If your Fresno practice is losing time to denials, underpayments or aging A/R, The Medical Billing can take over billing and coding end to end. We work with physicians, specialty groups and labs across Fresno County, California.
Medical Billing for Fresno's Healthcare Market
Healthcare in Fresno is anchored by Community Regional Medical Center, Saint Agnes Medical Center and Valley Children's Hospital. Independent practices here refer to — and receive referrals from — those systems every day, which means accurate referring-provider data, prior authorizations and place-of-service coding are essential to getting paid. We set up those details correctly at charge entry instead of fixing them after a denial.
California Payer Rules We Handle for Fresno Practices
- Medicare: Part B claims go to Noridian Healthcare Solutions; Medicare Advantage claims go to the patient's private plan with its own authorization rules.
- Medicaid: Medi-Cal is run by the Department of Health Care Services (DHCS), and most members are in county-based Medi-Cal managed care plans.
- Commercial plans: we bill Blue Shield of California, Anthem Blue Cross, Health Net and UnitedHealthcare and the employer plans common in Fresno County.
- Local detail: California is split into many Medicare payment localities, which means fee schedules — and expected payments — vary between Los Angeles, the Bay Area, San Diego and the Central Valley.
What's Included for Fresno 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, Medi-Cal 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 PAVE (Provider Application and Validation for Enrollment)
- Monthly reporting on collections, denials and days in A/R
Why Fresno Practices Outsource Billing to Us
An in-house biller has to know every payer rule, every code change and every portal. Our team already does. Fresno practices that outsource to us get specialist coders, daily denial follow-up and clear monthly reporting without adding payroll or software costs.
We also support practices in Clovis, Madera, Sanger and Selma, and across the rest of the state — see our California medical billing services or nearby pages for Los Angeles and San Diego. Specialty groups can read more about our neurology billing and rheumatology billing services.
Specialties We Bill For in Fresno
Frequently Asked Questions
Do you provide medical billing services in Fresno, CA?
Yes. We work remotely with physician practices, clinics, specialty groups and labs in Fresno and across Fresno County. We handle coding, claims, denials and A/R follow-up for Medicare, Medi-Cal and commercial payers.
Which insurance payers do you bill for Fresno practices?
Medicare Part B through Noridian Healthcare Solutions, Medicare Advantage plans, Medi-Cal and its managed care plans, and commercial payers such as Blue Shield of California, Anthem Blue Cross and Health Net.
Do you work with practices near Fresno?
Yes — including Clovis, Madera, Sanger and Selma. Billing is done remotely, so practices anywhere in California can work with us.
How much does medical billing cost for a Fresno 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.