eBillingWorks handles claims, credentialing, coding audits, and denial management for Pennsylvania practices, built around HealthChoices and every major commercial payer. Real Pennsylvania expertise, not a template.
A billing specialist reviews your submission personally. No automated replies.
Every claim and record handled under strict HIPAA safeguards.
Deep HealthChoices and MCO knowledge built into every claim we file.
See where your revenue is leaking before you commit to anything.
Getting a new provider enrolled with a HealthChoices managed care organization such as Keystone First, UPMC for You, Aetna Better Health PA, Gateway Health, or Health Partners Plans can take 60 to 120 days if paperwork isn’t clean on the first try. Every week of delay is a week of unbilled visits. How we handle it: we manage the full credentialing and re credentialing process for every MCO you work with, from application prep through active follow up, so nothing sits untouched in a queue.
Pennsylvania’s Medical Assistance program allows up to 180 days from the date of service under 55 Pa. Code section 1101.68, but individual HealthChoices MCOs can and do contract for shorter windows. Carelon, the Behavioral HealthChoices MCO, requires claims within just 90 days of the discharge or service date. Commercial payers such as Independence Blue Cross and Highmark typically range from 90 to 180 days as well. Miss the window and the claim is gone for good, with no way to bill the patient for the difference. How we handle it: claims move through eligibility and coding checks before submission, and we track each MCO’s specific deadline separately, which is why our typical billing cycle runs 30 to 45 days instead of stretching out from repeated rework and resubmissions.
Pennsylvania Medicaid and CMS update requirements throughout the year, and a missed change usually shows up weeks later as a wave of denials. How we handle it: we track payer policy updates as part of the account and support MIPS reporting for practices that need to stay compliant under MACRA.
Certified billers and coders are hard to keep on staff. When your one trained biller leaves, claims backlog immediately and denials go unwatched. How we handle it: you get a full team instead of a single point of failure. Certified coders and billers who specialize in cardiology, chiropractic, behavioral health, and urgent care billing specifically.
Pennsylvania is a mix of dense metro areas like Philadelphia and Pittsburgh alongside large rural and Appalachian regions where payer mix and prior authorization rules shift by county. Practices serving patients across county lines often lose track of which rules apply where. How we handle it: we track payer requirements by region, not just by payer, so multi county practices don’t have to guess.
eBillingWorks handles every step of your billing cycle, built around how Pennsylvania practices actually get paid.
Full claim cycle, from submission to denial management, tracked against Pennsylvania’s 180 day Medical Assistance filing rule and each individual HealthChoices MCO’s own, often shorter, contracted deadline.
Deep expertise in cardiology, chiropractic, behavioral health, and urgent care, backed by secure software that fits your existing systems.
Outsourced billing that runs 30 to 45 days on average, with clear revenue reports so you always know where things stand.
eBillingWorks conducts thorough medical billing audits to catch errors before they affect your revenue. Line by line review of claims, coding, and documentation against HealthChoices and commercial payer standards.
Underpayments, overpayments, and compliance gaps flagged before they turn into penalties or denied claims. A detailed report with clear recommendations to strengthen your billing process going forward.
We offer end to end revenue cycle management to optimize your cash flow, managing every phase from patient registration to final payment collection.
Insurance verification, coding, claims submission, and denial management, tracked to deadline across every HealthChoices MCO.
Technology that integrates with your systems for smooth data flow and stronger financial performance.
Transparent reporting and expert support throughout your revenue cycle, backed by a 30 to 45 day billing cycle.
eBillingWorks manages the full provider credentialing process so you can start seeing patients and getting paid faster. Enrollment and re credentialing with every HealthChoices MCO, Medicare, Medicaid, and commercial payers you work with.
Application prep, primary source verification, and active follow up so nothing sits untouched in a queue. CAQH profile management and license renewal tracking to keep your credentials current going forward.
eBillingWorks handles the billing side of remote patient monitoring so your practice can offer RPM without adding administrative burden.
Accurate CPT coding for device supply, setup, and monthly monitoring time, billed correctly the first time.
Claims tracked against Medicare, Medicaid, and commercial payer requirements specific to RPM services.
Clear reporting so you can see RPM revenue alongside the rest of your billing in one place.
eBillingWorks takes administrative tasks off your staff’s plate so your team can focus on patient care. Accurate medical transcription with fast turnaround, formatted to fit directly into your existing records.
Appointment scheduling and reminder calls that reduce no-shows and keep your calendar running smoothly. A dedicated team that understands the pace of a busy Pennsylvania practice.
We work directly with the practice management and EHR software you already use, so onboarding is smooth and your data stays connected.
Tebra, AdvancedMD, athenahealth, DrChrono, eClinicalWorks, NextGen, CareCloud, and Practice Fusion, along with most other major platforms.
From Philadelphia and Pittsburgh to smaller communities throughout the Commonwealth, we support practices across every corner of Pennsylvania, including Allegheny, Philadelphia, Montgomery, Bucks, Delaware, Chester, Lancaster, and York counties, along with the rest of the state.
Every claim and patient record handled under strict HIPAA safeguards.
All patient and billing data secured with industry standard encryption, both in transit and at rest.
Role based permissions ensure staff only access the information they need to do their job.
Tell us about your practice and current billing challenges. No obligation, no pressure.
We review a sample of your recent claims to identify where revenue is being lost.
We build a billing plan around your specialty, your systems, and your specific payer mix.
Real Pennsylvania expertise, not a template. We know HealthChoices, every MCO, and how Pennsylvania Medical Assistance actually pays.
A dedicated team, not a call center. You work with people who know your practice by name.
Transparent reporting so you always know exactly where your revenue stands, no guessing.
Billing cycles that run 30 to 45 days on average, keeping your cash flow steady and predictable.
“eBillingWorks turned our billing around. Our denials dropped and we finally have a clear picture of our revenue every month.” — Family Practice, Philadelphia, PA
“Credentialing with the MCOs used to take months. Their team handled it start to finish and kept us updated the whole way.” — Behavioral Health Practice, Pittsburgh, PA
“Real people who actually understand Pennsylvania payers. That alone makes them worth it.” — Urgent Care Clinic, Lancaster, PA
Most practices are fully onboarded within one to two weeks. We handle the transition so your billing continues without interruption.
Just your practice information, current EHR or practice management system, and recent claims data. We handle the rest of the setup.
Yes. We manage enrollment and re-credentialing with every HealthChoices MCO, along with Medicare, Medicaid, and commercial payers.
We specialize in cardiology, chiropractic, behavioral health, urgent care, and primary care, along with most other outpatient specialties.
Most practices see improved collections and fewer denials within the first 60 to 90 days as our processes take full effect.
We are not a generic national vendor. We know Pennsylvania payers, HealthChoices MCOs, and state filing rules in detail, and you get a dedicated team instead of a call center.
Click “Get Your Free Claims Audit” anywhere on this page, or call us directly. A billing specialist will review your submission personally within one business day.
