Medical billing and coding that gets claims paid the first time
ClaimEdgeSolutions certified coders review documentation, assign accurate CPT, ICD-10-CM and HCPCS codes with the right modifiers, and submit clean electronic claims within 24–48 hours of the visit. You see fewer rejections, faster payments and a cleaner audit trail.
Common problems we fix
If any of these are happening in your practice, revenue is slipping away every week.
- Under-coding that quietly leaves earned revenue on the table
- Modifier errors (25, 59, XU) that trigger NCCI edits and denials
- Charge lag that pushes claims past payer filing limits
- In-house staff stretched between the front desk and billing
How ClaimEdgeSolutions handles medical billing & coding
Charge entry & capture
Every billable service from your EHR, superbill or op note is captured and reconciled against the schedule.
Certified coding
CPC/CCS coders apply CPT, ICD-10-CM and HCPCS Level II codes to the highest supported specificity.
Claim scrubbing
Claims pass payer-specific and NCCI edits before they leave, so errors are fixed before a payer sees them.
Electronic submission
837P/837I claims go out through your clearinghouse with rejection monitoring every day.
Payment posting
ERA/835 and paper EOB payments are posted line by line, with underpayments flagged against your contracts.
Coding audits
Quarterly documentation and coding reviews with provider feedback to keep risk low and revenue right.
Specialists who own your medical billing & coding
You get named people who learn your providers, payers and workflows, not a rotating queue. Every open item has an owner and a deadline.
- Charge entry & capture
- Certified coding
- Claim scrubbing
The metrics we report on
Your monthly report tracks these numbers for this service, alongside your overall revenue cycle KPIs.
First-pass claims accepted without edits
Days from date of service to claim
Audit-verified code selection
From audit to results in four steps
Free revenue audit
We review your A/R aging, denial history, payer mix and coding patterns, then show you what is recoverable.
Onboarding
BAA signed, secure system access set up, workflows mapped and your dedicated team assigned.
Daily operations
Claims, payments, denials, A/R and patient billing are worked every business day.
Monthly review
A KPI report and a call with your account manager covering results and next steps.
Often paired with Medical Billing & Coding
Revenue Cycle Management
End-to-end RCM from patient scheduling to the final zero balance.
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Credentialing & Enrollment
Get providers enrolled with payers faster, and keep them active.
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Denial Management
Work every denial, win the appeal, and fix the root cause.
Explore serviceAvailable for every specialty, including
Frequently asked questions
Straight answers about how ClaimEdgeSolutions works with your practice.
Ask us anything01Do you work in our existing EHR and practice management system?
Yes. We work inside your current systems (athenahealth, eClinicalWorks, Kareo/Tebra, AdvancedMD, NextGen, ModMed and others) through secure, HIPAA-compliant access. No migration is required.
02Are your coders certified?
Coding is performed by AAPC- or AHIMA-credentialed coders, with specialty-specific training for the practices they support.
03How fast are claims submitted?
Our standard is claim submission within 24–48 hours of receiving complete documentation.
04Who owns the data?
You do. All records stay in your systems and you keep full access at all times.
05Do you sign a Business Associate Agreement?
Yes. A BAA is signed with every client before we access any protected health information.
See where your revenue is leaking
Get a free, no-obligation revenue audit. We review your A/R, denials and coding patterns and show you exactly what is recoverable.