About PrimeCore
Medical Billing
Experience You Can Measure
17 Years
of Experience
12+
Clients/Providers
92%
First Pass Claim Rate
45 Days
Average A/R Days
Nationwide
U.S. Billing Coverage
Medical Billing Built Around Your Practice
Our Story
Who We Are
What We Do
Medical Billing and Claims Management
We handle charge entry, claim scrubbing, submission, and status tracking. Our medical claims management process checks claims for common errors before they go out, which helps cut avoidable rejections and denials. Eligibility and benefits verification and authorization support come first, since a lot of downstream problems start there.
Denial Management and A/R Follow-Up
Denials get worked, not just logged. We find out why a claim was denied, fix what can be fixed, appeal when there's a basis, and track patterns so the same issue doesn't keep coming back. Unpaid and underpaid claims get steady follow-up until they're resolved.
Coding, Payment Posting, and Reconciliation
Our medical billing and coding specialists review documentation so claims are coded correctly from the start. On the back end, we post payments, compare them to expected reimbursement, and flag underpayments for review. Reconciliation keeps your records and your bank deposits in agreement.
Credentialing and Payer Support
Provider enrollment, credentialing, payer enrollment, and EDI services can hold up revenue for months when they go wrong. We support these processes and help with contracting questions and payer communication. For eligible out-of-network claims, we also provide out-of-network billing services and No Surprises Act (NSA) and IDR services. This includes administrative support through the applicable IDR process, including documentation, submission support, case tracking, and determination follow-up. No specific outcome is guaranteed.
Revenue Cycle Management
For practices that want one team accountable for the whole process, we provide full revenue cycle management. That includes hospital billing and coding services, professional and facility billing, hospital and FSED billing, freestanding emergency department (FSED) billing and coding services, DME billing and services, dental billing services, patient billing and support, and reporting and RCM analytics. If you'd rather keep some tasks in-house, you can hire us for specific parts of the cycle.
Our Approach to Revenue Cycle Management
What Makes PrimeCore Different
- A real point of contact who knows your account
- Claims and A/R worked on a schedule, so old balances don't sit while today's claims take priority
- Attention to the whole revenue cycle, beyond the claim submission step
- Denial trends tracked, so the cause gets fixed and not only the one claim
- Plain-English reports on claim status, denial reasons, and A/R trends
- Medical billing solutions for physicians built around your specialty and payer mix
- Work with your front office as well as the billing side, since check-in decides a lot of what happens later
- Early warning when something goes wrong or needs your attention
- Full RCM, or only the pieces you need
Our Commitment to Healthcare Providers
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.
Frequently Asked Questions
We provide professional medical billing services for healthcare providers, along with the revenue cycle work that keeps a practice paid. That covers charge entry, claim submission, payment posting, denial resolution, A/R recovery, eligibility and benefits verification, and reporting. Our medical billing support for healthcare providers can take on the full cycle or specific pieces of it.
Yes. We handle the full cycle, from front-end verification to final payment reconciliation. You can also hire us for individual services, such as denial management or A/R follow-up.
Yes. Physician practices are at the center of our work. Our physician billing solutions support independent physicians, group practices, and multi-provider organizations, and we can work alongside your existing billing staff if that fits your setup.
Yes. We're a medical billing company for small and large practices. Small practices get a reliable outsourced billing team, and larger practices and healthcare organizations get consistent processes across many providers.
Yes. As a medical billing and coding company, we handle coding review, claim preparation, and submission together, so claims match the clinical documentation behind them.
We stay involved after claims are submitted. Our focus is on clear communication, steady follow-up, plain reporting, and workflows built around each practice.