Streamline Your

At Optimum Medical Billing and Credentialing, we offer comprehensive solutions to enhance your billing process. Our expert team ensures accurate and timely reimbursements, allowing you to focus on patient care.

Welcome to Optimum

At Optimum Medical Billing and Credentialing, we pride ourselves on our dedicated team of experts who are committed to providing exceptional service. Our mission is to streamline the revenue cycle process for healthcare providers, allowing them to focus on patient care while we handle the complexities of billing, credentialing, and more.

500 clients served

We have successfully assisted over 250 healthcare providers in optimizing their billing processes, ensuring timely reimbursements and minimizing denials.

15 years of experience

Our team brings together over 30 years of combined experience in medical billing and credentialing, ensuring that our clients receive the best possible support.

1000 +

With over 25,000 applications submitted and a 99.9% client satisfaction rate, we are proud to be a trusted partner in our clients’ financial success.

0 states experience

We provide a comprehensive suite of services, including medical billing, coding, credentialing, audit and compliance preparation, revenue optimization, and growth strategies. Each service is thoughtfully tailored to address the unique needs of every healthcare provider nationwide.

Explore Our Comprehensive Services

Optimum Medical Billing and Credentialing offers a suite of services tailored to healthcare providers. Our expertise in medical billing, coding, credentialing, auditing, and revenue amplification ensures efficient processes, accurate reimbursements, and increased profits. Discover how we can optimize your practice’s revenue cycle.

Comprehensive Credentialing Services

Our credentialing services are designed to ensure your practice not only meets but exceeds all necessary qualifications and industry standards. We handle the entire credentialing process, from initial application to final approval, so you can focus on providing exceptional patient care. By meticulously verifying provider credentials, licenses, certifications, and revalidations we help reduce compliance risks and protect your organization from potential penalties or disruptions.

Expert Medical Coding Service

Our professional coding services are tailored to minimize claim denials, improve cash flow, and streamline your revenue cycle management. With an in-depth understanding of the latest coding standards, including ICD-10, CPT, and HCPCS, our team ensures every claim is accurate, compliant, and optimized for maximum reimbursement.

Efficient Medical Billing Solutions

Our medical billing services are designed to simplify your practice’s financial operations, ensuring timely reimbursements and minimizing claim denials. By leveraging cutting-edge technology and industry expertise, we manage every aspect of the billing process—from claim submission to payment posting—accurately and efficiently.

Compliance Assurance

Our Compliance Assurance Service is designed to help healthcare companies stay audit-ready and fully compliant with industry regulations. We conduct comprehensive reviews of your processes, documentation, and operational standards to identify potential risks and ensure adherence to all applicable guidelines. By addressing compliance gaps proactively, we help safeguard your organization against penalties and maintain your reputation for excellence. Trust us to simplify the complexities of audit preparation so you can focus on delivering high-quality care with confidence.

Amplify Revenue Streams

Our Amplify Revenue Streams Service is designed to help healthcare organizations maximize their financial potential. Through a detailed analysis of your current revenue streams, we identify opportunities for optimization and provide strategic recommendations to enhance income based on your existing services. Additionally, we advise on implementing new, profitable services tailored to your organization’s strengths and market demand. This service empowers you to achieve sustainable growth and unlock untapped revenue opportunities.

Why Optimum Medical Billing Stands Out

At Optimum Medical Billing, we prioritize accuracy and efficiency, ensuring your practice receives timely reimbursements. Our team of experts is dedicated to minimizing denials and optimizing your revenue cycle.

Expert Team

Our professionals are skilled in medical billing and coding, ensuring precision and compliance.

Integrated Technology

We utilize integrated, cutting-edge technology to streamline processes and enhance cash flow.

Advanced Technology & Compliance Measures

At Optimum Medical Billing and Credentialing, we leverage cutting-edge technology to streamline billing processes, ensuring accuracy and efficiency. Our compliance measures are designed to meet industry standards, safeguarding your practice against potential risks.

Tech Innovations

Utilizing human interaction, AI, and machine learning for accurate billing.

Compliance Standards

Adhering to HIPAA, PHI, and other federal and state regulatory requirements.

With our proven process, you can focus on excellence in patient care.

Discover how we enhance your revenue visibility with our expert services.

Commercial Enrollment Commercial Insurance Provider Enrollment & Credentialing (Anthem BCBS, Aetna, Cigna, United Healthcare, and any other plan available in geographic area) Can complete both initial and recredentialing applications

Medicare & Medicaid Enrollment Initial applications for both groups and providers Reassignment of benefits & group application updates (ownership, location, etc.) Revalidations for both groups and providers

Hospital Privileging Initial and recredentialing application support Access to our provider data management system which will store credentialing dates and recredentialing dates so you don’t have to worry about missing a deadline

Medical Licensing Services Initial license applications Assistance with license renewal applications CME tracking available within our provider data management system credentialing dates so you don’t have to worry about missing a deadline

Primary Source Verification Initial verification of provider information as outlined by NCQA standards. Monthly monitoring of OIG/SAMs databases Recredentialing available on a 2 or 3 year cycle based on your preference

Medical Credentialing Management & Monitoring Ongoing CAQH profile maintenance (Reattestations as required by health plans) Ongoing health care portal maintenance (Availity, One Health Port, etc.) Ongoing support- PayrHealth will provide you with general guidance and advice as you navigate payor relationships Access to our provider data management system which will house all of your providers’ information in one place

Optimize Your Revenue Cycle Today

Join us at Optimum Medical Billing and Credentialing to enhance your billing processes and ensure timely reimbursements. Let us handle the complexities while you focus on patient care.

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