Services — Medical Billing, Coding, Credentialing & RCM

Medical Billing

Accurate charge entry, clean claim submission, and proactive follow-up on unpaid claims. Every claim is scrubbed against payer-specific edits before it goes out the door, and nothing ages into a denial bucket because someone forgot to work it.

Charge entry tied to your encounter workflow.
Electronic claim submission with pre-submission scrubbing.
Payment posting reconciled line-by-line, not lump-summed.
Claim follow-up starting at day 14, not day 60.

What you get

A team that knows your payer mix, your fee schedule, and your practice — and a monthly conversation about the numbers, not just a report.

Medical Coding

Certified coders who keep your CPT, ICD-10, HCPCS, and modifier usage clean, compliant, and defensible. Coding is where revenue is either captured or quietly left behind — we don’t let it be quietly left behind.

Specialty-matched coders — plastic surgery, orthopedics, cardiology, and more.
Documentation feedback loop so providers know what’s missing before it becomes a denial.
Modifier audits for high-risk codes (24/25/58/59/78/79/62).
Annual code set updates reviewed and rolled into your workflow every January.

Compliance posture

Our coders follow AAPC/AHIMA guidelines and we maintain documentation that survives payer audits and external reviews.

Revenue Cycle Management

End-to-end ownership: eligibility, pre-authorization, charge capture, coding, submission, posting, denial management, and patient balance collection. One team, one accountable point of contact.

Eligibility verification at the point of scheduling.
Pre-authorization for procedures that require it, tracked to closure.
Patient balance workflow with statements, payment plans, and portal support.
Month-end close that actually closes.

Transparent KPIs

Days in A/R, first-pass yield, net collection rate, denial root causes — visible at all times, reviewed together every month.

A/R Management

Aging buckets don’t work themselves. We triage by dollar amount and age, start with the oldest recoverable dollars, and close out claims the prior biller gave up on.

A/R clean-up projects for practices switching billers.
Aged claim appeals where timely filing windows are still open.
Small-balance workflow that doesn’t swallow unpaid revenue as “not worth chasing.”

Transition specialty

When practices move to us from another biller, we inherit the aging report and work it alongside new-day claims — with a weekly report on recovery.

Denial Management

Every denial gets investigated, appealed where warranted, and — crucially — fed back into the front of the workflow so it doesn’t happen twice.

Root-cause analysis grouped by CARC/RARC.
Payer-specific appeal templates tuned to what each payer actually responds to.
Upstream fixes — eligibility, coding, documentation — so patterns stop.

Closed loop

A denial we fix once is a win. A denial we stop from recurring is a system improvement. We do both.

Credentialing

We provide credentialing services through our strategic partners. Payer enrollment, re-credentialing, CAQH maintenance, NPI/PECOS updates, and roster management — delivered by vetted specialist partners and coordinated end-to-end by your Avetalive account manager, so you get one point of contact and nothing falls through the seam.

New provider enrollment tracked through to effective dates.
Re-credentialing reminders that don’t arrive the week before expiration.
CAQH, NPI, PECOS maintenance handled end-to-end.
Multi-state licensure support for telehealth and traveling providers.

Strategic partner model

You get the benefits of a dedicated credentialing firm without managing a second vendor — Avetalive coordinates everything behind a single point of contact.

One team, one contract, the whole revenue cycle.