Billing that shows its work.
VitalCharge Services runs billing, credentialing and accounts receivable for medical practices, including mobile and facility-based groups rounding in skilled nursing facilities and assisted livings.
Primary care, podiatry, wound care, behavioral health, optometry and telehealth.
| Code | Payer | Billed | Status |
|---|---|---|---|
| 99308Nursing facility visit | Medicare Part B | 118.40 | Paid |
| 99309Nursing facility visit | Humana MA | 141.02 | Paid |
| 11721Nail debridement | NY Medicaid | 38.15 | In process |
| 97597Wound debridement | UnitedHealthcare | 96.80 | DeniedCO-197, auth missing. Appeal filed 3/14. |
What we handle
The whole revenue cycle, or the parts of it that are costing you money. Most practices come to us for one and end up handing over all three.
Billing and claims
Charge entry, claim scrubbing, submission, payment posting, patient statements and denial work. We work denials rather than writing them off, and we tell you which ones keep coming back so the front end can be fixed.
Credentialing and enrollment
Payer enrollment and revalidation, CAQH upkeep, group and individual linkage, and Medicare and Medicaid applications. The job is getting a new provider billable quickly and keeping every existing one from quietly falling off a panel.
Reporting and AR
A month-end workbook broken out by facility, payer and CPT, with estimated revenue, AR aging and outstanding balances. When a collection problem shows up, the data is already there to find the cause. You see the same numbers we do.
| Category | Mar | Apr | May | Jun | Jul | Aug | Total |
|---|---|---|---|---|---|---|---|
| Eligibility issue | 2 | 1 | 3 | 1 | 2 | 1 | 10 |
| Coding or modifier correction | 3 | 2 | 4 | 2 | 3 | 2 | 16 |
| Prior auth missing | 0 | 1 | 1 | 0 | 2 | 1 | 5 |
| COB update needed | 1 | 0 | 2 | 1 | 0 | 1 | 5 |
| Credentialing pending | 1 | 1 | 0 | 2 | 1 | 0 | 5 |
| Payer correction needed | 1 | 0 | 1 | 1 | 0 | 2 | 5 |
| Patient responsibility | 2 | 1 | 1 | 3 | 2 | 1 | 10 |
| Appeal submitted | 1 | 2 | 1 | 1 | 3 | 2 | 10 |
| Resolved, set to pay | 41 | 38 | 44 | 40 | 47 | 52 | 262 |
| Total claims | 52 | 46 | 57 | 51 | 60 | 62 | 328 |
Who we work with
Independent practices and provider groups, from a solo provider to multi-state professional corporations.
- Primary care
- Podiatry
- Wound care
- Behavioral health
- Optometry
- Telehealth
Mobile and facility-based practices
If your providers round in skilled nursing facilities, assisted livings or patients' homes, your billing has problems a standard office biller never sees: place-of-service rules, facility-specific payer mixes, Medicare Advantage plans that behave nothing like fee-for-service, and a census that never quite matches the schedule. That work is most of our book, and it is the reason practices move to us.
For the last year and a half, Vital Charge Services has handled our billing and collected 95% on it. When a collection problem does come up, the data Vital tracks makes it easy to find the cause and fix it fast. Their reporting is the most flexible and informative we've seen from any biller we've worked with. We recommend them highly.
Operations Manager
RLD Medical Services PC
Getting started
Three steps, and you will know what we think of your current billing before you commit to anything.
Review
Send us recent claim and AR data. We go through it and tell you what we find, including anything we think your current process is leaving on the table.
Transition
We map your fee schedule, payers, providers and facilities, confirm access to your system, and run alongside your current process so nothing drops during the handover.
Go live
Claims go out on a daily cycle. You get your first month-end workbook at the close of the first full month, and a standing call to go through it.
Questions practice managers ask us
The things people actually want to know before handing over billing, not general tips.
—We already have a biller. Why switch?
Usually not for a lower rate. It is because nobody can tell them why a specific claim was denied, or what is actually sitting in AR past 90 days. If your current biller sends a check and a percentage with no detail behind it, that is the gap we fill.
—Our providers round in SNFs and ALFs. Is that different?
Yes. Place-of-service rules, facility-specific payer mixes, and Medicare Advantage plans that pay nothing like fee-for-service all change the picture. A biller who only knows office visits will misbill nursing facility E&M codes and not know why the denials keep coming.
—We're a behavioral health practice. What do you look at first?
CPT utilization mix. A practice leaning heavily on the longer psychotherapy codes relative to the standard one is one of the first things a payer audit flags, and it is easy to drift into without anyone noticing. We also check place-of-service coding on telehealth sessions, which is a common source of denials in this specialty.
—How fast can a new provider get credentialed?
It depends on the payer, but revalidation lapses are the more common problem. We track expirations before they hit, so an existing provider does not quietly fall off a panel and go unpaid for months.
—What happens to our current AR during a transition?
Open claims and appeals from before the switch don't get written off. They stay on our worklist until they are resolved, alongside the new claims going out on the daily cycle.
—Do you handle Medicare Advantage, not just traditional Medicare?
Yes, including the prior authorization and denial patterns specific to MA plans, which behave differently enough from fee-for-service Medicare that they need to be tracked separately.
Talk to us
Tell us the specialty, roughly how many providers, and what is not working. We will come back to you the same business day.
- Phone
- (914) 566-4766
- billing@vitalchargeservices.com
- Schedule
- Book a 30-minute call
- Hours
- Monday to Friday, 9:00 to 5:00 Eastern
Thanks, we've got it.
Someone from VitalCharge will get back to you within one business day. If it's urgent, call us at (914) 566-4766.