Every step of the revenue cycle, owned end-to-end.
From the moment a patient calls to schedule until the last balance is collected, MBSPM operates the financial engine of your practice. Below is the full menu — engage us for the whole stack or just the pieces where you need help.
The single biggest source of denials isn't bad coding — it's bad eligibility. We catch coverage problems before the patient ever walks in the door, so you don't lose revenue, surprise patients, or write off charges that should have been collected at the front desk.
What's included
Real-time eligibility checks 24–48 hours before every visit
Co-pay, deductible, and benefit-remaining quotes
Prior authorization tracking & follow-through
Coordination of benefits (COB) when patient has multiple plans
Verification of in-network status by payer & plan
Daily exception reports flagged to your front desk
Coding standards we work to
Code setsCPT, ICD-10-CM, HCPCS Level II
Modifiers25, 59, X{EPSU}, 26/TC, 76/77, 91, 95
Audit cadenceMonthly internal QA on 5–10% of charts
Documentation reviewPre-bill scrub against payer LCD/NCD
Provider feedbackMonthly coding insights memo per provider
ComplianceOIG work plan & CMS bulletin alignment
02 — Coding
AAPC-Certified Medical Coding
Coding is where the money is made or lost. Under-coding leaves revenue on the table; over-coding invites audits. Our certified team reviews every encounter against the documentation and the payer's local coverage rules, then codes to the highest accurate level — with a complete audit trail so it stands up under scrutiny.
For complex specialties (cardiology, ortho, dermatology, mental health) we assign coders who specialize in your specialty rather than rotating generalists across your charts.
03 — Charge entry
Charge Entry & Encounter Capture
Charges that never get entered are revenue you'll never see. We pull encounters from your EHR, validate every charge against the documentation, attach the right modifiers, and have everything ready for submission within 24–48 hours of date of service.
What's included
Daily reconciliation of schedule vs. charges captured
Missing-charge alerts to providers within 48 hours
Acknowledgment tracking277CA monitoring, every claim
Secondary submissionAutomated COB once primary posts
04 — Claims submission
Claims Submission & Scrubbing
Every claim runs through a 200-plus rule scrub before it ever leaves the building — payer-specific edits, NCCI bundling, modifier validation, demographic checks. The result is a clean claim rate that consistently hits 98%, which is the single highest-leverage number in your revenue cycle.
We submit electronically through whichever clearinghouse you prefer, monitor the 277CA acknowledgment for every claim, and re-work rejections within one business day.
05 — Payment posting
Payment Posting & Reconciliation
Posting isn't just data entry — it's where you catch underpayments, identify denial patterns, and reconcile the bank. We post every ERA and EOB the day it arrives, flag any payment that comes in below the contracted rate, and reconcile against your bank deposits weekly.
Recovered revenue rate~70% of appealable denials overturned
06 — Denials
Denial Management & Appeals
Most billing operations write off denials they could have won. We don't. Every denied claim is reviewed within 24 hours, root-caused, and routed for appeal with the correct payer-specific letter, supporting documentation, and follow-up calendar.
Just as importantly, we feed denial trends back into your coding and front-office workflows so the same denial doesn't keep happening. Fixing the upstream cause is worth more than winning the appeal.
07 — A/R recovery
Accounts Receivable Management
Aging A/R is money you've already earned. We work every bucket — 30, 60, 90, 120+ days — with the urgency that bucket deserves. Insurance follow-up calls, payer portals, status checks, escalations, and resubmissions are all happening every day, not just at month-end.
For practices joining us with legacy aging, we run an A/R cleanup project up front to recover what's recoverable and clean up what's not.
A/R targets we maintain
Days in A/R≤ 30 days (we average 22)
A/R over 90 days≤ 15% of total A/R
Insurance follow-up cadenceEvery 14 days until resolved
Legacy A/R cleanupAvailable as a fixed-fee project
Workers' comp & MVASpecialized handling included
Bad-debt write-off reviewMonthly with practice approval
Patient experience standards
Statement designPlain English, itemized, branded to your practice
DeliveryMail + email + SMS payment links
Online paymentCard, ACH, HSA/FSA, payment plans
Phone supportEnglish-speaking, 8a–6p ET
Payment plansAuto-managed, no charge to patient
Collection escalationOnly with practice approval, after 3 cycles
08 — Patient billing
Patient Statements & Support
Patients remember the bill more than they remember the visit. We handle statements, online payment, payment plans, and inbound questions with the same care your front desk does. Statements are clear and itemized, payment is a click away, and our support team answers patient questions on your behalf — branded to your practice.
09 — Credentialing
Credentialing & Provider Enrollment
An out-of-network provider is denied revenue waiting to happen. We manage the entire credentialing and re-credentialing lifecycle — Medicare, Medicaid, Blue Cross, Priority Health, Meridian, Molina, McLaren, HAP, and the major commercial payers — and we keep CAQH, NPPES, and PECOS current so nothing falls through the cracks.
What's covered
Initial enrollment & re-credentialing
CAQH, PECOS, NPPES maintenance
Medicare revalidation tracking
Group & individual NPI management
Hospital privilege paperwork support
Payer contracting & rate negotiation guidance
Standard monthly report
Collections vs. targetPer provider, per location
Days in A/RTrended 12-month rolling
Denial rate & top reasonsBy payer, by CPT
Payer mixVolume + reimbursement
ProductivityRVUs, encounters, charge per visit
Action itemsThree priorities for next month
10 — Reporting & analytics
Reporting & Practice Analytics
You shouldn't have to ask how your practice is doing. Every client gets an always-on KPI dashboard, a monthly written executive summary in plain English, and a 30-minute video review with your account manager. The reports are designed for the practice owner, not for accountants.
We don't just report numbers — we recommend three specific actions every month, with the expected revenue impact attached.
11 — Practice consulting
Practice Management Consulting
Beyond billing, we help with the operational decisions that move revenue. Fee schedule benchmarking, payer contract review, EHR optimization, front-desk workflow audits, and revenue forecasting — drawing on what we see across our entire Michigan client base.
Common engagements
Fee schedule benchmarking against MI peers
Payer contract review & renegotiation strategy
Front-desk workflow & POS collection coaching
EHR/PM optimization for billing efficiency
New-service profitability analysis
Not sure which services you need?
Send us 90 days of de-identified data. We'll show you exactly which parts of your revenue cycle are bleeding — and what it would take to fix.
