Frequently Asked Questions About Medical Billing in Nevada

A medical billing company turns your patient visits into payments. We code each visit, submit clean claims to insurers, post payments, work denials and appeals, follow up on unpaid claims, and bill patients for their share. You get paid faster, and your staff spends less time on paperwork. See our medical billing services.

Outsourcing makes sense when claims are piling up, denials are rising, or your billing depends on one person. You get a full team of billers and certified coders for a percentage of collections, instead of a fixed salary. A free billing audit shows whether outsourcing would pay off for your practice.

Nevada practices are our focus, from Las Vegas, Henderson, and North Las Vegas to Reno and Carson City. Our team works with Nevada payers every day, including Nevada Medicaid and Medicare's regional contractor for Nevada. See the areas we serve.

Start with a free billing audit. We sign a Business Associate Agreement, review your recent claims, denials, and AR, then send you our findings and a written rate within 5 business days. There's no cost or obligation. Request your free audit.

Our pricing is 4–5% of monthly net collections: 4.9% for solo practices, 3.99% for groups of 2–10 providers, and volume pricing from 4.0% for larger groups, facilities, and MSOs. There's no setup fee. See medical billing pricing.

Net collections are the payments that actually reach your practice for claims we bill, after refunds and payer takebacks. Because our fee is a percentage of net collections, you never pay for charges that go uncollected. See how our fee is worked out.

No. There's no long-term contract and no setup fee. You can leave with 60 days' notice, or right away if we miss our written service levels two months in a row. See our pricing and terms.

For most small and mid-sized practices, yes. An in-house biller costs salary, benefits, software, and clearinghouse fees every month, whatever you collect. Our fee covers the full team and only applies to what's collected. Our pricing calculator compares both for your practice.

Medical billing covers claim submission, payments, and denials. Revenue cycle management (RCM) covers the full cycle, from eligibility checks and prior authorization before the visit to patient collections and reporting afterward. Most practices benefit from full RCM. See revenue cycle management.

We prevent denials before claims go out by verifying eligibility, securing prior authorizations, and scrubbing every claim against payer rules. When a denial does arrive, we correct or appeal it within 5 business days, then track denial trends so the same problem doesn't repeat. See denial management.

Yes. We work aged AR, including claims older than 90 days, on a contingency basis: you pay a share of what we recover, and nothing if we recover nothing. Claims past a payer's timely filing limit usually can't be recovered, so the sooner we start, the better. See AR follow-up and recovery.

Yes. We send clear patient statements, answer patients' billing questions on your behalf, and set up payment plans when your practice allows them. See patient billing services.

Yes. We submit prior authorization requests, track them to approval, and flag any visit scheduled without one. It's included in our Group and Enterprise plans. See prior authorization services.

Most payers take 60 to 120 days to credential a provider, and some commercial plans take longer. Starting early matters, because claims for services before your effective date may not be paid. We submit applications, follow up with each payer, and track every effective date. See medical credentialing services.

Credentialing verifies a provider's qualifications, such as licenses, education, and malpractice history. Enrollment (sometimes called contracting) gets the provider set up to bill a specific payer at an agreed rate. You need both before a payer will pay your claims. See credentialing and enrollment.

Yes. We handle Medicare enrollment through PECOS, Nevada Medicaid provider enrollment, and enrollment with Nevada Medicaid managed care plans and commercial payers. See medical credentialing services.

Credentialing is included in our Enterprise plan. On Solo and Group plans, it's quoted per provider, per payer, in writing before work begins. See pricing.

Yes. Certified coders review coding on our accounts, using current CPT, ICD-10-CM, and HCPCS code sets and each payer's rules. See medical coding services.

A billing audit reviews a sample of your claims, denials, and payments to find lost revenue and compliance risks. It covers coding accuracy, denial patterns, AR aging, and underpayments. Your first audit with us is free. See our free billing audit.

Most practices benefit from a coding review at least once a year, and after any major change, such as new providers, a new EHR, or annual code-set updates. Practices with high-risk codes or rising denials should audit more often. See medical coding services.

Yes. Practice Revenue Management, Inc., which operates Nevada Med Billing, acts as a HIPAA business associate. We sign a Business Associate Agreement before receiving any PHI, and maintain administrative, technical, and physical safeguards. See our HIPAA compliance page.

Yes, with every client, before any patient information is shared. We can provide our standard BAA, or review yours. See HIPAA compliance.

No company is HIPAA certified, because HIPAA has no official certification. Be cautious of vendors who claim one. We maintain the safeguards the HIPAA rules require and share evidence of them during vendor review. See how we protect PHI.

We follow 42 CFR Part 2 requirements for substance use disorder records in addition to HIPAA, and staff on SUD accounts are trained on them. See HIPAA compliance and substance abuse billing.

We bill Medicare, Nevada Medicaid and its managed care plans, Nevada Check Up, commercial health plans, TRICARE, workers' compensation carriers, and other regional plans. Each payer has its own claim rules, and we track them for you. See medical billing services.

Medicare Part A and Part B claims for Nevada are processed by Noridian Healthcare Solutions, the Medicare Administrative Contractor for Jurisdiction E. We submit claims, track their status, and handle redeterminations and appeals with Noridian. See medical billing services.

Medicare generally requires claims within 12 months of the date of service. Nevada Medicaid, its managed care plans, and commercial payers each set their own limits, often much shorter. Missing a limit usually means the claim can't be paid, so we submit within 24 hours of receiving documentation. See AR follow-up.

Nevada Check Up is Nevada's Children's Health Insurance Program (CHIP). It covers children in families who earn too much to qualify for Medicaid but can't afford private coverage. We bill Nevada Check Up for pediatric and family practices. See pediatric billing.

We bill for primary care, family and internal medicine, pediatrics, behavioral and mental health, psychiatry, substance use disorder programs, ABA, cardiology, gastroenterology, neurology, endocrinology, nephrology, oncology, dermatology, urgent care, and more. See all specialties.

Yes. We bill outpatient therapy and psychiatry, plus IOP, PHP, residential, detox, and MAT programs. Facility billing on the UB-04 includes authorization and concurrent review tracking. See behavioral health billing.

Yes. Both need careful prior authorization, accurate drug and procedure coding, and tracking of treatment sessions against payer limits. We handle each step. See Spravato billing and TMS billing.

Yes. ABA billing depends on authorized units, correct provider credentials for each code, and timely reauthorization. We track all three so sessions don't go unpaid. See ABA billing.

No. We work inside your current system, including DrChrono and eClinicalWorks, so there's no data migration and no retraining for your staff. If your system isn't listed, ask us. See our EHR integrations.

Most practices are fully onboarded within 2–3 weeks of signing. We set up access, payer connections, and reporting while your current claims keep moving, so there's no gap in cash flow. See how we get started.

Yes. Your data stays in your EHR or practice management system, and you receive monthly reports on collections, denials, and AR by provider. Group and Enterprise clients also get a monthly review call with their RCM lead. See revenue cycle management.