Medical Billing Services Built for Practices That Are Outgrowing Their Billing
Outsourced medical billing for independent clinics, multi-specialty groups, and health systems — run as a managed operation: denial prevention governed by CRIS 2.0, live performance dashboards, and one consistent standard across every provider and location. On the systems you already use.
14+
270+
>96%
ISO 27001
The Revenue That Never Arrives
days in A/R
Denial Reduction
Denials Worked / Month
The leak is predictable. So is the fix.
Trusted by 270+ healthcare organizations nationwide
Built for Where You Are — and Where You're Headed
Three kinds of organizations run their billing on Neolytix. Find yours.
Multi-Specialty Groups & Multi-Site Practices
Billing consistency across locations, denial root-cause analytics, and 30/60/90-day forecasting — without adding headcount.
Hospitals & Health Systems
Physician billing services for hospitals — run at scale inside Epic, with audit-ready documentation and multi-entity dashboards.
Independent Practices & Clinics
Full-service billing that gets you paid faster — without hiring anyone. Simple pricing, monthly performance summaries.
What Outsourced Medical Billing Services Should Cost — and What It Should Deliver
Most practices spend 13–14% of collections keeping billing in-house once you count salaries, turnover, software, and training. A well-run managed billing operation costs 4–8% of collections. At $10M in annual collections, that spread is $500–900K per year — before accounting for revenue improvements from lower denials and better charge capture.
of collections — typical all-in cost of in-house billing (salaries, software, training, turnover) — per MGMA Cost Survey data
of collections — a managed billing operation
the annual spread at $10M in collections
The honest caveat most vendors skip: outsourcing done badly costs more than it saves. The savings only materialize when performance is governed — which is what CRIS 2.0 exists to do.
| Comparison | Neolytix | In-house team |
|---|---|---|
| All-in cost | 4–8% of collections | ~13–14% of collections |
| Key-person risk | Engineered out | High — exits with staff |
| Denial prevention | CRIS 2.0 pre-bill controls | Reactive re-work |
| Reporting | Live dashboards + forecasting | Monthly spreadsheets |
| EMR migration? | Never required | Depends on vendor |
Every Non-clinical Operation, Handled End-to-end.
Billing for multi-specialty groups that’s consistent at every location — here’s the problem we built for:
One site collects at 98%, another at 89% — and nobody can explain why. Quality depends on which biller picked up the account.
You see the denial report every month. What you don’t get is root cause — or a fix that sticks.
PDF summaries tell you what happened, not what’s coming. And your board is asking for forecastable revenue.
Response times stretch, escalations multiply, and every new location means re-explaining everything.
What's Included in Our Outsourced Medical Billing
End-to-end, charge to payment — every function below is included, delivered by a dedicated team and governed by CRIS 2.0.
Charge Capture & Coding Review
Specialty-trained coders verify CPT, modifiers, and NDCs before submission — with high-risk-area audits for error-prone services.
Claim Submission & Edits
Claims out within 24–48 hours of receipt, scrubbed pre-bill, batch-submitted with daily clearinghouse rejection review.
ERA & Payment Posting
Electronic and manual remittances posted within 24–48 hours, reconciled monthly against bank deposits — to the penny.
Denial & Rejection Management
Follow-up initiated within 24–72 hours, root-cause trend analysis, and appeals worked to resolution — not just resubmitted.
A/R Follow-Up & Appeals
Every 30+ day claim worked monthly with payer-specific escalation paths; aging reported by location, payer, and provider.
Patient Statements & Support
Monthly statement cycles, payment posting, and balance resolution — handled with the same documentation standard as everything else.
Need more than billing? We run credentialing, payer contract negotiation, patient access, and full revenue cycle management as one consolidated operation.
Not a Billing Service. A Managed Billing Operation.
The full charge-to-payment cycle — charge capture, claim submission, rejections, payment posting, denial management, A/R follow-up, patient statements, month-end — run as a single operation across all your locations, with one accountable team and one performance standard.
Specialty-Trained Delivery Teams
Dedicated billers, coders, and A/R specialists organized around your specialty mix — with documented backup coverage on every task, so performance never depends on one person.
CRIS 2.0 Revenue-Integrity Controls
Claims out within 24–48 hours of receipt, scrubbed pre-bill, batch-submitted with daily clearinghouse rejection review.
Live Executive Dashboards
Electronic and manual remittances posted within 24–48 hours, reconciled monthly against bank deposits — to the penny.
Built for an Era Where Payers Use AI to Deny Faster.
Most billing vendors find revenue leakage after it happens — in last month’s report. CRIS 2.0 runs revenue-integrity checks continuously, across two levels.
Denial Intelligence
pre-bill claim scrubbing + denial-trend root-cause analysis, so repeat denials get engineered out, not re-worked
Patient Access Audit
catches registration-stage errors before they become denials
Coding Errors Check
CPT, modifier, and NDC verification
High-risk Area Audits
for error-prone specialty services
Encounter-to-claim Reconciliation
(weekly/monthly) — the #1 defense against missed billing
Daily Clearinghouse-to-payer Rejection Review
Payments-to-bank-deposit Reconciliation
Most billing vendors find revenue leakage after it happens — in last month’s report. CRIS 2.0 runs revenue-integrity checks continuously, across two levels.
Our Latest Success Stories
Discover how Neolytix has driven remarkable revenue growth for healthcare providers through expert contract negotiation. Our most recent successes showcase the impact of our services, demonstrating substantial gains in CPT codes billed across a range of healthcare practices.
Top 3 billed codes
increase in reimbursement rate
• FirstCare | Texas
All billed codes
increase across all billed codes
• Caresource | Georgia
Top 5 billed codes
increase in CPT code billing
• BCBS | Texas
Case Studies
Real challenges. Measurable outcomes. or Proven Results Across Healthcare Operations
Uncovering Revenue Leaks in a Behavioral Health Practice Through a Comprehensive Billing Audit
A mid-market behavioral health practice had fragmented billing workflows hiding significant revenue loss. Neolytix conducted a comprehensive billing audit, surfacing critical gaps in coding accuracy, documentation compliance, and denial tracking — and rebuilt the revenue cycle from the ground up.
Key Result: 🏆 99.72% claims submitted successfully | 0% critical missed billing events
How Automation and AI Boosted Anesthesia Department Revenue by Over 50%
A multi-specialty hospital’s anesthesia department was losing revenue despite high surgical volume — only 1% of providers were properly credentialed and 15% of billing events were being missed entirely. Neolytix deployed automated systems and AI-powered analytics to transform the department’s revenue cycle in 6 months.
Key Result: 🏆 +55% revenue increase | 60% reduction in denial rate | 95%+ first-pass claim accuracy
The Same Right Answer, at Every Location.
The reason billing quality varies across sites is tribal knowledge: each biller carries their own version of your payers’ rules, and when someone leaves, their knowledge leaves with them.
A biller in their first month works from the same complete picture as a ten-year veteran — so your Cigna claims are handled identically whether they originate from your downtown clinic or your newest acquisition.
Fourteen years of operational knowledge across 270+ healthcare organizations, structured into the system our teams work from.
Your Revenue, Visible. By Location, Payer, and Provider.
Every engagement includes a live Power BI reporting layer on HIPAA-compliant Azure: collections, clean-claim rate, denial trends, and A/R aging — drillable by location, payer, and provider, with 30/60/90-day revenue forecasting.
When your CFO asks which location is leaking and why, the answer is a click — not a request to your billing team for a spreadsheet.
Works where you work — no migration required:
Epic
Athena Health
AdvancedMD
eClinicalWorks
Kareo / Tebra
NextGen
+ most major EMRs via EMR Bridge
Physician Billing Services for Hospitals & Health Systems
Employed-physician billing without adding FTEs — governed by the same CRIS 2.0 controls, with multi-entity dashboards and audit-ready documentation.
1,000+
charges processed daily
144
ERAs posted per day
~300
denials triaged daily
100%
month-end reconciliation
Employed-physician billing without adding FTEs — governed by the same CRIS 2.0 controls, with multi-entity dashboards and audit-ready documentation.
If we run billing at hospital scale, your 12 locations are not a stretch — they're a Tuesday.
Specialty-trained Billing Teams, Not Generalists.
Payer behavior, coding nuance, and denial patterns differ by specialty — so our teams are organized around yours. Each spoke page covers specialty-specific denial codes, CPT considerations, and payer quirks.
Works where you work — no migration required:
Cardiology
Mental & Behavioral Health
Orthopedics
OB/GYN
Gastroenterology
Oncology
Nephrology
Pain Management
Pediatrics
Psychiatry
Medical Billing for Small & Independent Practices.
Full-service billing for independent practices: charge entry, claim submission, denial follow-up, payment posting, and patient statements — handled by a specialty-trained team, priced as a simple percentage of collections. You see everything in a monthly performance summary; we get you paid faster without you hiring anyone.
Why Not a Platform? Why Not a Bigger Bpo? Why Not in-house?
Versus billing software platforms (CureMD, AdvancedMD, etc.)
We integrate with your existing EHR/PM system, train your staff, and go live. From day one you have InCredibly dashboards and a weekly performance cadence.
Versus traditional billing companies
Most run on static SOPs and a few senior people’s memory. Quality slips three months in, and turnover takes the know-how with it. Our controls (CRIS 2.0) and AI knowledge system make performance independent of any individual.
Versus hiring in-house
You can build this team — in about 18 months, with recruiting risk and no benchmark data. We bring it on day one, benchmarked across 270+ organizations, at roughly half the all-in cost.
From First Call to Steady State
CRIS Walkthrough (45 min)
A guided tour of the control framework and sample reporting — see exactly how your billing would be governed. No discovery homework required.
Billing Performance Assessment
We benchmark your clean-claim rate, denial patterns, and A/R against specialty peers — and size the recoverable gap.
Transition (0–90 days)
Account discovery, protocol documentation, parallel running, then cutover — with daily progress calls during onboarding.
Billing & Coding Guides
Explore our in-depth guides covering specialty billing workflows, common denial triggers, CPT codes, modifiers, and documentation requirements, across care settings
CPT Code 97110: Therapeutic Exercise Billing Guide
CPT Code 99396: Adult Preventive Visit Billing Guide (2026)
CPT Code 90791 Explained: The Psychiatric Diagnostic Evaluation
CPT Code 90834: The 45-Minute Code Most Practices Undercode
CPT Code 90837: How to Bill 60-Minute Therapy Without a Downcode
CPT Code 36415: Venipuncture Billing, Bundling, and Units
Security-First. At Every Step.
Built for Compliance. Designed for Confidence.
Every service we deliver is built on a foundation of strict data governance and regulatory compliance. HIPAA safeguards and ISO 27001-certified security practices are embedded into how we work, not added after the fact.
Built for Compliance. Designed for Confidence.
FAQs
Frequently Asked Questions About Neolytix Medical Billing Services
How much does outsourced medical billing cost for a group practice?
Most group-practice engagements are priced as a percentage of collections, so cost scales with revenue and incentives stay aligned. Fixed-fee models are available above certain volumes. All-in, a managed billing operation typically costs 4–8% of collections versus 13–14% for an equivalent in-house team. The walkthrough includes a pricing range for your size and specialty mix.
Do we have to switch billing software or EMR?
No. Neolytix works inside your existing systems — Epic, athenahealth, AdvancedMD, eClinicalWorks, Kareo / Tebra, and most major EMRs — connected through our EMR Bridge. There is no migration, and your staff keep the workflows they know. This is a deliberate design choice: EMR migration is one of the most common failure modes in billing transitions.
How do you keep billing quality consistent across multiple locations?
Two mechanisms: CRIS 2.0, a 7-control revenue-integrity framework that audits every stage of the cycle, and an AI knowledge system our teams work from that applies your payer rules and account setup identically on every task, at every location — regardless of who’s working the account.
Is outsourcing billing cheaper than keeping it in-house for a group practice?
Usually, yes — and the gap widens with size. In-house billing for a multi-site group runs roughly twice the cost of a managed operation once salaries, software, training, and turnover are counted. The bigger financial lever, though, is performance: denial prevention and charge reconciliation typically move more revenue than the fee differential.
How long does the transition take?
Typical transition is 60–90 days from contract signature: account discovery and access first, protocol documentation and training in parallel, then a staged cutover with daily onboarding calls.
What size practice do you work with?
Our managed billing operation serves multi-site groups and specialty networks of roughly 20 to 300+ providers. Smaller independent practices are served through our standard medical billing service — see the section above.
Are your outsourced billing services HIPAA compliant?
Yes. Neolytix is ISO 27001 certified and HIPAA compliant, with documented access controls, encrypted data handling, and a full reconciliation audit trail on every account. Security documentation is available during the assessment.
What reporting is included with outsourced medical billing?
Every engagement includes live Power BI dashboards — clean-claim rate, denial trends, A/R aging, and collections by location, payer, and provider — plus weekly progress reports during transition and monthly/quarterly performance reviews after go-live. Not a monthly PDF.
Can you handle billing for multiple specialties within one group?
Yes — this is the core use case. Our teams are organized around your specialty mix, with dedicated coders and billers trained on the CPT patterns, modifier rules, and payer behaviors that apply to each specialty. One contract, one reporting layer, one performance standard across all of them.
See How Your Billing Would Be Governed.
A 45-minute CRIS 2.0 walkthrough with sample reporting — no discovery homework, no commitment. Just see the controls your current vendor doesn’t have.
Response within 1 business day · HIPAA-compliant onboarding · No long-term contracts required