Our process

The nine stages
of medical billing.

Nine connected stages turn an encounter into a claim, a payer response, and a financial record. Here’s where NexCare Solution can support the work.

Eligibility & authorization
Insurance Verification
Review active coverage, benefits, and authorization requirements before the encounter.
Accurate practice records
Patient Demographic Entry
Check patient and insurance information for missing or inconsistent details.
Documentation & coding
ICD, CPT, HCPCS Coding
Review the documented encounter and applicable diagnosis, procedure, and modifier information.
Encounter capture
Charge Entry
Enter charges against the practice fee schedule and check them against the encounter documentation.
Review & clearinghouse
Claim Submission
Review claim information and submit electronic claims through the clearinghouse.
Remittance reconciliation
Payment Entry & Posting
Post ERA or EOB information and review payments, adjustments, and remaining balances.
Review, correction & appeal
Denial Management
Review payer denial reasons, identify the cause, and prepare the appropriate correction or appeal.
Outstanding payer balances
A/R Follow Up
Follow up on aging insurance claims and record payer responses and the next action.
Financial visibility
Reporting & Analytics
Review claims, collections, denial trends, and A/R aging to identify priorities with the practice.

Getting started

A thoughtful transition,
one step at a time.

Tell us about your specialty, team, systems, and the billing challenges you want to address.

Review responsibilities, access requirements, pricing, and reporting before work begins.

Coordinate the transition around your practice and any vendor or payer requirements.

Transition timing is agreed after the practice review. Payer decisions and software dependencies can affect the schedule.

Start with a conversation

Tell us where billing is taking time away from your team. We’ll discuss a service scope that makes sense for you.