Medical Billing Pricing

Pricing Cards with Elegant Features

Basic Package

3%
Daily claim submission â–¶
ABC submits insurance claims to payers within 8 hours of claim creation to ensure timely reimbursements and maintain consistent cash flow for healthcare providers.
Posting insurance remittances/paymentsâ–¶
Accurate and timely posting ensures proper revenue tracking, minimizes billing errors, and streamlines claim reconciliation.
Handling claim denialsâ–¶
ABC reviews, corrects, and resubmits denied insurance claims within 48 hours of denial to ensure timely and accurate reimbursement. Additionally, we conduct root cause analysis to prevent future denials and enhance first-pass claim approval rates
Tracking and following up on unpaid claimsâ–¶
ABC will check the status of claims starting from the 10th day after submission, through various channels, including web portals, IVR systems, inquiries, or direct calls. Once the claim status is obtained, we take the necessary steps to address the denial and proceed with further processing to resolve the issue. - Refer (AR webpage)
Contacting insurance companies to resolve claim denial issuesâ–¶
ABC will contact insurance companies directly to resolve claim denials within 48 hours, addressing root causes and ensuring appropriate claim payments. Our goal is to reduce future denial rates and optimize the overall claims acceptance process.
Credentialing is a separate service with an invoice of $250.00 per applicationâ–¶
ABC coordinates directly with each payer and submits applications electronically to ensure faster processing. We also handle any required paperwork based on specific payer requirements. We manage end-to-end communication with payers for seamless processing. Our team handles all follow-ups to keep the credentialing process on track. We streamline provider enrollment by managing the full credentialing workflow.
Monthly financial reportâ–¶
ABC will send a payment report that includes detailed information on payments collected from insurance, including check numbers and check dates, as well as patient payments received. This report ensures transparency and accuracy in tracking all payments processed.
Year-end practice performance analysis reportâ–¶
ABC will provide a yearly report to assess the practice's performance and check if the billing company is doing well. The payment comparison report will show collections from insurance grouped by top five insurances and patients. Apple Billing and Credentialing help practices gets to maximize the reimbursements and reduce the insurance denials.

Enhanced Package

4%
Daily claim submission â–¶
ABC submits insurance claims to payers within 8 hours of claim creation to ensure timely reimbursements and maintain consistent cash flow for healthcare providers.
Posting insurance remittances/paymentsâ–¶
Accurate and timely posting ensures proper revenue tracking, minimizes billing errors, and streamlines claim reconciliation.
Handling claim denialsâ–¶
ABC reviews, corrects, and resubmits denied insurance claims within 48 hours of denial to ensure timely and accurate reimbursement. Additionally, we conduct root cause analysis to prevent future denials and enhance first-pass claim approval rates
Tracking and following up on unpaid claimsâ–¶
ABC will check the status of claims starting from the 10th day after submission, through various channels, including web portals, IVR systems, inquiries, or direct calls. Once the claim status is obtained, we take the necessary steps to address the denial and proceed with further processing to resolve the issue. - Refer (AR webpage)
Contacting insurance companies to resolve claim denial issuesâ–¶
ABC will contact insurance companies directly to resolve claim denials within 48 hours, addressing root causes and ensuring appropriate claim payments. Our goal is to reduce future denial rates and optimize the overall claims acceptance process.
Credentialing is a separate service with an invoice of $250.00 per applicationâ–¶
ABC coordinates directly with each payer and submits applications electronically to ensure faster processing. We also handle any required paperwork based on specific payer requirements. We manage end-to-end communication with payers for seamless processing. Our team handles all follow-ups to keep the credentialing process on track. We streamline provider enrollment by managing the full credentialing workflow.
Monthly financial reportâ–¶
ABC will send a payment report that includes detailed information on payments collected from insurance, including check numbers and check dates, as well as patient payments received. This report ensures transparency and accuracy in tracking all payments processed.
Year-end practice performance analysis reportâ–¶
ABC will provide a yearly report to assess the practice's performance and check if the billing company is doing well. The payment comparison report will show collections from insurance grouped by top five insurances and patients. Apple Billing and Credentialing help practices gets to maximize the reimbursements and reduce the insurance denials.
Managing inbound and outbound patient callsâ–¶
ABC will answer all patient inquiries regarding balances, receipts, and bills.
Sending bulk patient statements every 30 daysâ–¶
ABC will generate and send patient statements every 30 days, as per client requirements, to ensure consistent communication regarding outstanding balances. This regular process helps keep patients informed of their financial responsibility
Sending instant patient statements â–¶
ABC will promptly send statements to patients immediately after insurance processing to accelerate the practice’s payment flow. This ensures that patients are notified in a timely manner of their financial responsibility and reduce delays.
Bi-weekly AR report â–¶
ABC will generate the insurance-wise Account Receivable (AR) report bi-weekly. This will create transparency between the practice's revenue and outstanding receivables, allowing the client to monitor financial performance. It helps to identify payment trends, aging claims, and any potential bottlenecks in the reimbursement cycle.
Uploading claim batch files to ACO â–¶
ABC will fetch batches from the system and transfers it securely to the ACO's.
Mailing medical records to payers, attorneys, and workers' compensation.â–¶
ABC will submit medical records to payers upon request for claim verification. For workers’ compensation cases, ABC will include the necessary medical records when submitting the claim to ensure faster processing and reduce delays.
Mailing HCFA paper claim formsâ–¶
If the payer ID and fax number are not available for a specific payer, ABC will submit the claims via paper.
Transitioning from virtual credit cards to paper checks or EFTsâ–¶
Insurance companies may pay claims with virtual credit cards. Providers can process the card, but a transaction fee of 2% to 5% may apply. To avoid this fee, ABC has implemented a process to convert virtual card payments into paper checks or Electronic Funds Transfers (EFT). This ensures that providers receive their full reimbursement without incurring unexpected fees
Reconciliation of billed amounts against payer contracted amounts every six monthsâ–¶
ABC will perform a thorough reconciliation of all claims to verify that reimbursements are accurate and aligned with the payer’s contracted rates and terms.
Patient unapplied overpayment report generated every six months.â–¶
ABC will provide a report highlighting patient overpayments or credits to keep the practice informed of any discrepancies.
Posting patient remittances/payments â–¶
ABC will promptly post all patient payments to ensure account balances are accurately updated.
Posting inpatient hospital and other facility chargesâ–¶
"ABC ensures accurate billing for services provided during a patient’s hospital stay or at other healthcare facilities such as rehab centers or skilled nursing facilities. As part of this process, ABC will: 1. Review doctors’ notes, nursing records, and procedure reports 2. Verify that all services (e.g., lab tests, imaging, therapy, medications) are properly documented 3. Confirm service dates, service types, and assign correct CPT/HCPCS codes 4. Post charges to the patient’s account 5. Enter appropriate diagnosis (ICD-10) and procedure codes"
Quarterly zoom client meetings â–¶
ABC will conduct regular high-level account review meetings with clients to address concerns, share key performance metrics, and align on future goals and needs.
Monthly prior authorization and referral missing report. â–¶
ABC will provide the client with a detailed bi-weekly report identifying all claim denials related to missing precertification, prior authorization, or referral.
Enroll in ERA/EFT for eligible payers â–¶
ABC converts paper EOBs to electronic format and assists with direct deposit setup, saving time and ensuring faster payments.
POPULAR

Premium Package

5%
Daily claim submission â–¶
ABC submits insurance claims to payers within 8 hours of claim creation to ensure timely reimbursements and maintain consistent cash flow for healthcare providers.
Posting insurance remittances/paymentsâ–¶
Accurate and timely posting ensures proper revenue tracking, minimizes billing errors, and streamlines claim reconciliation.
Handling claim denialsâ–¶
ABC reviews, corrects, and resubmits denied insurance claims within 48 hours of denial to ensure timely and accurate reimbursement. Additionally, we conduct root cause analysis to prevent future denials and enhance first-pass claim approval rates
Tracking and following up on unpaid claimsâ–¶
ABC will check the status of claims starting from the 10th day after submission, through various channels, including web portals, IVR systems, inquiries, or direct calls. Once the claim status is obtained, we take the necessary steps to address the denial and proceed with further processing to resolve the issue. - Refer (AR webpage)
Contacting insurance companies to resolve claim denial issuesâ–¶
ABC will contact insurance companies directly to resolve claim denials within 48 hours, addressing root causes and ensuring appropriate claim payments. Our goal is to reduce future denial rates and optimize the overall claims acceptance process.
Credentialing is a separate service with an invoice of $250.00 per applicationâ–¶
ABC coordinates directly with each payer and submits applications electronically to ensure faster processing. We also handle any required paperwork based on specific payer requirements. We manage end-to-end communication with payers for seamless processing. Our team handles all follow-ups to keep the credentialing process on track. We streamline provider enrollment by managing the full credentialing workflow.
Monthly financial reportâ–¶
ABC will send a payment report that includes detailed information on payments collected from insurance, including check numbers and check dates, as well as patient payments received. This report ensures transparency and accuracy in tracking all payments processed.
Year-end practice performance analysis reportâ–¶
ABC will provide a yearly report to assess the practice's performance and check if the billing company is doing well. The payment comparison report will show collections from insurance grouped by top five insurances and patients. Apple Billing and Credentialing help practices gets to maximize the reimbursements and reduce the insurance denials.
Managing inbound and outbound patient callsâ–¶
ABC will answer all patient inquiries regarding balances, receipts, and bills.
Sending bulk patient statements every 30 daysâ–¶
ABC will generate and send patient statements every 30 days, as per client requirements, to ensure consistent communication regarding outstanding balances. This regular process helps keep patients informed of their financial responsibility
Sending instant patient statements â–¶
ABC will promptly send statements to patients immediately after insurance processing to accelerate the practice’s payment flow. This ensures that patients are notified in a timely manner of their financial responsibility and reduce delays.
Weekly AR report â–¶
ABC will generate the insurance-wise Account Receivable (AR) report weekly. This will create transparency between the practice's revenue and outstanding receivables, allowing the client to monitor financial performance. It helps to identify payment trends, aging claims, and any potential bottlenecks in the reimbursement cycle.
Uploading claim batch files to ACO â–¶
ABC will fetch batches from the system and transfers it securely to the ACO's.
Mailing medical records to payers, attorneys, and workers' compensation.â–¶
ABC will submit medical records to payers upon request for claim verification. For workers’ compensation cases, ABC will include the necessary medical records when submitting the claim to ensure faster processing and reduce delays.
Mailing HCFA paper claim formsâ–¶
If the payer ID and fax number are not available for a specific payer, ABC will submit the claims via paper.
Transitioning from virtual credit cards to paper checks or EFTsâ–¶
Insurance companies may pay claims with virtual credit cards. Providers can process the card, but a transaction fee of 2% to 5% may apply. To avoid this fee, ABC has implemented a process to convert virtual card payments into paper checks or Electronic Funds Transfers (EFT). This ensures that providers receive their full reimbursement without incurring unexpected fees
Reconciliation of billed amounts against payer contracted amounts every six monthsâ–¶
ABC will perform a thorough reconciliation of all claims to verify that reimbursements are accurate and aligned with the payer’s contracted rates and terms.
Patient unapplied overpayment report generated every three months.â–¶
ABC will provide a quarterly report highlighting patient overpayments or credits to keep the practice informed of any discrepancies.
Posting patient remittances/payments â–¶
ABC will promptly post all patient payments to ensure account balances are accurately updated.
Posting inpatient hospital and other facility chargesâ–¶
"ABC ensures accurate billing for services provided during a patient’s hospital stay or at other healthcare facilities such as rehab centers or skilled nursing facilities. As part of this process, ABC will: 1. Review doctors’ notes, nursing records, and procedure reports 2. Verify that all services (e.g., lab tests, imaging, therapy, medications) are properly documented 3. Confirm service dates, service types, and assign correct CPT/HCPCS codes 4. Post charges to the patient’s account 5. Enter appropriate diagnosis (ICD-10) and procedure codes"
Quarterly zoom client meetings â–¶
ABC will conduct regular high-level account review meetings with clients to address concerns, share key performance metrics, and align on future goals and needs.
Monthly prior authorization and referral missing report. â–¶
ABC will provide the client with a detailed bi-weekly report identifying all claim denials related to missing precertification, prior authorization, or referral.
Enroll in ERA/EFT for eligible payers â–¶
ABC converts paper EOBs to electronic format and assists with direct deposit setup, saving time and ensuring faster payments.
Download patient face sheets from hospital and other facility systemsâ–¶
ABC securely accesses hospital and facility systems to download patient face sheets directly, reducing manual hours for the practice.
Checking uninsured status across various portals.â–¶
ABC verifies active insurance coverage through facility portals, as well as Medicare and Medicaid, for uninsured patients before sending any statements.
Customized reports â–¶
ABC delivers all types of provider reports, customizing solutions when needed to ensure practices always have the insights they need.
Submit and follow up on patient collectionsâ–¶
ABC will submit patient accounts to third party collection agency and follow-up on the payments/disputes.
Submitting medical records to attorneys/payers for post-paid claimsâ–¶
Retrieving records from the hospital portalâ–¶
ABC securely accesses hospital and facility systems to download the Medical records directly, reducing manual hours for the practice.
Contacting hospitals/facilities to obtain prior authorization numbers â–¶
ABC contacts facilities directly to obtain prior authorizations or precertification numbers for denied claims, ensuring timely resubmission and secure payment.
Checking the facility portal for the preauthorization numberâ–¶
Prepare medical record invoice for post-paid claims â–¶
ABC raises invoice to third parties for the record request for any post-paid claims.
Appeal claims and hearing scheduling for payer denials.â–¶
ABC manages all claim appeals directly, ensuring denials are addressed without adjusting the original claim, so practices can recover maximum reimbursement efficiently.
Mailing appeal letters with tracking number Any postal mailâ–¶
ABC handles the mailing of all appeals with tracking, ensuring every submission is securely sent and easily monitored for timely follow-up.
Setting up insurance portals for practice and billingâ–¶
ABC empowers your team by setting up insurance portals that simplify workflows, reduce errors, and accelerate reimbursements.
Sending itemized bills to attorneys for post-paid claimsâ–¶
ABC raises invoice to attorneys for itemized bill or record request for any post-paid claims.
Contacting dialysis centers for provider lock-in verification â–¶
ABC directly contacts dialysis centers to resolve any lock-in issues promptly and efficiently.
Training for front office staffâ–¶
ABC will provide comprehensive training for front office staff covering key areas such as eligibility verification, obtaining authorizations, reviewing patient balances,etc to support accurate and efficient patient and billing workflows.
Complimentary coding audit report for the first three months from the signing dateâ–¶
ABC will perform a complimentary coding audit performed by a certified coder for the first three months from the signing date.
Complimentary practice consultation available anytimeâ–¶
We provide a complimentary consultation to help practices evaluate their current billing performance and address any questions beyond RCM services.
Complete practice management system (PMS) implementationâ–¶
"ABC coordinates directly with leading Practice Management Systems(PMS) such as eCW, Tebra, AdvancedMD, DrChrono, eMedicalPractice, Greenway and etc. We work closely with each vendor to ensure all essential settings are properly configured for a smooth setup. We schedule and attend setup meetings with PMS vendors on your behalf. ABC ensures system settings are customized to meet your practice’s specific workflow. We assist in integrating billing, scheduling, and reporting functionalities. Our team verifies that all modules are correctly activated and functioning. Ongoing support is provided during and after the implementation process."
Managing returned patient statements (RTS) â–¶
ABC identifies the correct mailing address for any payer-returned claims through calls and inquiries, then promptly resends the claim to the updated address.
Managing patient accounts submitted for collectionsâ–¶
Patient accounts submitted to collections will be reconciled every six months to ensure that the balances are accurate and up-to-date.
Collections payment monitoring and posting â–¶
Payments received after accounts are submitted to collections will be reviewed and posted monthly.
Collecting the patient balances directly in the PMSâ–¶
ABC will integrate e-payment services into the Practice Management System (PMS), allowing the practice to securely collect patient payments online.
Provider's CAQH profile up to dateâ–¶
ABC ensures each provider’s Council for Affordable Quality Healthcare(CAQH) profile remains up to date by regularly updating licenses, credentials, and other key information.
Reattesting the provider's CAQH profile if needed as per the payer's requirement â–¶
ABC ensures timely reattestation of individual provider Council for Affordable Quality Healthcare(CAQH) profiles. We manage the reattestation process to prevent delays in credentialing or reimbursement.
Clearing house setupâ–¶
ABC coordinates directly with leading Clearing house such as TriZetto, Waystar, Office Ally, Optum, eProvider Solution and etc. We work closely with each vendor to ensure all essential settings are properly configured for a smooth setup.
Medicaid CMO revalidation â–¶
ABC manages Medicaid Care Management Organization (CMO) revalidation by ensuring an individual provider information is current and compliant with payer timelines. We handle the revalidation process to prevent delays in credentialing or reimbursement.
Medicare revalidation â–¶
ABC handles Medicare revalidation for both individual providers and group practices, ensuring timely submission of accurate information to maintain active enrollment. We handle the revalidation process to prevent delays in credentialing or reimbursement.
Payer contract negotiation Attorney referenceâ–¶
ABC guides providers and practices in connecting with the right entitys for payer contract negotiations. We ensure you're referred to experienced legal professionals to help secure favorable contract terms. We help you understand when legal support is needed during payer negotiations. ABC refers attorneys with healthcare contract expertise. Our team supports you through the process, from review to execution. We aim to protect your financial interests and ensure compliance.
PECOS enrollment â–¶
ABC handles the complete Provider Enrollment, Chain, and Ownership System (PECOS) enrollment process for Individual providers (855I application), Group practices (855B application), and Reassigning of benefits (855R). We ensure smooth, timely submissions for efficient Medicare participation. We manage all necessary forms to ensure proper enrollment and revalidation.
Checking allowed rate with the payer contract â–¶
The allowed rates for the CPT codes are carefully verified against the payer contracts prior to posting any insurance payments.