The Medical Billing handles medical billing and coding for practices in Scranton, PA — from solo physicians and specialty groups to independent labs and clinics across Lackawanna County. We take the full revenue cycle off your desk so your staff can focus on patients.
Medical Billing for Scranton's Healthcare Market
Scranton practices work alongside large systems such as Geisinger Community Medical Center, Regional Hospital of Scranton and Moses Taylor Hospital. 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 Scranton 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 Lackawanna 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 Scranton 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 Scranton 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 Scranton 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 Wilkes-Barre, Dunmore, Clarks Summit and Carbondale, 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 endocrinology billing and ENT billing services.
Specialties We Bill For in Scranton
Frequently Asked Questions
Do you provide medical billing services in Scranton, PA?
Yes. We work remotely with physician practices, clinics, specialty groups and labs in Scranton and across Lackawanna 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 Scranton 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 Scranton?
Yes — including Wilkes-Barre, Dunmore, Clarks Summit and Carbondale. Billing is done remotely, so practices anywhere in Pennsylvania can work with us.
How much does medical billing cost for a Scranton 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.