Medical billing services built for independent U.S. practices.
Accurate coding, faster claims, and fewer denials — handled by a U.S.-based team that treats your revenue cycle like its own, not a queue to process.
What is medical billing?
Medical billing is the process of translating the care a provider delivers into standardized codes (CPT, ICD-10, and HCPCS), submitting those codes as claims to insurance payers, and following up until the practice is paid in full. It covers everything from charge entry and coding to claims submission, payment posting, and denial resolution — the entire path between a patient visit and money landing in your account.
What's included in ClaraRCM's medical billing services
Each piece works together — or stands alone, if that's what your practice needs.
Claim Submission
Clean, accurate claims submitted promptly to reduce first-pass rejections.
Medical Coding Support
CPT, ICD-10, and HCPCS coding aligned with current payer and CMS guidelines.
Denial Management
Root-cause review, appeals, and resubmission for every denied or underpaid claim.
AR Follow-Up
Active tracking of unpaid claims so balances don't quietly age past 90 days.
Payment Posting
Accurate ERA/EOB reconciliation so your books always match what's actually paid.
Eligibility & Benefits Verification
Coverage confirmed before the visit, so claims don't fail on eligibility alone.
Medical billing vs. medical coding: what's the difference?
The two terms get used interchangeably, but they're different steps in the same process.
Medical coding
- Translates a clinical visit into standardized CPT, ICD-10, and HCPCS codes
- Requires certified understanding of documentation and payer rules
- Happens before a claim is ever submitted
Medical billing
- Takes those codes and submits them as claims to payers
- Manages the full cycle — submission, posting, denials, appeals
- Ends when the practice is paid in full for the visit
How ClaraRCM handles your billing
Charge entry & coding
Visits are coded accurately using current CPT, ICD-10, and HCPCS guidelines before anything is submitted.
Claim submission & scrubbing
Claims are reviewed for errors and submitted promptly to reduce first-pass denials.
Posting, denials & reporting
Payments are reconciled, denials are appealed, and you get clear reporting on where your revenue stands.
Not another offshore billing vendor
Traditional offshore billing companies
Generic processing, limited visibility, slow response times, and little accountability when claims are handled incorrectly.
ClaraRCM
U.S.-based oversight on every account, full transparency into your claims and AR, and a team that acts as an extension of your practice — not a black box.
Medical billing by specialty
Coding rules and payer behavior vary by specialty — see how we handle yours.
Related revenue cycle services
Common questions about medical billing services
What is medical billing?
Medical billing is the process of translating patient visits into standardized codes and submitting them as claims to insurance payers, then following up until the practice is paid in full.
What's the difference between medical billing and medical coding?
Coding translates a clinical visit into CPT, ICD-10, and HCPCS codes. Billing takes those codes and manages the full claims cycle — submission, payment posting, and denial resolution — until the practice is paid.
How much do medical billing services cost?
Outsourced medical billing typically costs 4–9% of monthly collections, depending on practice size, specialty, and the scope of services included.
Is outsourcing medical billing worth it for a small or independent practice?
For most independent practices, yes. Outsourcing removes the cost of hiring and training in-house billing staff, and typically improves clean claim rates and reduces the number of claims left unresolved past 90 days.
What is a good clean claim rate?
A strong clean claim rate is generally 95% or higher — meaning that percentage of claims are accepted by the payer on the first submission, without requiring correction or resubmission.
How does ClaraRCM handle denied claims?
Every denial is reviewed for root cause, corrected, and either resubmitted or appealed with supporting documentation — rather than written off or left to age in accounts receivable.
Is ClaraRCM's medical billing service HIPAA compliant?
Yes. All claims and patient data are handled under HIPAA-compliant processes, with secure data transfer and access limited to the team working your account.
Which specialties does ClaraRCM provide medical billing for?
ClaraRCM supports primary care, mental health, urgent care, chiropractic, pediatric, physical therapy, cardiology, dental, telehealth, orthopedic, ER, laboratory, FQHC, RPM/CCM, MIPS, MOUD, and DME billing, among others.
How long does it take to switch medical billing companies?
Most practices can transition within a few weeks, starting with a free billing audit to review current claims and identify any existing issues before the switch.
Do I need to change my EMR to work with ClaraRCM?
No. ClaraRCM works within most major EMR and practice management systems already in use at your practice.
How is ClaraRCM different from an offshore medical billing company?
ClaraRCM provides U.S.-based oversight on every account, full visibility into claims and AR status, and a dedicated team — rather than a generic offshore processing queue with limited accountability.
What's included in ClaraRCM's medical billing services?
Charge entry, CPT/ICD-10/HCPCS coding, claim submission, payment posting, denial management, AR follow-up, and eligibility verification — as a full package or individually.