Eligibility & Benefits Verification
Support coverage checks and benefits information before services are delivered.
- Coverage status
- Copay and deductible data
- Administrative verification
Medical Billing & Coding
Extend your billing and coding capacity without building another internal department.
Outsource one defined workflow or combine multiple functions into a dedicated billing support team. Coding resources should be appropriately qualified for the specialty and scope agreed with the client.
Dedicated resourcesManaged deliveryClient-approved systemsQA & reporting
What we support
Build support around the revenue cycle tasks that consume the most internal time.
Outsource one defined workflow or combine multiple functions into a dedicated billing support team. Coding resources should be appropriately qualified for the specialty and scope agreed with the client.
Charge Entry & Claims Support
Assist with accurate charge entry and claim-preparation workflows using client-approved processes.
- Patient demographics
- Charge entry
- Claim status tracking
Medical Coding Support
Provide coding support aligned to the specialty, documentation and client-defined review process.
- ICD-10-CM
- CPT / HCPCS
- Coding review workflows
Payment Posting
Support posting and reconciliation workflows so payer and patient activity remains visible.
- ERA/EOB posting
- Adjustments
- Reconciliation support
Accounts Receivable
Add structured capacity for outstanding claims, payer follow-up and work-queue management.
- Claims status
- Payer follow-up
- Ageing work queues
Denial Follow-Up
Investigate denial reasons, collect required information and route corrective actions through the approved workflow.
- Denial categorisation
- Documentation follow-up
- Resubmission support
Why this model
Capacity with an operating layer around it.
The objective is not simply to move tasks offshore. It is to create a controlled, measurable workflow that can integrate with the client’s existing operation.
01
Dedicated billing capacity
Resources aligned to the account instead of a rotating generic pool.
02
Managed operations
Attendance, coaching and workflow issues can be handled through the AllshoreCX management layer.
03
Client-controlled access
Work within approved systems and permissions rather than moving sensitive data unnecessarily.
04
QA visibility
Use reviews, error trends and client feedback to improve consistency.
05
Flexible scope
Start with eligibility, AR or posting and expand when the model works.
06
Role-specific recruitment
Recruitment can reflect specialty knowledge, communication needs and software requirements.
Process
From scope to stable production.
Each engagement is adapted to the account, but the launch should always establish clear responsibilities, controls and performance expectations.
Assess the Workflow
Define the billing/coding functions, volumes, queues, responsibilities and pain points.
Map Systems & Access
Document approved applications, permissions, security and escalation routes.
Select & Train
Recruit against the role and train resources around the practice’s processes and terminology.
Controlled Production
Move agreed work into production with closer review during the ramp-up period.
Manage Exceptions
Escalate unclear coding, denial, access or client-dependent decisions through agreed channels.
Review & Improve
Use QA, turnaround data and client feedback to improve workflow consistency.
Systems & tools
Designed to fit the client’s existing stack.
Technology claims should reflect actual account experience or confirmed training capability. The examples below can be edited before launch.
RCM & PM Systems
Examples of common healthcare platforms.
Payer / Clearinghouse
Common portals and transaction platforms.
Workflow
Supporting tools may include client-approved document, ticketing and collaboration systems.
FAQ
Common questions about medical billing & coding outsourcing.
Do we have to outsource the entire billing function?
No. Clients can outsource a defined workflow such as eligibility, payment posting, AR or denial follow-up and expand later.
Can coding be included?
Yes, where the engagement includes appropriately qualified coding resources and a defined review/escalation process for the specialty.
Can the team work in our existing system?
Where secure remote access is available, the team can be trained to work within client-approved systems and permissions.
How is quality managed?
Quality can include accuracy checks, work-item reviews, trend analysis, coaching and client calibration.
Can you support multiple providers or locations?
The operating model can be designed around provider groups, locations or work queues, subject to scope and system access.
Ready to explore medical billing & coding outsourcing?
Share the current workflow, headcount, software, hours and pain points. We’ll help define the operating model before discussing staffing.