Medical billing for medical and surgical practices
Medical Billing Services for Fewer Denials and Faster Payment
Most practices don't lose revenue to one large problem. They lose it to hundreds of small ones. A claim goes out with a missing modifier. A denial sits unworked for three weeks. A payer underpays and nobody catches it.
100% U.S.-basedOver 26 yearsWorks inside your EHRDenials worked in 24 to 48 hours
Talk to Andy Garcia about your billing15 to 30%
Fewer denials
what practices typically see
15 to 25 days
Less time in A/R
on aged balances worked by payer
15 to 30%
Higher collections
from revenue already earned
98 percent first-pass claim acceptance, a track record confirmed by HRG's CFO.
None of those numbers comes from one big fix. Each one comes from catching the small leaks early, before they turn into a pattern.
Medical billing services cover the work between a finished visit and a paid claim: charge entry, claim scrubbing and submission, denial management and appeals, and A/R follow-up. HRG runs that chain inside the EHR, practice management system, and payer portals you already use. We install nothing, migrate no data, and add no separate dashboard.
Why a Missing Modifier Costs More Than One Claim
A missing modifier rarely fails once. The gap usually lives in a charge template or a habit, so it repeats every time the same visit pattern does. Take an established patient who comes in with knee pain and leaves with a steroid injection. The physician bills an office visit, 99213, and a major joint injection, 20610. Medicare folds a same-day visit into the payment for a minor procedure unless modifier 25 marks the visit as significant and separately identifiable, as the CMS global surgery booklet sets out. Leave the 25 off and the visit denies as bundled. Medicare billing guidance for joint injections also calls for RT or LT on 20610 to show which knee.
The clean version reads 99213-25 and 20610-RT. Your coders assign those codes and modifiers. The billing side's job is to catch the claim that leaves without them, then trace it back to the template that keeps producing it. Fix the claim alone and the same denial lands again next week.
The remittance names the problem in a Claim Adjustment Reason Code, from the X12 code list every payer uses. Three of them point straight at the small leaks above.
| CARC | What the payer is saying | Where it usually starts |
|---|---|---|
| 4 | The procedure code is inconsistent with the modifier used. | A modifier is missing, wrong, or conflicts with the code, such as 20610 sent without a side. |
| 97 | The benefit for this service is included in the payment for another service already adjudicated. | A same-day visit billed without the modifier that separates it, such as 99213 without 25. |
| 16 | The claim or service lacks information or has submission or billing errors. | A missing data element. The payer must add a remark code naming what is missing. That remark code is where the fix starts. |
Each code points to a different fix. Work any of them as a one-off and it comes back next month. Our guide to denial management in medical billing covers the appeal side.
What HRG's Medical Billing Services Cover
Billing is not one task. It is a chain, and revenue leaks wherever a link goes unwatched.
| ✓ | Claims submission and clearinghouse rules engine configuration |
| ✓ | Denial prevention that catches rejections before claims leave your system |
| ✓ | Aggressive appeal management on denied claims |
| ✓ | Accounts receivable follow-up and recovery |
| ✓ | Coding consultation as needed, with your coders keeping the coding work |
| ✓ | Real-time tracking inside your EHR and payer portals |
| ✓ | Specialty depth across cardiology, dermatology, primary care, rheumatology, urgent care, and health centers |
| ✓ | Platform expertise in eClinicalWorks, NextGen, and ModMed |
| ✓ | Medical credentialing and contracting through our Provider Services team, as a separate hourly service |
Every link in that chain runs in the screens your staff already open each morning, so you can watch the work while it happens.
Payer Contracting: The Rate Behind Every Clean Claim
Billing and contracting pull in the same direction. A better fee schedule means every clean claim pays more.
Many commercial contracts price every code off one base, such as a percentage of the Medicare fee schedule. A payer asked to raise that base for the whole contract usually says no. Carve-outs take a different route. They pull a handful of high-volume or high-value CPT codes out of the base and price them on their own terms. A rheumatology or orthopedic group billing 20610 all day has a case for that one code even when the payer will not move the base rate. HRG builds that case from your volume and specialty. Final terms rest with the payer and your practice.
Our Provider Services team runs fee schedule review, rate negotiation and carve-out requests, billed hourly and month to month. See how credentialing and payer contracting works.
How HRG Keeps the Work Visible
| ✓ | Real-time visibility inside your own EHR |
| ✓ | Weekly and monthly A/R reviews by the actual billers |
| ✓ | Invoices you review before we charge anything |
"From the contracting piece, paperwork and calls but really to pushing back to get us the best rates, I could never thank you enough."
Angela Sombrio, Revenue Cycle Manager, Ohio Vein
How HRG Works
Four things separate this from how most billing vendors operate.
- Weekly A/R reviews by the billers doing the work. Not a summary from a manager who never touched your claims.
- Onboarding in days, not months. We install nothing, so there is nothing to wait on.
- 100% U.S.-based workforce. Every biller and account manager on your account works from the United States.
- Direct access to your specialists. You talk to the people running your claims.
Together they answer what a practice burned by a past vendor wants to know first: who is touching its claims, and whether anyone can check the work.
Talk to Us About Your Medical Billing
Medical Billing Services Compared: In-House, Offshore or Generalist, and HRG
Most practices weighing medical billing services are choosing among three setups. They can keep billing in-house, hand it to an offshore or generalist vendor, or bring in a specialty team that works inside their own systems. Each setup tends to break in a predictable place. Where it breaks decides how long a denial sits before anyone sees it.
| In-house billing team | Offshore or generalist vendor | HRG | |
|---|---|---|---|
| Who works your claims | Your staff, between front-desk and patient calls | A shared pool working many practices and specialties | A 100 percent U.S.-based team on your account, with direct access to the billers |
| Where you see the work | Inside your EHR, when someone has time to look | The vendor's dashboard or a periodic report | Real time, inside your own EHR and payer portals |
| Denial follow-up | Worked when the backlog allows | Worked in batches on the vendor's schedule | Response inside 24 to 48 hours |
| A/R review | Whoever has time that week | A summary from an account manager | Weekly and monthly reviews by the billers doing the work |
| Recurring denials | Fixed claim by claim | Fixed claim by claim | Traced to the template or payer setup that causes them |
| Coding | Your coders, with no second look before submission | Varies by vendor | Your coders keep the coding. HRG consults as needed and flags issues before claims go out. |
| Payer contracting | Rarely revisited | Usually outside the scope | Fee schedule review and rate negotiation through Provider Services |
The costliest setup is the one that fails quietly. Nobody notices the denial until it ages past the payer's filing window.
What Changes After Practices Switch
A Kentucky pain management clinic came to HRG after a prior vendor stopped filing claims on time. Within months, that practice cut A/R by 20 percent, reduced denials by 35 percent, and improved collections by 40 percent.
"Their approach is both professional and highly personalized, making complex processes seamless and manageable, even for a small practice like ours."
Tara Roney
Medical Billing Questions, Answered
Which specialties does HRG bill for?
HRG bills for medical and surgical practices across cardiology, dermatology, primary care, rheumatology, urgent care, ENT, podiatry, pain management, and behavioral health. Federally qualified health centers get dedicated support through HRG's health center billing practice.
Will switching to HRG disrupt our EHR or workflow?
No. HRG works inside the system you already run, most often eClinicalWorks, NextGen, or Tebra, with nothing installed and no data migrated. Billing starts once the team learns your payer mix and procedures.
Does HRG perform medical coding?
No. HRG provides coding consultation as needed within the billing workflow. Your practice's coders or coding vendor perform the coding itself.
Does HRG manage prior authorizations?
No. Prior authorization stays with your practice. HRG can advise on the workflow.
Does HRG handle both billing and payer contracting?
Yes, as two services. Billers manage claims, denials and A/R on a longer-term agreement. Provider Services handles payer contracting, fee schedule review and rate negotiation, billed hourly and month to month. Contracting improvements show up directly in your billing results.
How does HRG keep billing transparent?
HRG shares invoices before charging, so there are no surprise fees. You see every claim and every dollar in real time inside your own system, with weekly and monthly A/R reviews by the actual billers.
Ready to See Where Your Revenue Is Leaking?
Every week a denial sits unworked is a week that claim ages. Talk to Andy Garcia about billing that runs inside the systems you already have. No pitch, no pressure.
Or call 913-937-2995