry, rehabilitation, mental health, laboratory and radiology, and physical therapy. It also lists oncology, OB/GYN, gastroenterology, orthopedics, pain management, pediatrics, sleep medicine and urgent care.

A separate dental division provides claims, AR follow-up and appeals for general dentists, specialty dental practices and dental service organizations. That team works with practice software such as Dentrix, Eaglesoft, Open Dental and Curve Dental. Medical clients range from solo practitioners and small offices to large multi-specialty groups.

How It Works With Clients

EMBS adapts its approach to each practice rather than using a fixed package. It says it can work with whatever billing system an office already uses, as well as its existing EHR or EMR, so practices don't have to switch platforms.

Its stated goal is to make reimbursement more transparent and efficient by finding the root causes of billing errors, not just fixing individual claims. Staff can be reached by phone, email or live chat. Prospective clients can book a free consultation or a live demo of the billing and revenue cycle services.

Background and Differentiators

The business operates as Expert Medical Billing Services LLC. It describes its work as HIPAA- and CMS-compliant, with encrypted data transfers, audit trails and restricted system access. Practices can hire a dedicated certified billing specialist or outsource the entire billing function. The firm also offers billing audits for practices that want an independent check on accuracy and compliance.

For Virginia buyers, EMBS says it works with providers in Roanoke, Richmond, Norfolk, Virginia Beach and Northern Virginia, and it adjusts its support to each state's payer rules.

MBAA is a Roanoke-area organization focused on medical billing advocacy: reviewing healthcare charges for mistakes, challenging inflated pricing and helping payers and patients recover from incorrect insurance handling. Founded in June 1997, it was created to give the then-emerging profession of bill review a shared network, and it has since grown into a provider of training, education and review services for advocates, companies and individual consumers across the United States.

Who MBAA Works With

The company's intake process reflects a broad client base. Inquiries are accepted from insurance carriers, physicians, attorneys, self-insured groups, brokers, government bodies, associations, international companies and members of the media, as well as individual patients. Buyers should note that MBAA currently states it has stopped accepting new consumer cases, so its present focus leans toward professional, business and institutional clients rather than individual patients disputing their own bills.

Review and Advocacy Services

For organizations that pay or scrutinize healthcare claims, MBAA examines bills from hospitals (inpatient and outpatient), nursing homes, rehabilitation facilities and behavioral health providers, along with professional charges from physicians, surgeons, anesthesiologists, laboratory and pathology services and radiology. Its listed service lines include:

• Compliance reviews of provider billing
• Pricing analysis to test whether charges are reasonable
• Medical record audits comparing documentation with billed items
• Disputes of contested medical bills
• Appeals of insurance denials and underpayments
• Education and training programs

The firm presents this work as a way for employers and other payers to avoid overpaying claims and protect their margins, while its consumer-oriented material emphasizes knowing which questions to ask before settling any bill and using negotiation and appeals to lower costs.

Training and Certification

A large part of MBAA's identity is teaching others to do this work. It runs public education resources, professional programs aimed at people launching or expanding an advocacy business or career, and corporate training for organizations.

Offerings referenced by past participants include a home study course that introduces the fundamentals of advocacy for the consumer market and a hospital compliance seminar that graduates describe as detailed and demanding. Its mission centers on training, educating and serving advocates, businesses and consumers while pushing for correct charges and fair pricing.

Background and Recognition

MBAA has built a national media profile as a source on spotting billing mistakes, excessive charges and insurer underpayments. It has appeared on NBC Nightly News, Prime Time Live on ABC, NBC's Dateline and CNN, in addition to a range of other broadcast and print outlets.

Its site also maintains a blog and video library covering topics such as charity care and personal wellness as a lever for reducing healthcare spending. For buyers comparing medical billing firms, MBAA stands apart less as a claims-submission or revenue cycle vendor and more as an auditing, advocacy and education specialist with more than two decades in the field.