Clean claims, faster pay
Scrubbing and eligibility checks raise first-pass acceptance and speed reimbursement.
BPO Service
Medical Billing Outsourcing Services
Direct answer
Medical billing outsourcing delegates revenue-cycle work — charge entry, coding support, claim submission, denial management, and AR follow-up — to a trained team. Actigy BPO runs medical billing for providers and billing companies with HIPAA-conscious controls, documented workflows, and QA, improving clean-claim rates and collections at a strong cost-to-quality ratio.
What Actigy reports
Clean-claim rateTracked & improved
Days in ARReduced
Denial rateWorked & root-caused
CollectionsReported monthly
What does medical billing outsourcing cover?
Medical billing outsourcing — also called outsourced revenue cycle management (RCM) or medical billing services — covers the steps between a patient encounter and payment: entering charges, supporting accurate coding, scrubbing and submitting claims, posting remittances, working denials, and following up on accounts receivable. Actigy runs these steps inside your practice-management and clearinghouse systems, for practices and billing companies of any size.
The objective is a higher clean-claim rate, faster reimbursement, and a smaller aged-AR balance. Clinical and compliance responsibility stays with your providers and coders of record; Actigy provides the operational capacity and documentation to keep the cycle moving.
Capabilities included
What Actigy handles
Charge entry & eligibility
Charges entered accurately and insurance eligibility verified before submission.
Coding support
CPT, ICD-10, and modifier support to improve clean-claim rates, aligned to your coders.
Claim scrubbing & submission
Claims validated against payer rules and submitted through your clearinghouse.
Payment & ERA posting
ERA/EOB payments posted with adjustments and reconciliation to expected reimbursement.
Denial management & appeals
Denials worked, root-caused, and appealed to recover revenue and prevent repeats.
AR follow-up
Aged accounts worked by priority to reduce days in AR and improve collections.
Patient statements & support
Patient billing statements and balance queries handled to your standards.
Who this is for
- Physician practices and specialty clinics of all sizes
- Medical billing companies needing scalable delivery capacity
- Provider groups with rising denials or aged AR
- Practices losing revenue to slow or inconsistent billing
- Operations leaders standardizing revenue-cycle workflows
Scenarios
Common situations we solve
If any of these sound familiar, outsourcing medical billing to Actigy is worth a conversation.
Denials are climbing and AR is aging.
We work and appeal denials and chase AR by priority.
Your biller left and claims are piling up.
We pick up charge entry, submission, and follow-up.
You're adding providers or locations faster than billing keeps up.
Capacity scales with your volume.
Collections are below benchmark for your specialty.
We raise clean-claim rates and report the metrics.
Is this the right fit?
When Actigy BPO is a strong fit
- You want a higher clean-claim rate and faster reimbursement
- Denials and aged AR are eroding collections
- You need documented, consistent revenue-cycle execution
- Your volume is growing faster than your billing team
- You want HIPAA-conscious handling and QA on billing work
When Actigy BPO may not be the right fit
- You need a practice-management or EHR software product rather than an operations team
- You require certified coders to hold final coding authority of record without your oversight
- You are unwilling to grant scoped, compliant access to your billing systems
- Your volume is too small to justify a managed billing operation
Why Actigy
Why outsource medical billing outsourcing to Actigy BPO
Denials worked and prevented
Denials are appealed and root-caused so the same rejections stop recurring.
HIPAA-conscious handling
Access is scoped and logged; operators work to documented privacy and security practices.
AR you can see
Days-in-AR, denial rate, and collections reported so revenue-cycle health is visible.
Delivery method
How Actigy launches your medical billing outsourcing team
Every engagement follows the same pilot-first method, adapted to the controls your process requires.
- 01
Process audit
We map the current workflow, volumes, systems, exceptions, and quality bar so scope and staffing are based on evidence, not guesswork.
- 02
SOP & KPI design
We document standard operating procedures and define the KPIs and SLAs we will be measured against before anyone touches live work.
- 03
Team selection
We assemble operators and team leads matched to your domain — finance, clinical, compliance, technical — and your tooling.
- 04
Training & knowledge transfer
We run structured onboarding against your SOPs, edge cases, and systems, with sign-off before the team carries production volume.
- 05
Pilot
A controlled pilot validates quality, throughput, and turnaround against the agreed KPIs. We tune the process before scaling.
- 06
Scale
We ramp the team to full volume with capacity planning, coverage models, and the reporting cadence agreed up front.
- 07
Continuous improvement
QA sampling, root-cause reviews, and monthly business reviews keep error rates down and throughput predictable over time.
Related services and industries
Services
Industries
Resources
Visibility
What you'll see every month
Outsourcing medical billing should make quality more visible, not less. Actigy reports on the numbers that matter and reviews them with you on a fixed cadence, so the operation stays accountable. The same discipline applies whether you run lean or at enterprise Healthcare & Clinics scale.
- A QA sample of completed work, scored against the accuracy bar agreed at go-live
- SLA attainment — turnaround and throughput measured against your targets
- Volume, backlog, and exception trends, so capacity stays ahead of demand
- Root-cause notes on any error, with the SOP change made to prevent a repeat
- A monthly business review with your point of contact and the team lead
Engagement model
How pricing and engagement work
Actigy prices medical billing on a transparent staffing model tied to scope, volume, and complexity — the cost-to-quality ratio, not an opaque per-transaction markup. Many teams run it alongside medical transcription outsourcing and accounts payable outsourcing under one delivery team, with a single point of contact.
Start with a pilot
A scoped, paid pilot proves quality and throughput before you commit to full volume.
Staffing-based pricing
You see the team, the roles, and the cost. Capacity flexes up or down with your volume.
You own the documentation
SOPs and process knowledge stay yours, which keeps switching costs low and cuts key-person risk.
Clean exit and transfer
If you wind the engagement down, Actigy returns current documentation and supports knowledge transfer.
See how Actigy would run your medical billing operation
Book a consultation and we'll assess scope, complexity, staffing, and delivery cost — then propose a pilot to prove quality before you scale.
FAQ
Frequently asked questions
What is medical billing outsourcing?
Medical billing outsourcing delegates revenue-cycle work — charge entry, coding support, claim submission, denial management, and AR follow-up — to a trained team that works inside your practice-management and clearinghouse systems. Actigy runs it with HIPAA-conscious controls and QA to improve clean-claim rates and collections.
Is outsourced medical billing HIPAA-compliant?
Actigy works to HIPAA-conscious practices: scoped system access, logging, and documented privacy and security procedures, governed by a business associate agreement. Compliance is treated as a delivery requirement, and expectations are agreed before any access is granted.
Can Actigy reduce our denials and aged AR?
Yes. Actigy works denials, appeals recoverable claims, and root-causes rejection patterns so they stop recurring, while systematically working aged AR by priority. The combined effect is a lower denial rate and fewer days in AR over time.
Does Actigy replace our coders?
Actigy provides coding support to improve clean-claim rates and works alongside your coding function. Final coding responsibility of record stays with your certified coders and providers; Actigy supplies operational capacity, documentation, and QA.
Which billing systems does Actigy work in?
Actigy operates within your existing practice-management, EHR, and clearinghouse systems rather than requiring new software, so your data stays in one place and there is no migration.
How much does medical billing outsourcing cost?
Actigy prices medical billing per FTE — a transparent monthly rate per role, set by the role and your specialty — not a percentage of collections or per claim. A Tech Lead owns quality; choose a managed team or staff augmentation. We work in your practice-management/EHR systems and quote after a short process audit.
Is outsourcing medical billing worth it?
It is worth it when denials, aged AR, or staffing gaps are eroding collections. Outsourced billing can raise clean-claim rates and reduce days in AR, with results reported monthly. Clinical and coding responsibility of record stays with your providers and coders.
Outsource the process. Keep control of the outcome.
Tell us what process you want to outsource. Actigy will assess scope, complexity, staffing model, and delivery cost.