Collections from Private Insurance, Medicare, and Medicaid
We help practices collect from Cigna, Aetna, UnitedHealthcare, Blue Cross Blue Shield, Humana, Medicare, Medicaid, managed care plans, secondary payers, workers' comp, and patient responsibility balances. Our team does not stop at claim submission. We pursue payment until the claim is paid, appealed, adjusted, or escalated.
We Work the Claim Until Money Hits the Account
Many billing teams submit claims and wait. MedRegion uses payer-specific follow-up, denial appeals, underpayment review, secondary billing, and patient balance workflows to improve net collections across commercial, Medicare, and Medicaid payers.
Private Insurance
- Eligibility and benefit verification
- Prior authorization tracking
- Claim status checks through portals and clearinghouses
- Denial appeal packets with documentation
- Underpayment and fee schedule review
- Secondary and tertiary claim follow-up
Medicare
- LCD and NCD policy checks
- Modifier and medical necessity review
- MSP and coordination of benefits handling
- Medicare Advantage plan follow-up
- RAC, MAC, and audit response support
- Appeals and redetermination support
Medicaid
- State-specific Medicaid rules
- Managed care plan billing workflows
- Eligibility, spend-down, and dual eligibility handling
- CHIP, EPSDT, and waiver billing support
- Timely filing and resubmission tracking
- Denied claim correction and appeals
How the money actually moves
Five steps, run on a schedule rather than on whoever remembers to chase.
Verify Before the Visit
We confirm active coverage, copay, deductible, authorization requirements, referral rules, and coordination of benefits before claims are created.
Submit Clean Claims
Claims are checked for coding, modifiers, medical necessity, provider enrollment, place of service, payer edits, and documentation gaps.
Follow Up by Payer and Aging Bucket
Open AR is worked by payer, dollar value, denial reason, timely filing risk, and 0 to 30, 31 to 60, 61 to 90, 90 plus day buckets.
Appeal Denials and Underpayments
We prepare appeal packets, attach clinical documentation, cite payer policy, correct coding issues, and pursue payer reconsideration.
Post, Reconcile, and Report
ERA and EOB payments are posted daily, underpayments are flagged, patient responsibility is moved correctly, and monthly payer performance is reported.
Private Insurance, Medicare, Medicaid. We Collect Across All of Them.
We review your payer mix and aging to show which insurers are holding your money, and how much of it is still recoverable.