The Medical Billing handles medical billing and coding for practices in Allentown, PA — from solo physicians and specialty groups to independent labs and clinics across Lehigh County. We take the full revenue cycle off your desk so your staff can focus on patients.
Medical Billing for Allentown's Healthcare Market
Allentown practices work alongside large systems such as Lehigh Valley Health Network and St. Luke's University Health Network. That brings a steady flow of referrals and shared patients, but also more payer edits on referrals, authorizations and place of service. Our coders check those details before the claim goes out.
Pennsylvania Payer Rules We Handle for Allentown Practices
- Medicare: Part B claims go to Novitas Solutions; Medicare Advantage claims go to the patient's private plan with its own authorization rules.
- Medicaid: Pennsylvania Medical Assistance is run by the Department of Human Services (DHS) through the PROMISe system, and most members are in HealthChoices managed care plans.
- Commercial plans: we bill Highmark Blue Cross Blue Shield, Independence Blue Cross, Capital Blue Cross and UPMC Health Plan and the employer plans common in Lehigh County.
- Local detail: Medicare Part B claims go to Novitas Solutions (Jurisdiction L), with separate payment localities for the Philadelphia area and the rest of the state.
What's Included for Allentown Practices
- Insurance eligibility and benefits verification before each visit
- Medical coding (CPT, ICD-10-CM, HCPCS and modifiers) by certified coders
- Charge entry and claim scrubbing to catch errors before submission
- Electronic claim submission to Medicare, Pennsylvania Medical Assistance plans and commercial payers
- Denial management and appeals with root-cause tracking
- A/R follow-up on aging claims, worked daily
- Payment posting from ERAs and EOBs, including underpayment checks
- Credentialing and payer enrollment, including PROMISe provider enrollment
- Monthly reporting on collections, denials and days in A/R
Why Allentown Practices Outsource Billing to Us
Most revenue is lost in small gaps: an eligibility check that was skipped, a denial nobody had time to appeal, a payment that was posted short. We close those gaps for Allentown practices with a structured process and transparent reporting, and we start with a free audit so you can see the numbers first.
We also support practices in Bethlehem, Easton, Whitehall and Emmaus, and across the rest of the state — see our Pennsylvania medical billing services or nearby pages for Philadelphia and Pittsburgh. Specialty groups can read more about our dental billing and pathology billing services.
Specialties We Bill For in Allentown
Frequently Asked Questions
Do you provide medical billing services in Allentown, PA?
Yes. We work remotely with physician practices, clinics, specialty groups and labs in Allentown and across Lehigh County. We handle coding, claims, denials and A/R follow-up for Medicare, Pennsylvania Medical Assistance and commercial payers.
Which insurance payers do you bill for Allentown practices?
Medicare Part B through Novitas Solutions, Medicare Advantage plans, Pennsylvania Medical Assistance and its managed care plans, and commercial payers such as Highmark Blue Cross Blue Shield, Independence Blue Cross and Capital Blue Cross.
Do you work with practices near Allentown?
Yes — including Bethlehem, Easton, Whitehall and Emmaus. Billing is done remotely, so practices anywhere in Pennsylvania can work with us.
How much does medical billing cost for a Allentown practice?
Most billing companies charge a percentage of monthly collections, commonly between 4% and 10% depending on specialty and claim volume. We give you a fixed quote after a free audit of your claims and A/R.
How long does it take to switch to your billing service?
It depends on how quickly payer and EHR access can be set up. We plan the transition so that existing A/R keeps being worked while new claims move to our team, and we share a timeline after the free audit.