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Services
Expert Billing, Eligibility, and Credentialing Services for Your Practice
Services
With over 25 years of experience in medical billing, we handle every part of the process with care, accuracy, and dedication. From submitting clean claims to verifying eligibility and managing credentialing, we take the stress out of billing so your practice can stay focused on providing exceptional care.
Billing
Medical billing is the process of submitting claims to insurers like Medicaid, Medicare, or private payers. It requires accurate coding (like CPT and ICD codes), solid documentation of diagnoses and treatments, and compliance with payer guidelines to ensure reimbursement.
Through our efficient follow-up and payment posting procedures, we ensure that claims are reconciled within four weeks.
Eligibility
Eligibility is the process of verifying a client’s insurance coverage before they receive services. This step ensures we confirm the client’s active coverage, identify any deductibles, co-pays, or co-insurance amounts. By doing this verification before the appointment, we avoid unexpected financial surprises and help clients understand their financial responsibility ahead of time, which ultimately improves the overall experience and reduces the risk of billing errors later.
Credentialing
Credentialing with insurance companies is the formal process of verifying a provider’s qualifications, including their licensure, education, work history, and professional reputation, so that they become “in-network” providers. Without being credentialed, a practice can’t bill insurance, meaning they would rely solely on private pay, which limits access for many clients. Thus, credentialing is afoundational step for ensuring a steady flow of reimbursement, building credibility with insurers, and enabling sustainable growth for the practice.
Consultation
At Breakthrough Medical Billing, we provide expert consulting tailored to your practice’s unique needs. Whether you're just starting out, setting up a private or group practice or simply navigating the complexities of medical billing, we're here to help.
From teaching you how to handle your own billing to guiding you through eligibility checks and claim statuses, we offer practical solutions every step of the way.
