Medical Billing & Coding Services

Medical Billing and Coding Support for Your Practice

Claim preparation Documentation-based coding Payment posting Payer follow-up

Overview

Medical billing and coding involves translating documented services into claims, submitting them to payers, recording responses, and following unresolved items. The exact workflow depends on the practice, its systems, payer mix, documentation, and service agreement.

Rafsons Med Billing can discuss support for coding workflows, claim preparation and submission, payment posting, denial review, and accounts receivable follow-up. We agree on responsibilities, system access, reporting, and data handling with each practice before work begins.

Codes should reflect the services documented in the medical record and applicable coding guidance. Payers make coverage and payment decisions; no claim acceptance rate, turnaround time, or reimbursement outcome is guaranteed.

Possible Service Activities

Documentation-based coding

Code services supported by the medical record and applicable coding guidance. Questions or missing information can be routed to the practice for clarification.

Claim preparation

Review claim data for completeness and coordinate corrections with your team before submission.

Payer follow-up

Track payer responses and document next steps for claims within the agreed work queue.

Payment posting

Record remittance information and identify balances or adjustments that need review.

Denial review

Organize denials by reason and help coordinate corrections, reconsiderations, or appeals when appropriate.

Workflow reporting

Agree on reports that show completed work, open items, and issues needing practice input.

How Work May Be Organized

Agree on responsibilities

Confirm the services, systems, access, communication, and data-handling terms for the engagement.

Receive encounter information

Your practice supplies the documentation and charge information needed for the agreed workflow.

Review and prepare claims

Coding and claim data are reviewed against the supplied record and applicable requirements; questions are sent back to your team.

Submit and track

Claims are submitted through the agreed process, then payer responses and unresolved items are tracked.

Post and report

Payment information and follow-up activity are recorded using the reporting approach agreed with your practice.

Frequently Asked Questions

What billing and coding work can be included?+

Depending on the engagement, work may include charge and claim review, coding support, claim submission, payment posting, denial follow-up, and reporting. We confirm the exact scope with your practice before work begins.

Which specialties and code sets do you support?+

Tell us your practice setting, specialties, and code sets during an initial discussion. We will confirm whether the requested work fits our current capabilities before proposing an engagement.

Do you guarantee a clean-claim rate or reimbursement amount?+

No. Claim acceptance and payment depend on documentation, payer rules, eligibility, authorization, timely filing, and other case-specific factors. Any performance measures should be defined and reviewed using agreed data and methods.

How do you handle coding questions?+

We document the question and request clarification from the appropriate practice contact. Coding should be supported by the medical record; reimbursement goals do not replace documentation or coding requirements.

Discuss your billing workflow

Tell us about your practice, systems, and the billing tasks you want to discuss. We will confirm scope, availability, and next steps.