Even the most organized clinics in South Carolina face recurring billing headaches. Here’s how we help fix them:
✅ Frequent Medicaid Rejections: We handle SCDHHS and MCO submissions correctly the first time — including secondary payer setups and crossover claims.
✅ Missed Authorizations: Our pre-visit eligibility checks flag missing pre-auths before you deliver care.
✅ Incorrect Modifiers: We apply South Carolina payer-specific modifier rules to avoid bundling issues and partial denials.
✅ Underpayments and Delayed Reimbursements: We compare remits to contract rates and appeal underpayments within 3–5 business days.
✅ CAQH and Credentialing Delays: We manage credentialing, revalidations, and payer enrollments to prevent reimbursement interruptions.
Your time belongs to your patients—not to payer portals. PracticeMate handles the rest.
Before every encounter, we verify coverage, copays, and deductibles through payer portals like BlueChoice and Healthy Connections Medicaid, preventing claim rejections and surprise bills.
Our AAPC-certified coders ensure every CPT, HCPCS, and ICD-10 code is accurate, fully supported by documentation, and compliant with SCDHHS and federal payer guidelines: no mismatched codes, no denials.
We scrub claims using payer-specific edits and submit them within 24–48 hours of encounter entry. Each claim meets the exact format required by South Carolina Medicaid and MCOs, ensuring near-perfect acceptance rates.
Our team tracks every denied or underpaid claim, identifies the root cause, and resubmits with complete documentation. We recover lost revenue fast and reduce recurring denial rates by up to 70%.
Old claims or unpaid balances? We specialize in recovering aged A/R, even those over 120 days old. Our follow-up team negotiates with payers to clear your overdue payments.
We handle credentialing for Medicaid, Medicare, and commercial payers, including Select Health, Molina, and Absolute Total Care. Our team manages CAQH updates, revalidations, and renewals to keep your credentials active and your revenue flowing.
We simplify patient statements and support calls, helping your patients understand their balances clearly. This transparency improves collections and boosts patient satisfaction.
We align your documentation and billing process with HIPAA, SCDHHS, and Palmetto GBA audit standards. Our preventive audit approach reduces penalties and ensures complete legal protection.
Our real-time dashboards provide visibility into claim trends, collection ratios, and payer performance. You’ll know exactly where your revenue stands — every day, without digging through spreadsheets.
We manage end-to-end billing and compliance for SCDHHS Medicaid, including plan-specific rules for Absolute Total Care, Molina Healthcare, and Select Health. Every claim is validated for modifier accuracy and eligibility before submission.
Our billing team aligns with payer-specific edits from BlueChoice HealthPlan, UnitedHealthcare, Aetna, and others — cutting denials by up to 65% through real-time claim scrubbing and cross-checking.
From Part B physician claims to Medicare Advantage, we ensure each submission meets Palmetto GBA's regional rules — preventing costly audit triggers.
We track denial patterns, perform internal audits, and create corrective action reports that help clinics pass payer or SCDHHS reviews with confidence.
South Carolina’s healthcare providers span every specialty — and so do we. Our billing team includes certified coders trained in payer rules for:
Our billing team is trained on SCDHHS, Select Health, and BlueChoice policies.
We file claims within 48 hours and maintain a 97% clean claim accuracy rate.
Preventive audits ensure every claim complies with requirements before submission.
Real-time dashboards track claim status, A/R days, and revenue growth.
Month-to-month pricing. No setup fees, no hidden charges.
We’re not just your billing company—we’re your financial operations partner.
PracticeMate proudly partners with clinics, hospitals, and solo practitioners in:
No more chasing unpaid claims, no more worrying about denials, and no more guessing if your revenue matches your effort.Our South Carolina billing experts handle everything — from Healthy Connections Medicaid submissions to BCBS, Select Health, and Molina claim follow-ups — with precision, speed, and total compliance.
FaqsYes. We serve solo practitioners, specialty clinics, and multi-location hospital groups across the state. Whether you're running a private behavioral health office in Charleston or a multi-specialty group in Columbia, we customize your billing process to your workflow and payer mix.
Absolutely. We manage claims through Healthy Connections Medicaid (SCDHHS) and its managed care networks — Select Health, Molina, Absolute Total Care, and Healthy Blue. Our team stays current on SCDHHS bulletins and policy updates, so your claims always meet the latest requirements.
Yes. We handle Medicaid, Medicare, and private payer credentialing, including CAQH management and revalidation. We reduce approval delays by up to 45%, ensuring you stay enrolled, verified, and paid without interruption.
Yes—we offer a wide range of specialties, including family medicine, pediatrics, behavioral health, physical therapy, OB/GYN, cardiology, and chiropractic care. Each specialty has its own billing rules, and our coders are trained to apply payer-specific edits for each field.
We're local-minded and compliance-driven. Every billing specialist assigned to your account understands South Carolina's Medicaid and commercial payer landscape. You'll have a dedicated account manager, transparent reports, and real-time claim visibility—not a faceless outsourcing team.
