Service
Medical billing that gets your claims paid the first time
Optimus runs your entire revenue cycle: eligibility, coding checks, claim submission, payment posting, denial management and patient statements. Billing starts at 2.9%* of collections, you keep your EHR, and we are paid when you are paid.
What is included
What you get
- 01
Eligibility and front-end checks
Coverage, copays and prior authorization requirements are confirmed before the patient arrives.
- 02
Claim scrubbing and submission
CPT, ICD-10 and HCPCS codes are checked, then claims are submitted electronically. Our clean claim rate is 98%.
- 03
Denial management
Denied claims are worked daily: root cause found, corrected, appealed and tracked. Our denial rate is 1.8%.
- 04
A/R follow-up
Unpaid claims are chased by age so money does not sit. A/R days are the number we manage hardest.
- 05
Payment posting and patient statements
Insurance and patient payments posted accurately, with timely statements and online or text-to-pay for balances.
- 06
Live reporting
Collections, A/R and denial patterns on a dashboard you can open any day, plus a financial audit to find billing leakage.
Inside the platform
What your billing team works in every day
Sample screens from the billing workspace, shown with sample data.
Billing and A/R dashboard
Claims by status, collection ratio and A/R aging by bucket, filterable by location, provider and payer, so you can check the numbers any day.
Insurance eligibility checks
Coverage is verified before the visit, so front-end errors do not turn into denials.
Electronic claim submission
Claims go to the payer electronically and are tracked from submission to acknowledgement. Rejected claims are flagged in the queue for correction.
Patient payments
Copay, co-insurance and deductible payments are posted against the right charge, so balances stay accurate.
Patient statements
Patients with an open balance are queued for statements automatically, by email or paper.
How it works
How we work with you
- 01
Practice assessment
We review your workflows, payer mix, goals and specialty so we know where revenue leaks before we start.
- 02
Intake and verification
Patient details and coverage are verified up front, so problems surface before the visit, not after the denial.
- 03
Claim scrubbing
Every claim is checked for CPT, ICD-10 and HCPCS coding errors before it leaves.
- 04
Electronic submission
Clean claims go out electronically. Our average turnaround is 24 hours.
- 05
Payment posting
Payer and patient payments are posted, with ERAs (electronic payment explanations) posted automatically.
- 06
Reports and follow-up
Denials are worked daily and you see collections, A/R and denial trends on a live dashboard.
FAQ
Answers before you ask
What does medical billing outsourcing cost?
Billing starts at 2.9%* of collections. Final pricing is based on your average monthly collections, number of providers and number of locations. There is no software to buy, and we confirm your full price before you sign.
What is a clean claim rate?
A clean claim is one a payer can process without sending it back. The clean claim rate is the share paid on the first submission. Ours is 98%.
Will you work inside my EHR?
Yes. We work inside all major EHR and PM systems. Our certified billers log in directly, so there is no migration.
How do you handle denials?
We work denials daily. Each one is traced to its cause, corrected and resubmitted or appealed, and patterns are fed back to the front end so the same error does not repeat.
How fast can we start?
Most practices are onboarded in 5–7 days.
Do you offer a billing audit?
Yes. A free billing audit compares your claims, denials and A/R against industry benchmarks to show where revenue leaks. It carries no obligation.
Ready when you are
Give your practice the revenue cycle it deserves
Book a demo or get a free, no-obligation billing audit. We will show you where revenue is leaking and what it would take to fix it.