03 · Billing & RCM
Revenue in full. Leakage at zero.
Every encounter coded, every claim scrubbed before submission, every denial worked without joining a queue — and every remittance reconciled to the cent.
- 99213 coded from signed note · auto
- 99214 + 36415 scrubbed · clean, submitted
- Denial CO-97 · corrected + resubmitted same day
- ERA posted · variance $0.00
- Weekly leakage report · $0 unworked rejections
Pipeline
From signed note to posted payment
Code
At signatureCPT and ICD-10 are derived from the signed note — supported by documentation, never inflated beyond it. Undercoding is leakage too, and we catch it.
Scrub & submit
Same dayPayer-specific edits run before submission, not after rejection. Modifier conflicts, eligibility gaps, and NCCI edits get fixed while the claim is still in the building.
Work denials
On arrivalDenials are parsed, categorized, corrected, and resubmitted automatically. What genuinely needs a human decision reaches you with the fix already drafted.
Reconcile
Every remittanceERAs post against expected amounts. Underpayments get flagged and appealed instead of quietly written off.
Direct-pay practices
Don't bill insurance? We bill for the model you chose.
For DPC and cash-pay practices, the same engine runs the revenue you do have — without dragging you back into claims.
Membership billing
Recurring memberships, family plans, failed-payment recovery, and churn alerts — handled.
Employer contracts
Per-employee invoicing, eligibility rosters, and the utilization reports employers actually ask for.
Hybrid support
Running a mixed panel? We keep the insurance side clean without letting it swallow the practice.
Questions
What practice managers ask us
Do you replace my biller or work with them?
Either. Solo practices often run MedPilot as the entire billing operation. Practices with billing staff use it to eliminate the queue work — scrubbing, denials, posting — so their biller handles exceptions and strategy.
How do you get to 91% first-pass?
By fixing claims before submission instead of after rejection. Payer-specific edits, eligibility checks, and documentation-supported coding remove the three biggest denial causes up front.
Is this compliant coding, or “aggressive” coding?
Compliant. Codes are always supported by the signed documentation — we recover revenue by eliminating undercoding and unworked denials, never by inflating levels.
What do you need to get started?
Access to your PM/EHR and clearinghouse, and a 90-day claims history so we can show you exactly where money has been leaking before we turn anything on.
Find out what leakage is costing you
Bring 90 days of claims history to a free consultation. We'll show you the denials, undercoding, and write-offs — and what the same period looks like on MedPilot.