Most billing VAs come from generic staffing agencies. Ours come from inside an active revenue cycle management operation, supervised by AAPC-certified billers in real time. So when your VA hits a complex denial, a payer escalation, or a coding edge case, they don’t escalate outside the company. They escalate to certified specialists working alongside them. HIPAA-compliant by design. No long-term contracts. Half the cost of an in-house biller.
Here’s the difference. Your in-house biller costs $65,000 to $100,000 fully loaded. Our RCM-trained VAs start at $18,000 annually. Same workflow depth. Same compliance rigor. Same escalation path inside the same RCM company. AAPC-certified supervised. SOC 2 Type II infrastructure. BAA signed before access. Built for solo practitioners, multi-specialty groups, and hospitals.
We confirm patient insurance coverage before appointments, identify copay and deductible amounts, flag coverage gaps before services are rendered, and reduce denials caused by eligibility errors. Most useful for practices with high new-patient volume or complex commercial payer mixes.
We submit prior authorization requests, track status with payers, flag pending authorizations before scheduled procedures, and follow up on delays. Most useful for surgical specialties, pain management practices, behavioral health groups, and any practice with high prior auth volume monthly
We prepare and submit clean claims to payers and clearinghouses, scrub claims against payer-specific rules before submission, monitor claim status to adjudication, and ensure timely filing deadlines are met. Most useful for high-volume practices and specialties with complex coding requirements.
We review denied claims, identify root cause, draft appeals with payer-specific supporting documentation, escalate complex denials to AAPC-certified billers inside the company, and track appeal status to resolution. Most useful for practices with denial rates above 5% monthly.
We post payer remittances and patient payments, reconcile against expected reimbursement, identify underpayments by payer, and flag variance for AR follow-up. Most useful for practices managing high commercial payer volume or complex secondary insurance coordination workflows daily.
We enter charges into your billing system, apply modifiers based on documentation review, support CPT and ICD-10 code selection under certified-biller supervision, and flag coding questions for escalation. Most useful for multi-provider groups and high-volume specialty practices.
We work aging AR reports, contact payers on outstanding claims, manage patient billing inquiries, set up payment plans, and support patient communication around balances. Most useful for practices with AR days above industry benchmark or growing patient AR balances monthly.
We handle payer phone calls, respond to payer requests, track payer communication, and escalate unresolved issues to certified billers. Most useful for practices managing complex commercial payer contracts or recurring payer disputes that consume in-house staff time daily.
We start with a 30-minute discovery call. We map your current billing workflows, identify VA-suitable tasks, define scope boundaries, and confirm hours and coverage. Output: a written engagement scope with task list, hours, supervisor assignment, and start date. You approve before anything starts moving forward here.
Once scope is approved, we sign the BAA, configure SOC 2 Type II access protocols, set up role-based EHR permissions, and complete VA background and HIPAA training documentation. PHI access does not begin until every compliance step is verified. This stage completes in 3 to 5 business days.
Based on your specialty, payer mix, EHR, and workflow complexity, we match a billing VA from our internal team. Most practices receive a match within 48 hours. The VA reviews your scope, payer fee schedules, and historical denial patterns before the first live shift begins here today.
Week 1 is shadow week. Your VA performs tasks under direct supervisor oversight with claim accuracy spot-checked at 100% sample rate. Adjustments are made to workflows, communication patterns, and escalation rules based on what we learn together. By end of week 1, the VA is fully calibrated.
From week 2 onward, the VA operates in your live billing workflow with daily supervision, weekly audits, and monthly performance reviews. You receive monthly reports on claim volume, denial rates, AR trends, and quality scores. Most practices see measurable claim turnaround improvement within the first 60 days.