At HealthClaim Partners, we specialize in out-of-network billing solutions tailored for specialists in orthopedics, neurosurgery, and pain management. With precision, transparency, and decades of experience, we help maximize reimbursements while reducing administrative burden. Our team ensures accurate claims, timely appeals, and regulatory compliance—empowering providers to focus on delivering exceptional care while we handle revenue recovery.
Expert Billing and Coding
for Out-Of-Network Claims
Out-of-network billing requires a nuanced approach, especially when dealing with high-value, complex procedures. Our experienced billing specialists understand how to appropriately code and submit claims to maximize reimbursements from commercial insurers. We ensure that every claim is submitted accurately, supported with the proper documentation, and tailored to align with payer-specific guidelines. By reducing errors and delays, we help expedite the reimbursement process and minimize denials.
Post-service Appeals and Arbitration Support
Denied or underpaid out-of-network claims are common, but they don’t have to result in lost revenue. Our team is highly skilled in managing the post-service appeal process, preparing persuasive appeals backed by detailed documentation, medical necessity justification, and legal references when needed. For more complex disputes, we offer arbitration support, including the preparation of comprehensive arbitration packets and collaboration with experienced attorneys who specialize in healthcare reimbursement cases.
Customized Reporting and Reimbursement Analysis
Transparency is central to our approach. We provide out-of-network providers with customized reports and reimbursement analyses that offer a clear view of claim outcomes, payer trends, and financial performance. These insights help providers identify underpayments, track success rates on appeals, and make informed decisions about fee schedules and negotiation strategies. Our goal is to give you the data you need to take control of your revenue cycle.
Compliance Support and Regulatory Guidance
Out-of-network providers are increasingly under scrutiny when it comes to billing transparency and compliance, especially in light of the No Surprise Act. We help ensure your practice remains aligned with federal and state regulations by reviewing policies, offering guidance on patient communications, and supporting the development of compliant billing workflows. Our team stays current with regulatory changes—minimizing the risk of penalties or reputational damage.
Coordination With Legal and Clinical Teams
We understand that successful out-of-network revenue recovery is a team effort. That’s why we work closely with both your clinical and legal teams to ensure all aspects of the billing and appeals process are aligned. Whether it’s helping gather clinical notes, coordinating with attorneys during arbitration, or advising on documentation best practices, we serve as a strategic partner committed to your financial and operational success.
Request a No-Obligation Consultation
Ready to improve your out-of-network billing results? During your consultation, our expert team will review your current billing processes, identify opportunities to increase reimbursements, and discuss how HealthClaim Partners can offer support. Whether you need help with appeals, compliance, or revenue optimization, our experts are here to help. This is your chance to ask questions, get clarity, and explore customized solutions—no strings attached.
Let’s talk about how we can simplify your billing and maximize your earnings—request your consultation today.
