MedCare MSO has managed revenue cycles for small practices for over a decade. Our medical billing services for small practices are priced for small teams, and they scale as you grow, supporting your clinical and financial performance. Our tailored RCM workflows reduce administrative workload, giving your team more time to focus on patient care.
Book A Free Consultation96%
Collection Ratio
98.5%
First Pass Clean Claims Rate
35%
Revenue Increase
35%
Reduction in A/R
98.5%
Clean Claims
You may run a small practice, but your medical billing should be as strong as that of a larger one. Since 2012, MedCare MSO has run revenue cycles for practices of every size, and we bring that same depth to solo providers and small teams, at pricing that scales with your collections.
Get a free billing analysis35%
Reduction in A/R
In medical billing for small practices, every claim moves through the same cycle. Here is the path and where we take over.
Before the visit, we verify insurance eligibility and benefits, capture patient demographics, secure prior authorization where required, and collect co-pays, coinsurance, and deductibles up front, with Good Faith Estimates for uninsured or self-pay patients when required.
Merely obtaining the authorization number is not enough to ensure getting paid, the insurance company has to accept the claim as well.
Provider documentation drives charge capture. Certified coders assign ICD-10-CM diagnosis and CPT and HCPCS Level II procedure codes with the correct modifiers, confirm that documentation supports applicable medical-necessity requirements, scrub every claim against NCCI edits and payer rules, and submit it electronically using the 837P transaction, which corresponds to the CMS-1500 paper claim form, through the clearinghouse.
The payer, Medicare, Medicaid, Medicare Advantage, or commercial, adjudicates the claim against coverage, your contracted fee schedule, and coding rules, then returns an 835 ERA showing the allowed amount, payment, contractual adjustment, and patient responsibility. We post payments, bill secondary insurance under coordination of benefits, send patient statements, and work every denial, underpayment, and aging balance until A/R converts to cash.
The claim is returned for invalid or missing data before any coverage decision, then corrected and resent. Claim scrubbing catches many errors before submission that could otherwise cause a rejection.
Claim is adjudicated but denied because of claims not being eligible, appropriate authorizations not being provided, not being coded correctly, not being proven to be medically necessary, containing duplications, not covered under coordination of benefits policies or timely filing reasons. These get root-cause analysis, correction, and appeal.
These four challenges are common to nearly every small practice we have dealt with, and here is how we handle each of them.
As a medical billing company for small practices, we see the same four challenges in nearly every practice we work with, and here is how we handle each of them.
CPT, ICD-10-CM, HCPCS Level II codes, as well as payer rules, are regularly modified, making it challenging for busy front-office personnel to keep track of them.
Our AAPC-certified coders receive ongoing training and review each encounter, so claims go out accurately the first time.
Small teams lose valuable staff hours to claims, follow-ups, and payer calls.
We create and submit claims, proactively calling in for follow-ups and posting payments, thus minimizing the need for administrative staff.
If there is no credentialing support, practitioners can be delayed in enrollment and participation, which will result in a lack of reimbursement for their services.
Our credentialing services support enrollment in commercial and government payer networks, with a 95 percent approval success rate.
Aging accounts are left unresolved due to a lack of time for constant follow-ups with payers as well as loss of revenue that happens after 120 days.
Our A/R recovery strategies have reduced outstanding balances by up to 30 percent and recovered revenue from accounts over 120 days old.
We keep medical billing for small practices affordable, including solo providers, through pricing that scales with actual collections.
Get a Free Billing AnalysisA dedicated billing expert supports you by phone at every step. Here is what our clients gain.
Automation and layered checks catch coding mistakes before submission, helping reduce avoidable claim rejections and denials.
Skip the cost of hiring, training, and equipping an in-house billing team. For a solo practice, the switch often pays for itself quickly.
Our dedicated team handles every denial, from complete rejections to easy fixes.
Your dashboard will allow you to monitor collections, denials, and A/R so that you can make strategic business decisions based on your data.
Increase A/R follow-up, coding review, or launch a new office without the security risks of hiring in-house staff.
You can focus on the patients while we take care of all billing needs, and you will be able to inform your customers about clear services, pending dues, and payments in one place.
Medical billing for small practices follows the same cycle as any large group, but with less room for error. One denied claim hits a small team's revenue harder. Here is each step and how our medical billing services for small practices handle it so nothing falls through.
We gather all details related to patient demographics and insurance at scheduling. Most downstream denials trace back to errors that are made here.
Before the visit, we verify coverage, benefits, co-pays, deductibles, along with plan-specific limits in real time, and flag inactive or out-of-network coverage.
We secure payer-required authorizations before services are provided, with claim documentation to support these claims.
We collect co-pays, coinsurance, and applicable deductibles before the appointment, and prepare Good Faith Estimates for uninsured and self-pay patients.
Our AAPC-certified coders code straight from your documentation with correct ICD-10-CM and CPT/HCPCS codes, right modifiers, and medical necessity verified against LCDs and NCDs.
We scrub every claim against NCCI edits, payer rules, and your specialty's edit library before it goes out, so errors get fixed right at this stage.
Clean claims go out electronically via 837P through the clearinghouse. If a claim is rejected due to missing or incorrect information, we fix it and resubmit the claim on that same day.
When we receive the 835 ERA from the payer, we post the payment and any adjustments and tally them against your contracted rates, checking for underpayments.
Denials are rectified at their source and not merely refiled. The cause of the denial, be it eligibility, coding, authorization, or late filing, is fixed.
We handle secondary claims, patient statements, and every aging balance, even 120+ day accounts, until it converts to cash. You watch it all from your live dashboard.
Maximus, our cloud-based medical billing software, manages clinical and financial operations in one secure, HIPAA-compliant platform, with charge entry rules and claim edits configured for your specialty rather than a generic template. Our AI-driven tools flag likely denials before submission and check claim status around the clock, and sensitive data is encrypted in storage and in transit. Prefer your current system? We also work inside the software you already own.
From claim creation to payment collection, across every specialty we serve. If yours is not listed, ask our billing manager.
Cardiology
Pulmonology
Hepatology
Hematology
Psychiatric
Traumatology
OB-GYN
Dermatology
Gastroenterology
Nephrology
Small practices face the same regulatory risks as larger groups. Our billing processes are aligned with the frameworks that govern them: HIPAA privacy and security rules protect patient data through encrypted systems and trained staff, and every engagement starts with a formal Business Associate Agreement. We also pay attention to Stark Law, the Anti-Kickback Statute, and the False Claims Act. Our coders verify claims with respect to Local Coverage Determinations (LCDs) and National Coverage Determinations (NCDs), while documentation is created to serve payer and governmental audits.
As of 2026, the requirements of CMS-0057-F regarding prior authorizations are applicable, including denial reasons and decision periods, with additional requirements regarding APIs in 2027. According to the No Surprises Act, organizations are obliged to provide Good Faith Estimates for patients who do not have insurance or pay for services.
We also track what is coming. HHS has proposed the largest overhaul of the HIPAA Security Rule in more than two decades. We already encrypt sensitive data in storage and in transit and restrict access, while we continue monitoring the rulemaking.
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Our medical billing services for small practices provide a complete solution, including system setup, electronic data interchange (EDI) setup, documentation, and process management. There are no software installation fees, making it an affordable choice for practices of all sizes.
I highly recommend MedCare MSO if you are looking for help with your billing and gain some freedom to see more patients or manage your business.
Practice Owner, TXEC
MedCare MSO has been an excellent organization to work with, I highly recommend them for their quality of service and commitment to excellence.
Back Office Manager, STST
We are definitely impressed by the Team’s performance. I worked with a lot of different folks from all over the world on different business transactions, and Mark is truly a top notch talent!
Director of Corporate Development, SC & SF
MedCare MSO’s exceptional communication and expertise elevated our RCM experience and my bank accounts!
Owner, R.D.
MedCare MSO did a great job with our billing and helping clean up old AR. Regular updates and good communication were very appreciated.
Co-Owner, PCP
Chief Operating Officer, MAKO MEDICAL LABORATORIES
Chief Executive Officer, CARE NOW CLINIC
Chief Operations Officer, ION DIAGNOSTICS
Co-Founder, AW Care
Working with MedCare MSO has been a game-changer for my practice. Their expertise in medical billing, AR management, and coding has significantly streamlined our revenue cycle, reduced claim denials, and improved cash flow. The team is proactive, detail-oriented, and always available to address my concerns.
Practice Owner, F&A Clinic
We have experienced tremendous improvements within our billing and claims department that we have entrusted MedCare MSO to manage.
President/CEO, RLT
I am impressed with MedCare MSO’s promptness to respond to any inquiries, with the time they dedicate to reviewing each one of the cases.
Practice Owner/FBH
Medical billing for small practices is the process of converting each patient visit into a clean, payer-ready claim: verifying eligibility, applying the correct ICD-10 and CPT codes, submitting the claim to insurance payers, and following up until payment posts. A practice can handle it with in-house staff or outsource it to a medical billing company for small practices.
Mostly, yes. Because outsourcing fees change with collections or claim volume of the practice, a solo practice pays for the billing it actually generates instead of a full-time salary. Medical billing services for small practices bring down the fixed cost of staffing, software setup, and training. Tell us your specialty and monthly collections.
No. You keep live access to the same dashboards our billers use, a dedicated billing expert reachable by phone, and audit rights in the contract. Outsourcing the work does not mean outsourcing the oversight.
MedCare MSO charges on your net collections. We are paid on what actually arrives in your account, not on what was billed.
Yes. We work software-agnostic, inside the practice management system and EHR you already own, or you can use our Maximus platform at no installation cost. Either way, your data stays under your access controls.
We develop a strategy that minimizes billing problems experienced while changing systems. While new claims are being submitted right from the start of the onboarding process, your company will continue to work on its previous invoices, and this will ensure that cash flow does not stop or get affected in any way.
We follow all security regulations and requirements set down in HIPAA. All sensitive information is encrypted. Staff that works with billing are trained periodically regarding security issues. All patient data is sent through secure channels.
We work them. Our A/R recovery team starts working on your existing backlog. This also includes the account over 120 days old. Meanwhile, existing A/R is reviewed and submitted subject to payer timely filing, appeal, documentation, and contractual requirements.
Tell us your specialty and monthly collections, and our team returns a written assessment of your denial patterns, A/R aging, and the revenue an outsourced model would target. A member of our team responds within 12 hours.
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TXEC
I have worked with MedCare MSO for the past eight months, and it has been a great experience. Moses, Mark, Travis, Sebastian, and Tammy have been a pleasure to work with, as well as the rest of the team, including the credentialing folks.
I highly recommend this group and MedCare MSO if you are looking for help with your billing. They will meet with you once a week to review the issues that need to be fixed to improve your payment and capture rate.
If you are looking for help with your billing and gain some freedom to see more patients or manage your business, this is the team you need to work with.
Dr. Jose Correa
Practice Owner
TXEC
STST
MedCare MSO has been an excellent organization to work with. Mark has consistently demonstrated outstanding attention to detail, thorough documentation, and strong professionalism in maintaining accurate records of his findings.
His reliability and dedication have contributed greatly to a positive experience.
I highly recommend MedCare MSO for their quality of service and commitment to excellence. I can’t say enough good things about Mark and his company.
Thank you
Shaunna Mock
Back Office Manager
STST
SC & SF
Hi Ali, I hope this message finds you well. I wanted to give you some feedback on the team.
We are definitely impressed by the Team’s performance. Definitely what we were looking for from switching partners.
In particular Mark Zaiden has been very helpful. In my 5+ years of experience as a M&A Professional, I worked with a lot of different folks from all over the world on different business transactions, and Mark is truly a top notch talent!
Austin has done a great job of leading the communications process and keeping the train going in the right direction. Tammy and some other folks have been key players as well. We really are happy with everyone on the team.
I wanted to pass this feedback along to you as we are really pleased with working with MedCare MSO so far.
Have a great weekend!
Max Owens
Director of Corporate Development
SC & SF
R.D.
MedCare MSO’s exceptional communication and expertise elevated our RCM experience and my bank accounts!
Most helpful is the open/responsive communication of their team with my office and each other, along with the specialty levels of expertise amongst my team for each aspect of RCM.
Kelly Ballou
Owner
R.D.
F&A Clinic
Working with MedCare MSO has been a game-changer for my practice. Their expertise in medical billing, AR management, and coding has significantly streamlined our revenue cycle, reduced claim denials, and improved cash flow. The team is proactive, detail-oriented, and always available to address my concerns.
I would like to take time to recognize two members of MedCare MSO specifically. Moses for his exceptional support and dedication. He is always responsive, and knowledgeable, and goes above and beyond to ensure smooth operations. His professionalism and commitment make a huge difference in our day-to-day workflow. George also for his quick feedback and recognition of what is needed most. He is extremely efficient and always available for clarification and to share his knowledge and expertise.
I highly recommend MedCare MSO to any healthcare provider looking for a reliable and efficient billing partner.
RLT
Hello,
I am writing this email to express our appreciation of the MedCare MSO’s team and all they have done for our business at RLT. In the past year, we have experienced tremendous improvements within our billing and claims department that we have entrusted MedCare MSO to manage. We went from having over $100k in uncollected/billed claims to now reaching near $100k in collection some months.
We are also happy to express our thankfulness that MedCare MSO is now helping us acquire new contracts with different insurance companies. This will in effect benefit everyone involved, allowing us to expand our services and provide more resources for our staff/business partners.
Please note special appreciation for the following:
David Lucas
Mario Ortega
Ambrose William
FBH
I have been a customer of MedCare MSO for one year. They have provided billing and credentialing services for my private behavioral health practice, and I am impressed with their promptness to respond to any inquiries, with the time they dedicate to reviewing each one of the cases, and with their willingness to educate me and my staff about the ever-changing rules of medical billing and the best use of coding. This is a company I Trust with my billing needs.
Dr. Neufeld
Practice Owner
FBH
