Provider Services

Provider Services

By partnering with Vertex Medical Billing for revenue cycle management and healthcare information services, healthcare organizations can focus their time and resources on their core priorities. Our clients trust us for our extensive industry expertise, personalized account management, and innovative approach to overcoming challenges. With over 25 years of experience, Vertex Medical Billing is dedicated to transforming the revenue cycle and health information management landscape. We deliver cutting-edge solutions powered by deep knowledge, proven experience, and an unwavering commitment to excellence—reflected in our people, processes, and technology.

At Vertex Medical Billing, we share a commitment to advancing healthcare excellence by partnering with providers to tackle their most critical challenges. Through our comprehensive suite of solutions—including coding, billing, and risk adjustment—we streamline operations and enhance patient care, fostering a more efficient and effective healthcare system.

We proudly deliver a full range of revenue cycle management and health information management services to leading hospitals, health systems, physician groups, and ambulatory surgery centers nationwide. Our focus is on exceeding industry standards for quality, accuracy, turnaround time, and security, driving outstanding outcomes for our clients.

With over 25 years of experience, Vertex Medical Billing is dedicated to transforming the revenue cycle and health information management landscape. Our solutions are powered by deep expertise, proven knowledge, and a steadfast commitment to excellence—reflected in every aspect of our people, processes, and technology.

Coding/Health Information Management (HIM)

Accurate and compliant medical coding must go hand-in-hand with fair and optimized service payments. In today’s volatile regulatory environment—with evolving care models, a growing self-pay patient base, and increasingly complex federal audit requirements—the stakes are higher than ever. At Vertex Medical Billing, our specialized coding expertise ensures high accuracy rates, quick turnaround times, and enhanced productivity, all while providing the flexibility our clients need. Operating within a strictly regulated, HIPAA-compliant framework, we deliver exceptional coding solutions that are both reliable and cost-effective. We prioritize hiring and investing in the industry’s best coders while also sponsoring their AHIMA or AAPC certifications to ensure continued professional growth. Our team is composed entirely of individuals trained in medical, nursing, para-medical, and life sciences fields, fostering a well-rounded and knowledgeable workforce. Additionally, we build specialized teams of clinicians and nurses dedicated to DRG validation and HEDIS. Our commitment to quality is demonstrated through proven multi-step quality assurance processes and the implementation of process improvement methodologies like HKPD (Hoshin Kanri Policy Deployment) and Six Sigma. With extensive experience working across numerous HIS and coding systems—including EPIC, Cerner, Siemens, MEDITECH, 3M, Sorian, Optum, and eClinicalWorks—we deliver high-quality results. Our dedication to our employees has resulted in one of the lowest turnover rates in the industry. Each year, we code and review millions of charts for a wide range of healthcare providers, including acute care hospitals, academic hospitals, urgent care centers, physician groups, ACOs, and payers.

  • Clinical documentation improvement
  • Coding audits
  • Clinical abstraction
  • Remote coding

Revenue Cycle Management

Vertex Medical Billing offers a comprehensive suite of end-to-end revenue cycle management services tailored for hospitals, physician billing, and ambulatory surgery centers. Leveraging our deep expertise and best practices in revenue cycle management, we deliver high-quality, cost-effective solutions that drive results. Our specialized teams focus on streamlining operations, reducing insurance claim denials, and maximizing revenue—all while ensuring strict compliance with industry regulations.

With turnaround times of 24 to 48 hours, our clients benefit from accurate, timely, and reliable outcomes. Powered by a strong combination of skilled professionals, efficient processes, and technology-driven solutions, Vertex Medical Billing is committed to providing the tools and support your organization needs to stay ahead of the competition.

We offer a comprehensive suite of healthcare support services designed to streamline and optimize revenue cycle management. Our services include credentialing, scheduling, and pre-registration, ensuring that patient onboarding is seamless from the start. We handle eligibility and benefit verification, patient demographic entry, and provide efficient prior authorization services, including automation to reduce delays. Our expertise extends to transcription, medical coding, charge entry, claims edits, and claims rejection management. We manage payment posting, credit balance review, and correspondence and denial management with precision. Additionally, we leverage robotic process automation (RPA) to enhance efficiency and accuracy across processes. Our risk adjustment management services include RAPS to EDPS conversion, charge capture optimization, coding audits, and clinical documentation improvement. We also specialize in clinical abstraction and provide consulting services to help healthcare organizations achieve operational excellence.

Call Center Services

With over 25 years of experience in the healthcare services industry, Vertex Medical Billing provides fast, dependable healthcare call center support tailored to meet patient care needs. Our services go beyond standard call center functions, aiming to enhance the patient experience and optimize healthcare operations. By delivering valuable support, we help healthcare organizations improve both patient satisfaction and overall operational efficiency.

We specialize in coordinating appointment bookings across multiple channels, ensuring a smooth and consistent experience for patients. Our services focus on improving call responses and significantly reducing call abandonment rates, enhancing overall patient satisfaction. We also address and fix referral leakage, ensuring that patient referrals are efficiently managed and retained. Our team expertly handles both inbound and outbound calls, schedules appointments and follow-ups, and verifies insurance details to streamline the entire patient engagement process.