Transforming Healthcare Finances

Medical Billing Services In Washington

If You're Seeing 30 Patients a Day and Still Struggling With Cash Flow.

Discover the easiest way to plug profit holes, slash admin burnout, and finally gain control of your cash flow. We don't sell services. Our Medical Billing Services In WA solve your billing pain.

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HIPAA Compliant HIPAA Compliant
99.9% Accuracy 99.9% Accuracy
24/7 Support 24/7 Support
Revenue Dashboard
+24.5%
$48,250
This Month
97.3%
Collection Rate
Claims Processed
1,248
Days in A/R
18 days
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Increase Revenue
Up to 30% more
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Save Time
20+ hours/week
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Reduce Costs
Up to 50% less
Practice Information Practice Information
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Ready to Predict
Enter your practice information to get AI-powered denial rate predictions and insights.

The Real Reason Washington Providers Are
Struggling With Reimbursements

Watch how a simple patient visit becomes a billing nightmare
Week 1 Week 12+
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Confusing Regulations
BBPA vs No Surprises Act creates claim paralysis
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Payment Delays
32% of claims unpaid for 90+ days
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Outdated Tech
No API integration, manual systems
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Staffing Gaps
One-person billing teams, high turnover

The Result
85%
WA hospitals ended 2024 in the red
32%
Claims unpaid for 90+ days
60¢
Medicaid pays per $1 of care
Want to see how much you're losing and how we'll get it back?
Request Your Free Revenue Recovery Snapshot

Generic RCM Services in Washington Doesn't Cut It

You Know That.
So Do Your Denials.
Let's be blunt.
If your current billing partner...
BBPA Arbitration Handling
Never handled a single BBPA arbitration
Failure Rate: 100%
Regulatory Conflicts
Doesn't understand regulatory conflicts and precedence
ProviderOne Integration
Not fully integrated, struggles with submission errors
Medicaid Workflow Differentiation
Can't differentiate between Medicaid workflows
Prior Auth API Integration
Still uses manual workflows for prior auths
VS
HMS USA LLC Solution
Alternate Text BBPA Arbitration Handling
Washington's Balance Billing Protection Act
Alternate Text Expert BBPA arbitration management with proven track record
Success Rate: 95%
HMS USA LLC Solution
Alternate Text Regulatory Expertise
Expertise in regulatory compliance and conflict resolution
Alternate Text Proven track record in regulatory navigation
Success Rate: 92%
HMS USA LLC Solution
Alternate Text ProviderOne Integration
Seamless ProviderOne integration for error-free submissions
Alternate Text Automated, reliable submission process
Success Rate: 90%
HMS USA LLC Solution
Alternate Text Medicaid Workflow Differentiation
Tailored Medicaid workflow solutions
Alternate Text Custom processes for Medicaid compliance
Success Rate: 93%
HMS USA LLC Solution
Alternate Text Prior Auth API Integration
Automated prior authorization API integration
Alternate Text Faster, error-free prior auth workflows
Success Rate: 94%

Accurate, Compliant Billing for Every Washington Specialty We Serve

Because a cardiologist's revenue cycle doesn't look anything like a psychiatrist's—and we know the difference.
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Psychiatry & Psychology
Washington payers are notorious for denying psych claims for "lack of medical necessity." We know how to pre-code, document, and defend sessions—especially for Medicaid and MCOs like Molina and Amerigroup.
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OB/GYN Billing
Bundled pregnancy billing under Apple Health can wreck cashflow if not timed right. We track every date-of-service and code transitions for full-cycle maternity billing, including postpartum follow-ups and WA parity rules.
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Primary Care
E/M visits, CCM, TCM, annual wellness...we maximize revenue under complex Medicare/Medicaid blends. We also know how to navigate Washington's telehealth billing rules and HB 1357 prior auth timelines.
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Behavioral Health
HCA enrollment issues, EVV coding errors. Outpatient mental health denials. We've fixed them all. Whether you're billing under Apple Health or struggling with MCO authorization chaos—we've got your back.
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Orthopedic Surgery
Pre-auth delays and surgical bundle confusion are revenue killers. We pre-clear every CPT cluster, justify with local payer guidelines, and avoid denials on bundled or multi-procedure claims.
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Rural Health Clinics
We handle PPS logic, wrap-around claims, and Medicare cost-report-ready documentation. Plus, we know the pitfalls of ProviderOne and WA Medicaid enrollment for rural providers.
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Don't See Your Specialty?
We've likely already optimized revenue for a clinic like yours—right here in Washington.
Ask About Your Specialty
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Our 10-Step Medical Billing & Coding Process

Specifically designed for Washington Providers with state-specific compliance and optimization
Step 1
Initial Billing System Audit
We analyze your current workflow, denial history, payer mix, and compliance risks—through a Washington lens.
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Step 2
Payer Contract Review
We evaluate reimbursement rates, credentialing gaps, and dispute resolution procedures (including BBPA & NSA alignment).
Step 3
Code & Modifier Accuracy Check
We scrub your CPT, HCPCS, ICD-10, and POS codes correct for Washington Medicaid rules, MCO plans, and specialty-specific traps.
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Step 4
Prior Authorization Flow Rebuild
We streamline and automate your PA process aligning it with WA's HB 1357 timelines and upcoming EHR integration mandates.
Step 5
ProviderOne & EHR Integration
We connect your billing system with ProviderOne, MCO portals, and your EHR to eliminate duplicate entry, claim dropouts, and human error.
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Step 6
Clean Claim Submission Optimization
We batch-process and scrub every claim pre-submission minimizing denials and ensuring payer compliance, including Apple Health and Medicare Advantage.
Step 7
Denial Management & Appeals Engine
We build a real-time rejection feedback loop, appeal improper denials, and track insurer tactics across your top payers.
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Step 8
AR Recovery & Aging Claims Cleanup
We aggressively work your backlog resubmitting, appealing, and recovering old dollars that were written off or forgotten.
Step 9
Compliance & Documentation QA
We monitor for policy changes, coding updates, and payer-specific alerts (e.g. OIC rules, gender-based denials, parity law shifts).
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Step 10
Reporting, Forecasting & Revenue Intelligence
You get transparent dashboards, payer behavior insights, and monthly strategy reviews so you're never left guessing again.

Where Most Washington Clinics Are Losing Revenue

(And Don't Even Know It)
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Billed Claims
Total claims submitted
100%
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Authorization Delays
Stuck in authorization limbo
12% lost
88% Remaining
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Claim Denials
Rejected by payers
9% lost
79% Remaining
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Appeals Process
Denials accepted without fight
7% lost
72% Remaining
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Written Off
Amount Insurance Written Off
4% lost
32% Remaining
Total loss of billable revenue lost downstream

Before & After Partnering with HMS USA LLC

See the dramatic improvements our Washington clients experience within the first 90 days
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Days in AR
Reduced accounts receivable aging
Before: 87days
After: 51days
Alternate Text41% faster
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Clean Claim Rate
Higher first-pass acceptance rate
Before: 84%
After: 97%
Alternate Text15% increase
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Monthly Collections
Increased revenue collection
Before: $142K
After: $181K
Alternate Text27% boost
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Denial Rate
Fewer claim rejections
Before: 26%
After: 9%
Alternate Text65% reduction

Complete Performance Overview

Visual comparison of all key metrics before and after HMS partnership

What Your Billing Reports Will Start Showing

(Once We're Involved)
Transform your basic reports into powerful business intelligence tools with actionable insights.
Report Feature Current State HMS Enhanced Impact
Denial Root Causes Generic percentages CPT, provider, and MCO-level data +85% insight depth
AR Insights Aged buckets only Time-to-pay by payer, with alerts +60% faster resolution
Modifier Impact Not reported Payment % loss by modifier used Previously hidden
Appeal Visibility Missing entirely Live status for every appeal cycle 100% transparency
Payment Timeline Accuracy Processed ≠ paid Clean posted vs. actual paid dates +95% accuracy
Denial Root Causes
Current State
HMS Enhanced
Generic percentages
CPT, provider, and MCO-level data
+85% insight depth
AR Insights
Current State
HMS Enhanced
Aged buckets only
Time-to-pay by payer, with alerts
+60% faster resolution
Modifier Impact
Current State
HMS Enhanced
Not reported
Payment % loss by modifier used
Previously hidden
Appeal Visibility
Current State
HMS Enhanced
Missing entirely
Live status for every appeal cycle
100% transparency
Payment Timeline Accuracy
Current State
HMS Enhanced
Processed ≠ paid
Clean posted vs. actual paid dates
+95% accuracy

Quality Payment Program Optimization For Washington Providers

We ensure you maximize revenue from the state and federal value-based programs you're already participating in
Medicaid MCO Incentive Programs
PROGRAM 01 OF 06
Maximize payouts from Molina, CHPW, and other managed care organizations
$25K+
Average annual increase per provider
Optimized
Automated compliance
Hospital Quality Incentive (HQI) Payouts
PROGRAM 02 OF 06
Optimize HQI reporting for maximum state incentive capture
$50K+
Maximum annual HQI bonus
Optimized
Automated compliance
Behavioral Health Integration Models
PROGRAM 03 OF 06
FUH, FUA, and APM bonus optimization for mental health services
30%
Higher reimbursement rates
Optimized
Automated compliance
CMS MIPS / QPP Submissions
PROGRAM 04 OF 06
Strategic Medicare Quality Payment Program optimization
9%
Medicare bonus potential
Optimized
Automated compliance & reporting
HEDIS-Aligned Billing Workflows
PROGRAM 05 OF 06
Streamlined processes for quality measure reporting
100%
Automated compliance
Optimized
Automated compliance & reporting
Documentation Strategy
PROGRAM 06 OF 06
Encounter form strategy for bonus trigger accuracy
95%
Accuracy improvement
Optimized
Automated compliance & reporting

Why Choose HMS USA LLC

(The ROI Is the Reason)
HMS USA LLC isn't a cost—it's a revenue multiplier
REVENUE RECOVERY
$71K
Recovered
Seattle mental health clinic recovery
Progress85%
0100
INCENTIVE BONUSES
$29K
Claimed
QIP-linked visit optimization bonuses
Progress95%
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DENIAL REDUCTION
32%
Fewer
Reduction after payer-specific scrubbing
Progress68%
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STAFFING SAVINGS
$0
New Hires
We handle backend and appeals workflow
Progress100%
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CLEAN CLAIMS
+14%
Increase
Improvement in first billing cycle
Progress78%
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CONTRACT TERMS
$0
Setup Cost
No setup fees, no long-term contracts
Progress92%
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What Clients Say About Us

Below, you will find feedback from some of our cherished clients. We are proud to have helped them reach their business goals, and we appreciate the kind words they have shared about our services.

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