---
title: "Claims paid, AR down, books reconciled"
description: "Medical billing and revenue cycle management: eligibility, charge entry, claim submission, ERA posting, denial management and AR follow-up."
url: https://ledgerbpo.com/services/medical-billing/
updated: 2026-09-11
publisher: LedgerBPO (SS Support Network LLC)
language: en-US
---

# Claims paid, AR down, books reconciled

LedgerBPO's medical billing services give your practice a named, HIPAA-trained biller who verifies eligibility, enters charges, scrubs and submits claims, posts ERAs, works denials and follows up on insurance AR inside your own Kareo/Tebra, AdvancedMD or Office Ally account. Because the same team keeps your books, posted payments and bank deposits reconcile every month.

- Since 2020
- US · UK · CA · AU
- Named accountant plus backup
- Your software, no lock-in

[Book a billing audit](https://ledgerbpo.com/book-a-call/?topic=billing-audit) [Book a 20-minute call](https://ledgerbpo.com/book-a-call/) In short

- One named biller, a backup and a team lead, in your practice software
- Eligibility to patient statement handled as one connected workflow
- Claims, deposits and the general ledger reconciled by the same team

Updated September 2026 · Reviewed by [Nimra Khalid](https://ledgerbpo.com/team/nimra-khalid/)

## What is medical billing outsourcing?

Medical billing outsourcing means a remote team runs the revenue cycle for a practice: checking coverage, entering charges, submitting claims, posting payments, working denials and chasing unpaid insurance balances. The practice keeps its own practice management system and clearinghouse accounts. The provider works inside those systems under a business associate agreement, on a fixed daily schedule.

## Who it is for

### Independent practices

One to ten providers, one office manager, and a billing backlog that grows every time someone is out. You want claims out daily without hiring a second biller.

### Practice administrators

You have an in-house biller who is buried in payment posting and phone holds. Handing the daily work queue to a dedicated team frees them for payer contracts and patient questions.

### Multi-site groups and MSOs

Several locations, several tax IDs and several fee schedules need one consistent billing process with location-level reporting that still rolls up cleanly.

## What's included

- Insurance eligibility and benefit checks before each date of service
- Charge entry from your EHR encounter or superbill within one business day
- Claim scrubbing against payer edits before submission through Availity or your clearinghouse
- ERA and EOB payment posting with contractual adjustments applied
- Rejection and denial work queue with a reason code on every item
- Insurance AR follow-up by payer and aging bucket
- Secondary and tertiary claims filed after primary adjudication
- Patient statements and balance explanations under your practice name
- Credit balance and refund review each month
- Posted payments reconciled to bank deposits and your general ledger
- Monthly reporting by payer, provider, location and procedure code
- Weekly status note listing unbilled encounters and open questions

## Deliverables and KPIs

| Deliverable | KPI we report | Cadence |
| --- | --- | --- |
| Claims submitted | Encounters billed within 2 business days of provider sign-off | Daily |
| Payments posted | ERAs posted within 1 business day; postings tie to deposits | Daily |
| Denials worked | Every denial touched within 5 business days with a next action | Weekly |
| Insurance AR follow-up | Every claim over 30 days has a documented payer contact | Weekly |
| Patient statements | Statement cycle run on your schedule with balances explained on request | Monthly |
| Revenue cycle report | First-pass rate, denial rate and AR aging tracked against published industry benchmarks | Monthly |

KPIs are what we measure and report, agreed per engagement. Service-level commitments are set in your agreement.

## How it works

1. ### Billing audit call
A 30-minute call to map your specialties, payers, practice management system, clearinghouse, monthly encounter volume and where claims currently stall. We review a sample of recent denials and your AR aging.
2. ### BAA, access and payer setup
We sign a business associate agreement, then you grant role-based access to your practice software, clearinghouse and payer portals. We confirm fee schedules, provider enrollments and EFT and ERA setup within the first week.
3. ### Dedicated biller assigned
A named biller, a trained backup and a team lead take over the daily work queues. The first two weeks run alongside your current process so nothing is missed at cut-over.
4. ### Daily queues, monthly reconciliation
Charges, claims, postings and denials are worked every business day. At month-end the team reconciles postings to deposits, closes the ledger and sends a plain-English revenue cycle report.

Our BillingLine process

Payer follow-up calls and patient balance questions run through our BillingLine desk, a phone and email desk that answers under your practice name. Every call is logged against the claim or statement it concerns, so the biller and the caller always see the same history.

## Software we work in

- [Kareo (Tebra)](https://ledgerbpo.com/software/kareo-tebra/)
- [AdvancedMD](https://ledgerbpo.com/software/advancedmd/)
- [QuickBooks Online](https://ledgerbpo.com/software/quickbooks-online/)
- [Xero](https://ledgerbpo.com/software/xero/)
- [All 50 platforms](https://ledgerbpo.com/software/)

## How much does medical billing cost?

Medical billing is commonly priced as a percentage of collections, per claim, or per dedicated biller, and each model suits a different practice size and specialty mix. We quote whichever fits your volume, and engagements run month-to-month with no setup fee. Pricing depends on volume and scope, so we send a custom quote within 1 business day.

### What moves the quote

- Monthly encounter and claim volume across all providers
- Number of payers, specialties and locations
- Whether you need patient statements and patient billing calls
- Size of the existing AR backlog to be worked at the start

### Market benchmarks

| Market | Typical range | Source |
| --- | --- | --- |
| US | Dedicated offshore billing staff typically run $8 to $35 per hour all-inclusive, against $40 to $75 per hour for US-based staff | Madras, Acculink, Rose Talent (2026) |

Third-party ranges for orientation, not our prices.

[Book a billing audit](https://ledgerbpo.com/book-a-call/?topic=billing-audit) No setup fee. Month-to-month.

## Medical billing for your industry

- [Medical practices & clinics](https://ledgerbpo.com/industries/medical-practices/)
- [Behavioral health practices](https://ledgerbpo.com/industries/behavioral-health/)
- [Clinical laboratories](https://ledgerbpo.com/industries/clinical-labs/)
- [Home care & home health agencies](https://ledgerbpo.com/industries/home-care/)
- [DME & HME suppliers](https://ledgerbpo.com/industries/dme/)
- [Dental practices](https://ledgerbpo.com/industries/dental-practices/)
- [All 26 industries](https://ledgerbpo.com/industries/)

## Security and compliance

- HIPAA-trained staff, a signed BAA, and minimum-necessary access to PHI
- MFA on every login, per-client access logs, no PHI on local devices or paper
- Card data is never stored by us; patient payments run through your practice portal

Full control list on the [security page](https://ledgerbpo.com/security/) and country rules on the [compliance page](https://ledgerbpo.com/compliance/). Certifications are listed only when held.

## Frequently asked questions

### How much do medical billing services cost?

Pricing depends on volume and scope, and we send a custom quote within 1 business day. Medical billing is commonly priced as a percentage of collections, per claim, or per dedicated biller, and we will tell you which model we recommend for your practice and why. As a market reference, dedicated offshore billing staff typically cost $8 to $35 per hour all-inclusive, compared with $40 to $75 per hour for US-based staff (Madras, Acculink, Rose Talent, 2026).

### Do I have to change my practice management system?

No. We work inside your existing Kareo/Tebra, AdvancedMD, Office Ally, DrChrono or similar system and your current clearinghouse. You keep the subscription, the data and the payer enrollments. If you plan to move systems, we can support the migration as a separate project.

### Who handles my claims, and are they HIPAA-trained?

A named biller assigned to your practice, supported by a trained backup and a team lead who reviews the work. Every team member completes HIPAA training before touching a client account, and we sign a business associate agreement with every practice. You will know your biller by name and can message them directly.

### How do you handle denials?

Every rejection and denial goes into a work queue with a reason code, a root cause and a next action, and is touched within five business days. Corrected claims are resubmitted within timely filing limits, and appeals are drafted with the supporting documentation. Denial patterns are reported monthly so front-desk or coding issues can be fixed at the source.

### Can you reconcile insurance payments to my books?

Yes, and this is the main reason practices choose us. The same team that posts ERAs also reconciles the posted payments to bank deposits and your QuickBooks Online or Xero ledger each month. Unapplied cash, refunds and payer takebacks are explained rather than left as a plug.

### Which specialties do you bill for?

We bill for primary care, behavioral health, physical therapy, urgent care, specialty clinics, labs and other outpatient settings. During the billing audit call we confirm the coding conventions and payer rules for your specialty. If a specialty needs certified coding support, we say so rather than guess.

### Do you call patients about balances?

Yes, when you want us to. Patient statements and balance calls are handled under your practice name through our patient billing call center service, with respectful scripts, payment plan options and no card data stored by our agents. All outbound calling follows US TCPA rules and your practice policy.

### What about the old AR sitting in my system today?

We start with an AR clean-up sprint. The backlog is sorted by payer, age and dollar value, timely-filing risk is worked first, and every claim gets a status note. You receive a written summary of what is collectible, what needs appeal and what should be adjusted, and you approve every write-off.

### How fast can we start?

Most practices are live within two to three weeks of the billing audit call. The BAA, system access, EFT and ERA confirmation and fee-schedule review happen in week one, and the biller runs alongside your current process in week two so no claims fall through at cut-over.

Talk to a person

A 20-minute call with someone who runs medical billing every day. No sales script.

[Book a 20-minute call](https://ledgerbpo.com/book-a-call/) [Book a billing audit](https://ledgerbpo.com/book-a-call/?topic=billing-audit) Compliance note

You approve and release every payment. We never move money, sign returns or give audit opinions. [Country rules](https://ledgerbpo.com/compliance/).

Next step

## Books closed. Invoices paid. Every month.

Tell us what is going on with your books or billing. You will hear from a named person within 1 business day, with a custom quote and a plan for the first close.

- Reply from a named person within 1 business day
- No setup fee, month-to-month
- Your software, your data, no lock-in

Start with a custom quote

[Book a billing audit](https://ledgerbpo.com/book-a-call/?topic=billing-audit) [Book a 20-minute call](https://ledgerbpo.com/book-a-call/) Or call [+1-657-777-0006](tel:+16577770006) during US, UK or Australian business hours.

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Source: https://ledgerbpo.com/services/medical-billing/ · Contact: https://ledgerbpo.com/contact/ · Full site map for agents: https://ledgerbpo.com/llms.txt