Medical Billing & Coding — Accurate Claims, Faster Payment & Every Dollar Collected.

Most revenue leakage in medical practices does not come from one big mistake — it comes from a steady drip of small, systematic ones. Wrong CPT code. Missing modifier. Late submission. Denied claim nobody worked. Netix handles your entire billing and coding operation so claims go out clean, get paid fast, and every dollar your practice earns actually arrives in your bank account.

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Medical Billing & RCM

Claims submitted within 24–48 hours of encounter

Every denial worked — not written off

Medical Billing & RCM
Claims submitted within 24–48 hours of encounter
Every denial worked — not written off

The Hidden Cost

Why Most Medical Practices Are Getting Paid Less Than They Should

The average medical practice loses 5–15% of annual revenue to billing errors — not because of bad clinical care, but because the billing process behind it is broken in ways most physicians never see until the losses have compounded for months.

Undercoding is silent and systematic

Most physicians default to lower E&M levels to avoid audit risk — billing 99213 when the encounter supports 99214 or 99215 under the 2021 MDM guidelines. Undercoding by one level on even 30% of encounters represents tens of thousands in annual lost revenue.

Coding errors create denials that never get worked

A wrong diagnosis code, a missing modifier, an incorrect place of service — each creates a denial. Most in-house teams set it aside. By 90 days the timely filing window is closing and the revenue is gone.

Late claim submission delays cash flow

Claims submitted 5–7 days after the encounter instead of 24–48 hours create a permanent cash flow gap — on a $100,000/month practice, a 5-day delay means $16,000 is always in transit instead of in the account.

Credentialing gaps keep providers unbillable

A new provider joins but credentialing isn’t complete. Every patient they see for the first 60–90 days can’t be billed correctly — one of the most expensive billing failures in any practice.

AR aging is never systematically worked

Most practices bill claims and hope for payment. When it doesn’t come, the claim ages — 30, 60, 90 days — and by 120 days most claims are considered lost. A systematic follow-up process prevents this; most practices don’t have one.

Our Services

What Netix Handles for Your Practice

Every step of the revenue cycle, covered end to end. Effective medical billing requires more than submitting individual claims. Our revenue cycle management approach connects charge capture, coding, claim submission, payment posting, denial follow-up, and accounts receivable into one coordinated process, helping practices maintain a more consistent and efficient billing workflow.

Charge Entry

Every patient encounter entered into the billing system within 24 hours of the visit — no backlog, no missed charges.

CPT Coding

Accurate CPT code selection for every service — E&M visits coded under the 2021 MDM framework, correct procedure codes, and modifier application that prevents bundling errors.

ICD-10 Diagnosis Coding

Correct diagnosis coding to the highest specificity — primary and supporting diagnoses, and HCC-relevant chronic conditions coded annually for Medicare Advantage risk adjustment.

Claim Scrubbing

Every claim reviewed before submission — clearinghouse and NCCI edits checked, payer rules verified, errors corrected and resubmitted the same day.

Electronic Claim Submission

Clean claims submitted electronically to all payers within 24–48 hours of the encounter — among the tightest turnaround targets in the industry.

Payment Posting

Every payment posted to the correct patient account, claim line, and adjustment category within 24–48 hours of receipt.

Denial Management

Every denial categorized within 48 hours — resubmission, appeal, or payer call. Root cause analyzed so the same denial stops recurring.

AR Follow-Up

Systematic, scheduled follow-up on every unpaid claim — payer portal checks, calls, and escalation for claims nearing timely filing deadlines.

Underpayment Identification

Every payment compared to contracted rates — underpayments identified, disputed, and pursued instead of silently accepted.

Monthly Reporting

Clear, plain-English reports — collections by payer, denial rate, AR aging, days in AR, and clean claim rate, with every trend explained.

When claims are denied, timely action can make the difference between recovered revenue and an avoidable write-off. Our denial management process identifies the reason behind each denial, coordinates the appropriate response, and helps prevent recurring billing issues.

Once a claim has been submitted, consistent follow-up is essential to keep outstanding payments from aging unnecessarily. Our accounts receivable management process tracks unpaid claims, follows up with payers, and escalates outstanding balances to help practices recover revenue more efficiently.

The Process

How Netix Runs Your Billing — Start to Finish

Within 24 Hours

Encounter documented, charge captured

Patient is seen. Encounter documentation is completed by the physician. Charge capture triggers in your EHR.

Within 24 Hours

Coded, scrubbed, and submitted

Charge entry completed. CPT and ICD-10 codes assigned. Claim scrubbed for errors. Clean claim submitted electronically to the payer.

Days 3–14

Payment posted, denials worked

Electronic remittance received for most payers. Payment posted. Any denials categorized and immediately worked.

Days 15–30

AR follow-up and escalation

AR follow-up begins on unpaid claims. Payer status checks run. Any stalled claims escalated.

Coding Accuracy

Medical Coding — The Foundation of Every Clean Claim

Accurate coding isn’t just compliance — it’s the single most important revenue driver in your practice. The right code on the right claim is how your clinical work translates into correct payment.

E&M Level Selection Under 2021 Guidelines

The 2021 E&M changes replaced history/exam counting with Medical Decision Making complexity. Most practices systematically underbill because physicians were trained under the old framework. Our coding review identifies your current E&M distribution and shows exactly where documentation supports a higher level than what’s being billed.

99213

Low complexity — one stable chronic illness or minor problem. Minimal data. Low risk.

99214

Moderate complexity — multiple chronic conditions, or one with exacerbation. Moderate data. Rx management.

99215

High complexity — severe exacerbation, new problem requiring workup, or threat to life. High-risk decisions.

Procedure Code Accuracy

Every procedure code must match the documentation — technique, extent, approach, and any complications or additional procedures performed. A wrong code creates either an underpayment or an audit trigger. Both cost money.

Modifier Application

Modifiers tell payers what they need to know to pay correctly — modifier 25 for a significant separately identifiable E&M on a procedure day, modifier 59 for a distinct procedural service, modifier 51 for multiple procedures. Wrong modifier means denial; missing modifier means a bundled payment instead of a separate one.

ICD-10 Specificity

The more specific the diagnosis code, the more defensible the claim — and the better the clinical data for your practice.

Incomplete: “Diabetes mellitus”

Complete: “Type 2 diabetes mellitus with diabetic chronic kidney disease, stage 3”

No Migration Needed

We Work Inside Your Existing System

We plug into the EHR and practice management system you already use — no migration, no disruption, no learning curve for your clinical staff.

EHR / PMS Systems

Kareo/Tebra

AdvancedMD

eClinicalWorks

Athenahealth

Office Ally

DrChrono

Practice Fusion

NextGen

Greenway Health

Meditech

Allscripts

Epic (outpatient)

Cerner (outpatient)

Clearinghouses

Availity

Waystar

Trizetto/Cotiviti

Change Healthcare

Office Ally

Relay Health

Payer Portals

Medicare

Medicaid (all states)

Blue Cross Blue Shield

Aetna

Cigna

UnitedHealthcare

Humana

500+ commercial & regional payers

Security

HIPAA-Compliant Billing Operations — Built Into the Architecture

Every billing operation at Netix runs on a security infrastructure designed from the ground up for healthcare data.

Zero local PHI storage — all billing work performed on secure virtual desktops; no patient data ever touches a team member’s local device

Watermarked sessions — every screen session is traceable to the individual; screenshots or photos carry the user’s identity

Role-based access — each team member sees only the data their role requires

2-factor authentication on every system login

Signed BAA with every client as standard

Documented HIPAA training for every team member with records

Incident response plan — documented and rehearsed, not theoretical

OUR APPROACH TO SECURITY

HIPAA Compliance Built Into the Architecture — Not Bolted On Afterward

The most common concern about remote medical billing is data security. It’s the right concern to have — and it deserves a real answer, not a vague “we take security seriously” paragraph.

ALIGNED INCENTIVES

We earn when you collect

We bill on a percentage of collections — your revenue maximization and ours are identical goals. There’s no scenario where it benefits us to underperform.

SPECIALTY KNOWLEDGE

Your specialty’s playbook

We know the coding rules for your specialty — not generic billing stretched across every practice type.

NO LOCK-IN

Simple notice period

No multi-year contract trap. We earn your renewal with results every month.

DEDICATED MANAGER

One named person, not a queue

Not a call center. One person who knows your practice, your payers, and your history — and answers within a business day.

TRANSPARENT REPORTING

Plain-English monthly reports

Every number explained. Every trend noted. Every recommendation made in language you can act on.

Who We Serve

Practices We Help With Medical Billing & Coding

Solo physicians

Complete billing operation without hiring billing staff.

Small to mid-size group practices

Consistent billing across all providers with per-provider reporting.

Multi-location practices

Unified billing management across all locations.

New practices

Billing setup, credentialing, and first-claim submission from day one.

Practices recovering from billing problems

High denial rates, AR backlogs, poor collection rates from a previous biller.

High-volume practices

24–48 hour submission turnaround that scales with volume.

FAQ

Medical Billing & Coding Questions

How is your billing service different from what we’re doing now?

Do we need to change our EHR or practice management system?

No. We work inside whatever system you already use. The only change is who is doing the billing work — not how your system is set up.

How do you handle specialty-specific coding?

We have billing teams trained by specialty — each team handles the coding rules, modifier requirements, and payer behaviors for their specific specialties. Your billing is handled by people who know your specialty, not generalists.

What is your clean claim rate?

Our target is 98%+ first-pass clean claim rate — meaning 98% of claims submitted pass payer edits and process without rejection on the first submission. The remaining 2% are corrected and resubmitted within 24–48 hours.

How quickly do you submit claims?

Our standard is claim submission within 24–48 hours of receiving encounter information. Fast submission is how we keep your cash flow cycle as short as possible.

What happens to denied claims?

Every denial is categorized within 48 hours — corrected claim resubmission, formal appeal, or payer call based on the denial reason. We track every denial to resolution and analyze root causes monthly to prevent recurrence.

How much does your service cost?

We typically bill a percentage of collections — usually 3–7% depending on specialty, volume, and services included. Your free audit includes a specific quote for your practice.

Most in-house billing teams process claims reactively — submit, wait, write off denials. We work every claim proactively — systematic AR follow-up, root-cause denial analysis, underpayment identification, and monthly reporting that shows exactly what moved and why. No. We work inside whatever system you already use. The only change is who is doing the billing work — not how your system is set up.
We have billing teams trained by specialty — each team handles the coding rules, modifier requirements, and payer behaviors for their specific specialties. Your billing is handled by people who know your specialty, not generalists.
Our target is 98%+ first-pass clean claim rate — meaning 98% of claims submitted pass payer edits and process without rejection on the first submission. The remaining 2% are corrected and resubmitted within 24–48 hours. Our standard is claim submission within 24–48 hours of receiving encounter information. Fast submission is how we keep your cash flow cycle as short as possible. Every denial is categorized within 48 hours — corrected claim resubmission, formal appeal, or payer call based on the denial reason. We track every denial to resolution and analyze root causes monthly to prevent recurrence.
We typically bill a percentage of collections — usually 3–7% depending on specialty, volume, and services included. Your free audit includes a specific quote for your practice.

Find Out How Much Revenue Your Practice Is Leaving on the Table

The free billing audit reviews your current clean claim rate, denial patterns, AR aging, coding distribution, and collection rate — and shows you in plain numbers what’s being lost and exactly what we’d do about it.

Get My Free Billing Audit

📞 +1 (307) 443-6706

✉️ info@netixmedicalbilling.com