Philadelphia is one of the country's great academic medicine cities, home to Penn Medicine, Jefferson Health and CHOP, with Independence Blue Cross as the leading commercial insurer in the region.
Medical Coder provides outsourced medical billing services in Philadelphia for independent practices and groups — from eligibility checks to final payment — so you get paid faster with fewer denials.
Philadelphia Medical Billing Built Around Pennsylvania Payers
Most avoidable denials start with payer rules. For Philadelphia practices we work every major payer in Pennsylvania:
- Medicaid: Pennsylvania Medical Assistance, administered by the Department of Human Services (DHS), through HealthChoices physical health plans such as UPMC for You, Keystone First, AmeriHealth Caritas Pennsylvania and Highmark Wholecare.
- Medicare: Part A and Part B claims through Novitas Solutions (Jurisdiction L), plus Medicare Advantage plans.
- Commercial plans: Highmark Blue Cross Blue Shield, Independence Blue Cross, Capital Blue Cross, UPMC Health Plan, Geisinger Health Plan, Aetna and UnitedHealthcare.
- TRICARE and VA Community Care for military families and veterans.
Pennsylvania has payer rules of its own — see medical billing in Pennsylvania for how we handle them.
Billing Challenges for Philadelphia Practices
Philadelphia practices bill Independence Blue Cross, Medicaid HealthChoices plans such as Keystone First, and Medicare through Novitas. We know each payer's edits and keep denials low.
What Our Philadelphia Medical Billing Services Include
- Eligibility and benefits verification before every visit
- Certified ICD-10, CPT and HCPCS coding with modifier review
- Charge entry and claim scrubbing before submission
- Electronic claim submission and payment posting
- Denial management and appeals
- A/R follow-up on every unpaid claim, including aged A/R
- Patient statements and balance support
- Provider credentialing and payer enrollment
- Monthly reporting on collections, denials and days in A/R
Healthcare in Philadelphia
Philadelphia's healthcare market includes major systems such as Penn Medicine, Jefferson Health, Temple University Hospital, Children's Hospital of Philadelphia and Fox Chase Cancer Center. Independent practices compete with these systems for patients and staff — outsourced billing gives you the same revenue cycle depth without building a billing department. We support practices across Center City, University City, South Philly, Northeast Philadelphia, Upper Darby, Bensalem, Norristown and King of Prussia.
Specialties We Bill For in Philadelphia
We bill for 45+ specialties, including mental and behavioral health, OB-GYN, radiology, wound care. See all specialties.
Why Philadelphia Practices Outsource Medical Billing
- Lower cost than in-house billing — no salaries, benefits, training or billing software to pay for.
- Fewer denials — every claim is scrubbed before submission and every denial is worked.
- Faster payments — consistent follow-up on every open claim, not just the big ones.
- Clear monthly reporting on collections, denials and A/R.
Get a Free Medical Billing Audit in Philadelphia
We will review your claims, denials and A/R at no cost and show you where revenue is being lost. Start with a medical billing audit, see how pricing works, or explore our Pennsylvania medical billing services and nearby pages for Pittsburgh and Erie.