Even the most organized clinics in Georgia hit billing roadblocks. Here are some frequent headaches we help solve every day:
Due to coding mismatches or missing documentation.
From major payers like Blue Cross Blue Shield of Georgia, Cigna, and UnitedHealthcare.
Especially for behavioral health and pediatric services.
That vary across carriers.
From unposted ERAs, underpaid claims, or missed secondary billing.
We don’t just process claims—we manage the whole revenue cycle from patient check-in to final payment.
Our team verifies insurance coverage and benefits before each visit. We confirm co-pays, deductibles, and prior authorizations with Georgia payers such as Aetna, BCBSGA, and Cigna.
Our certified coders (CPCs and CCSs) ensure every claim meets Georgia-specific and federal billing regulations. We review documentation and apply correct CPT, ICD-10, and HCPCS codes.
We start right at the front desk—ensuring all patient details, demographics, and insurance data are accurately entered. Proper registration helps prevent rejections and claim errors before they even start.
We track every unpaid or denied claim. Our team appeals denials, identifies root causes, and prevents repeat issues — helping you recover thousands in lost revenue.
Before any claim leaves your practice, our billing specialists scrub it for coding accuracy, missing modifiers, and payer-specific rules. Clean claims mean faster reimbursements and fewer denials — period.
We manage statements, payment plans, and patient inquiries to keep your collections steady and your staff stress-free.
Healthcare billing in Georgia isn’t just about clean claims — it’s about staying ahead of an evolving web of state and federal rules. One small oversight in documentation or coding can trigger payment delays, audits, or even compliance penalties. That’s why we keep your billing airtight and fully aligned with Georgia’s healthcare laws and payer requirements.
Here’s how we make sure your practice stays compliant at every step:
We stay up to date with the Georgia Medicaid Management Information System (GAMMIS) to ensure your claims meet every requirement — from EPSDT (Early and Periodic Screening, Diagnostic, and Treatment) standards for pediatric services to telehealth and managed care billing protocols. We handle Medicaid and its Managed Care Organizations (Peach State, Amerigroup, and CareSource) with precision — no guesswork, no missed revenue.
Under Georgia’s Prompt Pay Law (O.C.G.A. §33-24-59.5), insurers must pay all “clean claims” within 15 days for electronic submissions and 30 days for paper claims. We track payer timelines closely, escalate delays, and file appeals when carriers fail to meet their payment obligations — so your practice never leaves money on the table.
Patient data security isn’t optional — it’s essential. Our systems comply with all HIPAA, HITECH, and PHI protection standards to safeguard every piece of patient information. From encrypted file transfers to restricted system access, we treat your data like it’s our own — secure, private, and fully compliant.
Georgia has specific scope-of-practice laws that affect billing for nurse practitioners, physician assistants, and behavioral health professionals. We ensure your claims reflect the correct provider type, supervision requirements, and service limitations defined by the Georgia Composite Medical Board (GCMB) and DCH, keeping your billing accurate and audit-proof.
We also keep your practice aligned with the federal No Surprises Act and Georgia’s own balance billing rules. This helps you stay transparent about costs while avoiding compliance pitfalls when treating patients with out-of-network insurance plans.
We proudly serve a wide range of specialties across the state — from large hospitals to small-town clinics.
We understand the payer mix, regional trends, and Medicaid complexities specific to the state.
Our first-pass acceptance rate is over 98%, minimizing delays and denials.
You’ll work with a real human who knows your practice, not a generic support line.
Get detailed monthly reports showing your collections, denials, and KPIs.
Choose from full-service billing or a la carte solutions that fit your clinic’s size and budget.
We combine technology, experience, and good old-fashioned accountability to keep your revenue cycle running strong.
Stop losing sleep (and revenue) over rejected claims. Whether you’re a solo provider or a multi-location clinic, we’ll help you collect faster, stay compliant, and focus on patient care.
FaqsYes. We work with solo providers, group practices, and multi-specialty medical centers across the state. Whether you’re a one-physician family clinic in Augusta or a growing outpatient center in Atlanta, our billing process scales to your needs. We tailor solutions for your claim volume, specialty, and payer mix — so you get the same precision and performance no matter your size.
Absolutely. We handle both traditional Medicaid and Managed Care plans such as Amerigroup, CareSource, Peach State, and WellCare, all operating under Georgia’s Department of Community Health (DCH). Our team understands GAMMIS submission workflows, prior authorization rules, and EPSDT requirements inside out. We make sure every Medicaid claim follows state-specific policies to the letter, so payments arrive quickly and cleanly.
Yes. We manage complete provider credentialing, revalidation, and CAQH profile updates for Georgia-based providers. From filling out payer applications to tracking status updates and handling re-enrollment deadlines, we take the administrative headache off your hands. Our credentialing specialists ensure you get approved faster with top insurers like BCBSGA, UnitedHealthcare, Aetna, and Cigna — helping you start billing sooner.
We offer flexible pricing options — either a percentage of collected revenue (a small share) or flat monthly rates based on your claim volume. There are no setup fees, long-term contracts, or hidden charges. You pay only for what you need, and you keep complete visibility into collections and performance through monthly reports.
Yes, we work with PracticeMate, but we also integrate seamlessly with other billing systems, including Kareo, AdvancedMD, Athenahealth, and eClinicalWorks. If your current software is causing claim delays, duplicate entries, or payment posting issues, we can help transition you to a more efficient platform. Our goal is simple — to streamline your workflow, eliminate technical roadblocks, and keep your billing process smooth and transparent.
