Trusted Medical Billing Company That Keeps Your Claims Moving

Denied claims, unpaid balances, and payer follow up calls eat up hours your staff doesn’t have. PrimeCore Medical Billing is a medical billing company that handles claims, denials, A/R, and payer communication so your practice spends less time chasing money it already earned. We work as an extension of your front and back office, not a black box you have to manage.

Connected billing workflow

What Proof Will Look Like Here

We’d rather leave this section honest than fill it with numbers we can’t back up. Once we has verified performance data, this is where it belongs:

17 Years

of Experience

12+

Clients/Providers

92%

First Pass Claim Rate

45 Days

Average A/R Days

Nationwide

U.S. Billing Coverage

Only figures PrimeCore Medical Billing can actually stand behind should appear here. Placeholder numbers hurt trust more than no numbers at all.

What We Handle

Medical Billing

Full Revenue Cycle Management (RCM)

Claims Management & Submission

Denial Management & Appeals

A/R Follow-Up & Recovery

Payment Posting & Reconciliation

Eligibility & Benefits Verification

Charge Entry & Claim Scrubbing

Credentialing & Provider Enrollment

Payer Enrollment & EDI Setup

Contracting & Payer Negotiations

No Surprises Act (NSA) & IDR Support

Complete IDR Process Management

Open Negotiation & IDR Submission

IDR Case Tracking & Determination Follow-Up

Out-of-Network Billing & Reimbursement

Hospital & FSED Billing

Professional & Facility Billing

Coding & Documentation Review

Patient Billing & Support

Insurance Verification & Authorization

Reporting, Reconciliation & RCM Analytics

Free Practice Audit

Not sure which billing services your practice needs? Start with a Free Billing Assessment & Audit. We can review your current billing process and identify where claims, A/R, denials, payments, or other revenue cycle issues may be affecting your practice.

The Billing Problems Costing Your Practice Time

Most billing problems don’t start at the claim. They started earlier, in a step nobody noticed until the denial showed up.

Here’s what that usually looks like in a real practice:

A claim goes out with a small error that triggers a denial or a delay

A patient's eligibility never gets confirmed before the visit

The coding doesn't quite match what's in the documentation

A prior authorization gets missed or filed too late

A payer underpays without any real explanation

Denials pile up faster than anyone has time to appeal them

A payer takes weeks to respond, and someone has to keep calling

Older claims sit untouched because the front desk is busy with today's patients

Staff spend hours on hold instead of talking to patients

None of this means your team isn't working hard. It usually means billing has grown past what your current staffing can reasonably keep up with. That's the gap we are built to close.

How PrimeCore Medical Billing Handles The Full Billing Cycle

PrimeCore Medical Billing manages medical billing as one connected process, not a set of separate tasks handed off between different people. Eligibility checks inform coding. Coding informs claim submission. Denials get traced back to their actual cause instead of just getting resubmitted and forgotten.

That connection is what makes a real difference. A denial that gets fixed without anyone asking why it happened will probably happen again next month. So we look at three things for every practice we work with:

Billing Visibility

You should always know what’s happening with your claims, denials, and A/R without having to ask.

Root Cause Management

Fixing a denied claim is only half the job. Finding out why it happened, and whether it’s part of a pattern, is the other half.

Full Cycle Accountability

From the first patient interaction through the final payment, one team should be able to see the whole picture, not just their piece of it.

Our Medical Billing & RCM Services

We’ve organized our services into three groups, because billing works best when it’s treated as a connected system rather than a list of unrelated tasks.

A Free Billing Assessment & Audit can help determine which of these services your practice actually needs, where your current workflow may have gaps, and which areas may need more attention.

FRONT-END BILLING

Eligibility & Benefits Verification

Coverage is verified before the visit to identify eligibility issues, coverage limitations, and potential billing problems before they affect the claim.

Credentialing & Provider Enrollment

Support with provider credentialing, payer enrollment, re-credentialing, and participation to help ensure providers are properly enrolled and ready to bill.

Payer Enrollment & EDI Setup

Assistance with payer enrollment, EDI setup, electronic claims, ERA, and related payer connectivity requirements.

Prior Authorization Support

Verification of authorization requirements, tracking of pending requests, and follow-up on approvals to help prevent authorization-related denials.

Chager Entry & Charge Capture

Accurate and timely capture and entry of charges to ensure services are properly reflected before claims are submitted.

Insurance Verification & Authorization

Insurance verification and authorization support to help identify coverage and authorization requirements before they create billing problems.

CLAIMS & PAYMENTS

Medical Billing & Coding

Coding and claim preparation aligned with documentation and payer requirements, helping reduce errors and prevent avoidable denials.

Claims Management & Submission

End-to-end claim submission, claim scrubbing, status tracking, correction, and payer follow-up.

Claims Quality Assurance

Pre-submission review and quality checks designed to identify billing, coding, demographic, and payer-related errors before claims are submitted.

Payment Posting & Reconciliation

Accurate posting of insurance and patient payments, including ERA/EOB processing and payment reconciliation.

Insurance Follow-Up

Ongoing payer follow-up on outstanding claims to identify delays, obtain payment status, and resolve unpaid balances.

Patient Billing & Support

Patient billing assistance, account inquiries, balance follow-up, and payment-related support.

Payment Reconciliation

Reconciliation of payments, EOBs, ERAs, checks, and account balances to maintain accurate financial records.

Get a Free Billing Assessment & Audit to see how your current claims, payments, follow-up, and reconciliation processes are working.

REVENUE RECOVERY & RCM

Denial Management & Appeals

Identification of denial reasons, correction of underlying issues, appeal preparation, and tracking of recurring denial trends.

A/R Management

Structured follow-up on outstanding accounts, prioritizing aging, high-value, and time-sensitive balances.

Underpayment Recovery

Identification and follow-up of payer underpayments to help ensure reimbursement aligns with applicable contracts, fee schedules, and payment terms.

Revenue Cycle Management

End-to-end coordination of billing, coding, claims, payments, A/R, denials, and reporting as one connected revenue cycle.

Contracting & Payer Negotiations

Support with payer contracting, reimbursement terms, negotiations, and contract-related billing considerations.

IDR & No Surprises Act Support

End-to-end support for eligible out-of-network payment disputes, including eligibility review, open negotiation, IDR submission, documentation, determination tracking, and payment follow-up.

Out-of-Network Billing & Reimbursement

Billing and reimbursement support for eligible out-of-network services, including claims, payment review, disputes, and recovery.

Facility & Professional Billing

Billing support for both facility and professional services across hospitals, FSEDs, physician groups, and healthcare organizations.

Hospital & FSED Billing

Specialized billing and RCM support for hospitals, freestanding emergency departments, emergency medicine, and other acute-care facilities.

Reporting & RCM Analytics

Customized reporting, A/R analysis, collection tracking, denial analysis, payment reconciliation, and revenue-cycle performance monitoring.

Why Practices Work With PrimeCore Medical Billing

We work the A/R

An A/R report is only useful if someone is actively working the balances behind it. Our team follows outstanding claims, prioritizes aging accounts, and tracks payer responses instead of simply sending you a spreadsheet.

We manage the revenue cycle as a connected process

Eligibility, credentialing, authorization, coding, claims, payments, denials, A/R, and reporting all affect one another. We coordinate these functions instead of treating them as isolated billing tasks.

We look for why claims deny

Fixing a single denied claim doesn't solve a recurring billing problem. We look for patterns across payers, codes, documentation, and workflows so the same issue doesn't keep coming back month after month.

We support complex out-of-network billing and IDR

For eligible out-of-network payment disputes, we provide support throughout the Independent Dispute Resolution process, from case preparation and open negotiation through submission, determination tracking, and payment follow-up.

Your billing is built around your practice

Services are shaped around your practice size, specialty, payer mix, and existing workflow. We don't ask you to change how you operate to fit our process.

We help keep credentialing and enrollment moving

Provider enrollment and payer participation can directly affect your ability to bill. We help manage credentialing, enrollment, re-credentialing, and related payer requirements.

You get clear reporting

You should be able to see what's happening with claims, payments, denials, and A/R without having to ask someone to dig it up for you.

You have a real point of contact

You have access to responsive billing professionals who understand your account, rather than relying solely on an automated system or rotating support queue.

We treat every specialty differently

Coding, documentation, payer requirements, and billing workflows vary by specialty. Our processes are adapted to the services and reimbursement requirements your practice actually deals with.

We handle protected health information with care

Our billing workflows are designed around secure, compliance-focused processes for handling patient, claim, and financial information.

What A Free Billing Assessment & Audit Actually Looks Like

We know “get a free assessment” can sound vague, so here’s what we actually review:

Current A/R aging and how much of it is realistically recoverable
Denial patterns by payer, code, and cause
Your claim submission workflow, from front desk to final billing
How payments are currently posted and reconciled
How payer follow up is currently handled
Common coding or documentation issues
Front end billing gaps, like eligibility or authorization steps
Where revenue is likely getting delayed or lost

The first billing assessment and audit is designed to give you a clearer picture of your current revenue cycle before you decide what kind of support you need.

There’s no obligation and no generic sales pitch attached to it. You walk away with a clearer picture of where your billing process actually stands, whether or not you decide to work with us.

INDEPENDENT DISPUTE RESOLUTION (IDR) SUPPORT

When A Payer Payment Does't Match The Circumstances

Sometimes, a provider delivers a covered service but the payment received does not match the circumstances of the claim. For certain out of network claims, the dispute may qualify for the applicable Independent Dispute Resolution process rather than going through a standard appeal.

IDR can involve specific deadlines, paperwork, and procedural requirements. PrimeCore Medical Billing helps with the billing and administrative side of eligible IDR cases, including:

Organizing claim and payment documentation

Reviewing billing records related to the dispute

Tracking important
deadlines

Keeping required documents organized

Supporting the administrative steps throughout the process

Maintaining clear billing records for the disputed claim

We do not promise a guaranteed payment, specific settlement amount, or guaranteed outcome. Those decisions depend on the applicable IDR process and the circumstances of each case. Our role is to keep the billing and administrative work organized and handled carefully, so important details or deadlines are not missed.

BUILT AROUND YOUR PRACTICE

Who We Serve

Small & Private Practices

Billing support for practices that need experienced help without building an internal billing department from scratch.

Specialty Practices

Workflows adapted to the coding, documentation, and payer requirements that come with specialty care.

Physician Groups

Consistent billing processes across multiple providers, locations, and payer relationships, so nothing falls through the cracks between offices.

Clinics & Multi-Provider Practices

Billing support that scales as your provider count and patient volume grow, instead of buckling under the added workload.

Hospitals & Healthcare Organizations

Support for higher claim volume and more complex payer relationships, with the same visibility into A/R and denials.

Freestanding Emergency Departments (FSEDs)

Billing and revenue cycle support for freestanding emergency departments and their complex billing requirements.

Urgent Care Centers

Billing support designed around urgent care claim volume, payer requirements, and timely reimbursement.

Ambulatory Care Centers

Revenue cycle support for ambulatory care organizations managing professional and facility billing needs.

Emergency Departments

Billing and RCM support for emergency department services and complex payer relationships.

Behavioral Health Practices

Billing support adapted to behavioral health services, documentation, coding, and payer requirements.

Independent Laboratories

Billing and revenue cycle support for laboratory services, payer requirements, claims, and reimbursement.

Multispecialty Practices

Connected billing support across multiple specialties, providers, payer relationships, and workflows.

Surgical & Specialty Centers

Billing support for surgical and specialty services with attention to coding, documentation, claims, and reimbursement.

Healthcare Organizations & Medical Facilities

Revenue cycle support for healthcare organizations and medical facilities with complex billing and payer needs.

MEDICAL BILLING OUTSOURCING

Should You Keep Billing In House or Outsource It?

In house billing works well for plenty of practices, especially smaller ones with manageable claim volume and dedicated staff. Outsourcing tends to make sense once claim volume, denial rates, or A/R backlog have grown past what your current staff can realistically stay on top of, not as a replacement for a team that’s already working hard, but as backup for the parts that have outgrown it.

Here’s a simple way to think about the tradeoff:

Keep Everything In House

Hiring and training billing staff

Covering staff absences and turnover

Internal team managing all A/R

Manually tracking denials

Limited visibility into billing status

Administrative workload that keeps growing

Work With PrimeCore Medical Billing

Dedicated billing support already in place

Continuity of billing work regardless of staffing changes

Structured, ongoing A/R follow up

Organized denial management with pattern tracking

Regular, clear reporting

Support that scales with your practice

If you're weighing whether to outsource your medical billing or keep it in house, that decision usually comes down to volume, complexity, and how much time your staff is currently spending on billing instead of patient care.

The Full Revenue Cycle, One Connected Process

Healthcare revenue cycle management covers the entire financial journey of a patient encounter, not just the claim itself:

Patient Registration

Eligibility Verification

Coding

Charge Capture

Claim Submission

Claim Tracking

Payment Posting

Denial Management

A/R Follow Up

Patient Balances

With no shared visibility, information gets lost between handoffs. An eligibility issue doesn't get flagged before coding. A coding question doesn't get resolved before submission. A denial doesn't get connected back to what actually happened on the original claim. As a medical billing and revenue cycle management company, we manage this as one continuous process, so each stage carries the context from the one before it.

Specialties We Support

PrimeCore Medical Billing supports practices across primary care and specialty medicine, including but not limited to:

Primary Care

Cardiology

Orthopedics

Dermatology

Mental Health

Neurology

Gastroenterology

Pain Management

Physical Therapy

Urgent Care

Family Medicine

Internal Medicine

Pediatrics

OB/GYN

General Surgery

Radiology

Behavioral Health

Anesthesiology

Multi-Specialty Practices

Emergency Medicine

Hospital Medicine

Independent Laboratories

If your specialty isn't listed here, that doesn't mean we can't support it. It means we build the workflow around what your specialty actually requires.

What You Can Expect From PrimeCore Medical Billing

When you work with PrimeCore, you can expect:

Direct Communication

Clear and timely updates on claims, denials, A/R, payments, and billing activity.

A Team That Knows Your Account

Consistent billing professionals who understand your practice, history, workflows, and payer relationships.

A Workflow Built Around Your Practice

Billing processes tailored to your specialty, payer mix, provider structure, and existing workflow.

Proactive A/R Management

Outstanding balances are actively worked and prioritized rather than simply reported.

Denials That Get Investigated

We identify the reason behind a denial, address the underlying issue, and take the appropriate next step rather than simply resubmitting.

End-to-End RCM Support

From front-end processes and claims through payment posting, denials, A/R, and revenue recovery.

Clear, Actionable Reporting

Reports that help you understand collections, A/R, claims, denials, and overall revenue-cycle performance.

Specialized IDR Support

Support with eligible out-of-network payment disputes through the Independent Dispute Resolution process.

Still have
questions?

Our team is here to help. Get in touch and we’ll be happy to answer your questions or help you find the right solution for your practice.

ANSWERS FOR YOUR PRACTICE

FAQs

Why should a medical practice outsource medical billing?

Practices usually consider outsourcing once claim volume, denial rates, or unpaid A/R have grown beyond what in-house staff can manage alongside patient care. Outsourcing gives practices access to billing professionals and a structured workflow without the cost of hiring and training an internal team, and it can make claim follow up and reporting more consistent.

What medical billing services does PrimeCore Medical Billing provide?

PrimeCore Medical Billing provides medical billing and coding, claims management, denial management, A/R management, eligibility verification, prior authorization support, payment posting, credentialing, revenue cycle management, payer enrollment, EDI setup, contracting and payer support, patient billing, out-of-network billing, IDR related billing support, and reporting and RCM analytics. Services can be scoped to match what a specific practice actually needs. A Free Billing Assessment & Audit can help identify which services may be most relevant to your current billing needs.

Can PrimeCore Medical Billing work with small medical practices?

Yes. We work with private practices and small medical practices as well as larger multi provider groups. Billing support is scaled to the size of the practice, so a smaller practice isn't paying for services built for a much bigger operation.

Does PrimeCore Medical Billing provide medical billing and coding services?

Yes. Coding and claim preparation are aligned with your clinical documentation, which helps reduce the kinds of preventable errors that lead to denials or delays.

Does PrimeCore Medical Billing provide A/R management?

Yes. Outstanding balances get structured, ongoing follow up, with older and higher priority accounts worked first so aging claims don't get left behind.

Can physicians outsource their entire revenue cycle?

Yes. You can outsource the full revenue cycle, from eligibility verification through coding, claims, payment posting, denial management, and A/R follow up, or choose to outsource just specific parts of it, depending on what your practice actually needs. A Free Billing Assessment & Audit can help determine where support may be needed most.

Does PrimeCore Medical Billing provide credentialing and medical billing services?

Yes. Credentialing support includes help with provider enrollment and payer participation, often paired with ongoing billing services so credentialing delays don't hold up your ability to bill and get paid.

Can PrimeCore Medical Billing help with IDR related billing processes?

We can support the administrative and billing side of eligible IDR cases, including organizing claim documentation and tracking relevant timelines. This support doesn't include legal representation, and no specific outcome is guaranteed.

Can PrimeCore Medical Billing work alongside our existing billing staff?

Yes, if that fits what your practice needs. Some practices want full service billing, while others just need help with a specific piece, like A/R, denials, coding, or claims follow up.