Charge Entry and Claim Scrubbing
Charges are entered from your superbills or EHR and reviewed by a certified coder for diagnosis linkage, modifiers, NCCI edits and payer-specific rules before the claim is submitted.
Outsourced Medical Billing
Medical Billing Services for Practices Across the United States
ClainetRCM is a medical billing company that takes your claims from charge entry to final payment. AAPC and AHIMA certified coders scrub every claim, file it within 24 to 48 hours of receiving your documentation, and work your aging AR on a 14-day cycle. Pricing starts at 2.29% of monthly collections, with no setup fee and no long-term contract.
- AAPC and AHIMA certified coders
- HIPAA compliant, BAA signed
- Practices in all 50 states
- No setup fee, no long-term contract
Last updated October 2026.
24-48 hrsFrom your documentation to a submitted claim
14 daysHow often your full AR aging is worked
2.29%Starting rate, charged on monthly collections
What Are Medical Billing Services?
Medical billing services turn the care you deliver into paid claims. A billing team takes each encounter, checks the patient's coverage, applies the correct ICD-10, CPT and HCPCS codes, submits the claim to the payer, posts the payment, and follows up on anything that is denied, underpaid or ignored.
When you outsource medical billing, that work moves from your front desk to a dedicated team that does nothing else. You keep your EHR, your fee schedule and your bank account. We work inside your system, and every dollar is paid directly to your practice.
Many practices that call us are not short on patients. They are short on follow-up. Claims go out late, denials sit unworked past the appeal deadline, and the 90-day AR bucket grows quietly. Outsourced medical billing fixes that by putting certified staff and a fixed schedule behind every claim.
What our medical billing service covers
- Patient demographics and insurance checks
- Charge entry and coding review
- Claim scrubbing and electronic submission
- Clearinghouse and payer rejection fixes
- ERA and EOB payment posting
- Denial management and appeals
- Insurance and patient AR follow-up
- Patient statements and monthly reports
Outsourced Medical Billing Services We Provide
One team handles the full claim lifecycle, so nothing falls between the person who codes, the person who submits and the person who follows up.
Electronic Claim Submission
Clean claims go out through your clearinghouse within 24 to 48 hours of receiving documentation. Rejections are corrected and resubmitted the same cycle instead of waiting in a queue.
Payment Posting and Reconciliation
ERAs and paper EOBs are posted line by line. Payments are compared with your contracted rates, so underpayments are flagged and disputed rather than silently accepted.
Denial Management and Appeals
Every denial gets a documented root cause, a corrected claim or a written appeal, and a follow-up date. See our denial management services for the full process.
AR Follow-Up
Your full aging report is reviewed every 14 days, payer by payer, with the oldest and highest-value balances worked first. Details are on our accounts receivable page.
Patient Billing and Statements
Clear statements, balance reminders and payment-plan support for patient responsibility, handled in a way that protects the relationship you have with your patients.
Monthly Reporting
A monthly report shows charges, collections, denial reasons, days in AR and aging by payer, so you can judge our work against your own numbers.
In-House Billing vs. Outsourced Medical Billing
Both models can work. The difference is usually consistency: what happens to your claims when your one biller is sick, on leave, or buried in phone calls.
| In-house billing | Outsourced to ClainetRCM | |
|---|---|---|
| Cost | Salary, benefits, training, software seats and turnover costs, whether collections are up or down | A percentage of what you collect, starting at 2.29%, with no setup fee |
| Coverage | Work stops during vacations, sick days and resignations | A team covers your account, so claims go out every business day |
| Coding expertise | Depends on one or two people keeping up with annual code changes | AAPC and AHIMA certified coders review every claim |
| Denial follow-up | Often pushed aside when the front desk gets busy | Reworked within 24 to 48 hours and reviewed on a 14-day cycle |
| Software | You buy and maintain the billing system | We work inside the EHR and practice management system you already use |
| Visibility | Varies with how much time staff have for reports | Monthly reporting on collections, denials and AR aging |
How Our Medical Billing Process Works
Onboarding takes 7 to 14 business days. We run alongside your current process until the handover is clean, so claims keep going out during the switch.
- 1
Onboarding and access
We sign a Business Associate Agreement, then set up secure access to your EHR, practice management system, clearinghouse and payer portals.
- 2
Eligibility and demographics
Patient and insurance details are checked before charges are entered, because many front-end denials start with a wrong ID or an inactive plan.
- 3
Coding review and charge entry
A certified coder confirms the codes match the documentation and the payer's rules, then enters the charge.
- 4
Scrub and submit
The claim is scrubbed and submitted electronically within 24 to 48 hours of receiving your documentation.
- 5
Post and reconcile
Payments are posted, adjustments are checked against your contracts, and underpayments are flagged for follow-up.
- 6
Work denials and AR
Denials are corrected or appealed, and the full aging report is worked every 14 days until each balance is resolved.
Medical Billing for Small Practices, Groups and Specialty Clinics
The billing cycle is the same everywhere. The pressure points are not. We set up each account around how the practice actually runs.
Solo and small practices
Small practices rarely have room for a full billing department. Our medical billing services for small practices fill that gap. See how we work with solo providers and private practices.
- A billing team without the payroll
- No minimum fee and no long-term contract
- One point of contact for the owner or office manager
Group practices and clinics
Our physician billing services give multi-provider groups and outpatient clinics the same rules and reporting across every provider and location.
- Provider-level and location-level reporting
- Consistent coding rules across the group
- Credentialing support as you add providers
Specialty and facility billing
We also bill for specialty centers, urgent care, labs and home health agencies, where the coding rules are narrower.
- Coders matched to your specialty
- Modifier, global period and bundling rules handled
- Prior authorization tracking for high-cost services
Why Practices Choose ClainetRCM as Their Medical Billing Company
Certified coders on every claim
AAPC and AHIMA certified coders review the work. A rules engine helps, but a person signs off before submission.
You keep your software
We work in most major EHR and practice management systems, so there is no migration and no new license to buy.
Transparent pricing
Pricing starts at 2.29% of monthly collections. No setup fee, no hidden charges and no long-term contract. We are paid only when you are.
A team that knows your account
You get a dedicated account manager who knows your payer mix and gives you regular performance updates.
HIPAA compliant from day one
A signed BAA with every client, encrypted data handling and access-controlled systems before any PHI changes hands.
Numbers you can check
Monthly reports show exactly which accounts moved, which payers are stalling and what we are appealing.
Medical Billing Services in All 50 States
Billing rules change at every state line. Each state runs its own Medicaid program and managed care plans, Medicare claims go to a different Medicare Administrative Contractor depending on where you practice, and the commercial payers with real market share are different in Texas than they are in Massachusetts.
ClainetRCM bills for practices nationwide and sets up each account around its local payer mix: state Medicaid and its MCOs, your regional MAC, Medicare Advantage plans, Blue Cross Blue Shield and the commercial carriers in your market.
Find your state
Medical billing by specialty
Medical Billing Services: Frequently Asked Questions
Most medical billing companies charge a percentage of the money they collect for you, commonly somewhere between 4% and 10% depending on specialty, claim volume and scope. Others charge a flat fee per claim. ClainetRCM's pricing starts at 2.29% of monthly collections, with no setup fee and no long-term contract. Your exact rate depends on your specialty, volume and which services you need. See our pricing page for details.
Outsourcing usually makes sense when your denial rate is rising, AR over 90 days is growing, billing depends on one person, or you are spending more on billing staff and software than a percentage fee would cost. In-house billing can work well for practices with a stable, well-trained team and good reporting. A free audit of your aging report will show which situation you are in.
Onboarding with ClainetRCM takes 7 to 14 business days, depending on how quickly EHR credentials and payer portal access come through. We run in parallel with your current process until the handover is clean, so there is no gap in claim submission.
No. We work inside most major EHR and practice management systems, including Epic, athenahealth, eClinicalWorks, NextGen and others. You keep your software, your data and your workflows.
Each denial is categorized by reason code, corrected or appealed, and refiled within 24 to 48 hours. Your denial queue is reworked every 14 days, and recurring causes are reported monthly so they can be fixed at the source.
We bill for more than 50 specialties, including family medicine, cardiology, orthopedics, mental health, pediatrics, dermatology, gastroenterology, radiology, urgent care and physical therapy. Browse all specialties.
It is when the billing company acts as a HIPAA business associate. We sign a Business Associate Agreement with every client before any patient data is shared, train staff on HIPAA, and use encrypted, access-controlled systems.
You receive a monthly report covering charges, payments, adjustments, denial reasons, days in AR and aging by payer, along with notes on the accounts we are appealing or escalating.
See Where Your Billing Is Losing Money
Send us a recent aging report and we will show you where your money is stuck before you commit to anything. We sign a BAA before any patient data is shared. Onboarding takes 7 to 14 business days, pricing starts at 2.29% of collections, and there is no setup fee and no long-term contract.
Free revenue audit
Find out what your practice is losing to denials.
Send us 90 days of remittance data and we will show you, line by line, which claims were underpaid, denied, or never worked, and what it would take to recover them. No cost, no obligation, and you keep the report either way.
No setup fee. No long-term contract. Pricing from 2.29% of monthly collections.