Physician Billing Services
Professional-component billing across specialties, with specialty-specific coding review.
What it covers
- Professional-component (CMS-1500) billing
- Specialty-specific coding review
- E/M level validation against documentation
- Incident-to and split/shared visit rules
- Modifier accuracy for bundled and bilateral services
- Provider-level productivity and denial reporting
Where practices lose money here
E/M levels chosen defensively
Consistently under-coding to avoid audit risk is a silent, permanent revenue loss — and it is just as much a compliance problem as over-coding.
Modifier errors on bundled services
Modifier 25, 59 and the XE / XP / XS / XU set decide whether a legitimately separate service gets paid or bundled away.
Incident-to rules applied by habit
Billing a mid-level's service under the physician NPI without meeting the supervision requirement is a refund exposure, not a shortcut.
How Medway handles it
- Certified coders review documentation against the assigned E/M level — in both directions.
- Modifier use is validated against payer-specific edits, not just NCCI.
- Supervision and split/shared requirements are checked before the claim goes out.
- Denials are reported per provider, so patterns are visible to the people creating them.
What you get
- Coding that matches the documentation, defensibly
- Specialty-aware review rather than generic billing
- Per-provider denial and productivity visibility
- Audit-ready records
Get a free audit of your physician billing claims. Send us a recent aging report and we will show you, in writing, where the recoverable revenue is — no cost, no commitment.
Frequently Asked Questions
You send us a recent accounts receivable aging report and, where possible, a denial export. We review them and give you a written breakdown: where recoverable revenue is sitting, which denial reasons are costing you most, what your timely-filing exposure looks like, and the fixes we would make in priority order. It is yours to keep whether or not you work with us. Please do not include patient health information — we only need claim-level financial data.
Most of the timeline is payer enrollment and EDI setup, and neither is fully in our control — that is the honest answer. Practices already enrolled with their payers typically start seeing claims go out within two to three weeks. Where new enrollments or revalidations are needed, budget longer, because the payer sets that pace. We tell you which of the two you are in after looking at your current setup.
Solo practitioners are often the strongest case for it, not the weakest. A one-person billing office has no redundancy — a vacation or a resignation stops your revenue cycle, and the cost is not the temp, it is the AR that ages and the claims that pass their filing deadline while nobody is working them.
Access to your existing EMR/PMS, your payer list and contracts, your fee schedule, and a recent AR aging report. If you are moving from another biller, we also need clarity on who works the open AR at transition — that is the single most commonly mishandled part of a billing switch.
