MedsIT Neuxs is equipped with nationally accredited revenue cycle experts who specialize in navigating the intricacies of hospital facility billing. In the past few years, we have worked with renowned hospitals in the USA, streamlining their billing and claim processing for complex patient care scenarios in inpatient and outpatient settings. Our enhanced workflows recovered $20 million from outstanding Receivables and established a foundation for the client's expansion.
Our Specialties
Accomplish Rapid Growth
Billing complications slow down operational efficiency. Get rid of the hassle with our qualified billing experts and boost your revenue
Get a QuoteMedsIT Nexus has a dedicated team specialized in the hospital billing and collection process, applying their experience and best practices in recovering aged invoices and managing claim denials that increase 98% of the institution's net collection rate and maximize the cash flow.
MedsIT Nexus specializes in MS–DRG–based billing for acute care hospitals, LTACHs, IRFs, and SNFs. We ensure accurate DRG assignment, clean claims, and compliant documentation. Our best practices streamline inpatient revenue cycles, reduce denials, and accelerate reimbursements for diverse inpatient facility types.
Knowledge of MS-DRG Reimbursement method, Complex bundling and unbundling techniques
Our medical coding experts have vast experience in translating complex inpatient care scenarios into the required medical codes
MedsIT Nexus medical billing staff is proficient in completing the CMS-1450 (UB-04) form accurately with relevant codes and appropriate Type of Bill (TOB), which results in increasing the first-pass claim rate
With expertise in medical billing for inpatient facilities, we enhance revenue cycle efficiency while maintaining strict compliance with Medicare and commercial payers.
At MedsIT Nexus, our hospital billing specialists bring extensive expertise in Medicare Part A billing, specifically for diagnostic services rendered in inpatient facility settings. We ensure full compliance with regulatory requirements while optimizing reimbursement and streamlining revenue cycle management (RCM) for hospitals.
Precise classification of claims based on patient status (inpatient vs. observation), provider roles, and facility type to ensure accurate DRG assignment and coding integrity
Applying Inpatient Prospective Payment System (IPPS) methodologies, including MS-DRG and revenue code alignment, to support correct billing and reimbursement
Technically distinguishing diagnostic services performed by the hospital’s in-house laboratory staff from those outsourced to external or reference labs, ensuring accurate billing and compliance with CMS guidelines
With a strong focus on inpatient facility billing, we ensure accurate diagnostic service documentation, compliance with CMS guidelines, and maximized reimbursement—all while facilitating seamless coordination between clinical and billing departments.
MedsIT Nexus has a dedicated team that specializes in outpatient facility-level billing. With significant knowledge of the required reimbursement methods, unique billing and coding requirements, our professionals navigate the everyday challenges of recovering aged invoices and managing claim denials that result in increasing institution's net collection rate and maximizing the cash flow
MedsIT Nexus has hospital billing professionals who specialize in the required reimbursement methods. With expert knowledge in the revenue cycle processes, our team ensures accurate claims processing for the complex patient care scenarios that take place in the provider & non-provider-based Emergency Room, Urgent Care Centers, and ASCs, resulting in enhanced financial performance of your organization
Our team has significant knowledge and experience in the OPPS & APC reimbursement system, enabling us to streamline billing and claims processing for hospital outpatient services
Our team is equipped with medical coding experts specializing in the required medical coding set in the outpatient setting. Ensuring proper reimbursement with accurate code assignment
Our professionals expertly create and process UB-04 claims with the required billing codes, ensuring accurate and compliant billing for hospital outpatient facility settings
With cutting-edge billing technology and a commitment to precision, our best practices result in enhanced financial performance for the outpatient facilities of your organization.
MedsIT Nexus hospital billing experts are specialised in At MedsIT Nexus, our hospital billing specialists excel in Medicare Part B outpatient billing, ensuring compliance and optimal reimbursement for Advanced Practice Providers (APPs) in hospital-based outpatient settings. With the following expertise, we streamline the RCM process
Accurately classifying claims based on provider employment structure and place of service (POS) to ensure correct CPT® and HCPCS coding
Applying Ambulatory Payment Classification (APC) reimbursement models for outpatient facility services
Separating technical and professional components for services like diagnostic tests and therapeutic procedures
Our expertise in hospital-based outpatient billing ensures precise documentation, regulatory compliance, and maximized reimbursement while maintaining seamless coordination with hospital departments.
With our hospital revenue cycle management services, you can maximize reimbursements, reduce denials, and streamline workflows. From patient access to final payment, we ensure your facility stays financially healthy and audit-ready.
Ensure your hospital’s revenue integrity with our expert Hospital Billing Audit services. We dive deep into UB-04 claims, revenue codes, and DRG assignments to uncover missed charges, compliance risks, and documentation gaps. Our audits validate inpatient vs. outpatient status, charge capture accuracy, and alignment with Medicare regulations. Protect your facility from denials, maximize reimbursements, and stay audit-ready with a partner who understands the complexity of institutional billing.
Get your hospital credentialed with confidence. Our Hospital Facility Credentialing service ensures your facility meets all payer and regulatory requirements — from NPI Type 2 setup to Medicare, Medicaid, and commercial insurance enrollments. We handle licenses, CLIA, DEA, and accreditation verification to position your hospital for seamless institutional billing. Stay compliant, avoid denials, and accelerate your reimbursement process with a credentialing partner who understands the complexity of facility-level approvals.
Optimize your hospital’s revenue with our expert Hospital Coding Services. We specialize in accurate facility coding and APCs to ensure compliance and maximize institutional reimbursement. From inpatient to outpatient settings, our certified coders translate complex clinical documentation into precise codes that reflect your hospital’s services. Reduce denials, improve audit readiness, and streamline billing cycles with a team that understands the intricacies of hospital-level medical coding.
Maximize hospital revenue and minimize payment delays with our expert Hospital Accounts Receivable Management Services. We specialize in managing complex institutional claims, resolving denials tied to DRGs, APCs, and revenue codes, and accelerating cash flow across inpatient and outpatient services. Our team handles high-dollar claims, payer audits, and underpayment recovery with precision. From aging A/R follow-up to secondary billing, we ensure your hospital gets paid faster and more accurately. Trust a team that understands the unique A/R cycle of hospital facilities and delivers results that improve your bottom line.
Turn hospital denials into recovered revenue with our specialized Hospital Denial Management Services. We tackle complex denials tied to DRGs, APCs, medical necessity, and inpatient status disputes—backed by thorough documentation and expert appeals. Our team works across departments to resolve high-value claims quickly, reduce write-offs, and prevent future denials through root cause analysis. Whether it's authorization gaps, level-of-care rejections, or coding inconsistencies, we bring precision and persistence to every case. Safeguard your revenue cycle with a denial management strategy built for hospital-level complexity and compliance.
Ensure uninterrupted care and faster reimbursements with our expert Hospital Insurance Verification Services. We verify multi-level coverage across inpatient, outpatient, and surgical services—coordinating with payers to confirm benefits, eligibility, and preauthorization requirements. From high-cost diagnostics to complex admissions, we handle every detail to prevent claim denials and delays. Our team navigates payer rules, secures real-time approvals, and provides the documentation hospitals need to stay compliant. Trust us to protect your revenue from the very first step in the billing cycle.
Discover accurate credentialing with MedsIT Nexus's innovative portal. Thecredentialing offers a quick way for providers to include their details and get credentialed.
Eliminates paperwork, streamlining credentialing with automation for faster approvals, improved accuracy, and regulatory compliance.
Reduces administrative workload and automates credentialing, helping healthcare facilities lower costs while ensuring compliance.
Accurate credentialing minimizes claim errors, accelerates approvals, and ensures timely reimbursements, improving cash flow.
Whether you're a public, private, non-profit, or for-profit hospital, our billing solutions adapt to your financial ecosystem. We align with your revenue model and payer mix, handling Medicare, Medicaid-heavy claims, charity care adjustments, and sliding-scale billing. In for-profit systems, we drive faster cash flow with aggressive, compliant RCM strategies.
Need a customized billing plan based on your hospital’s structure
Doctors lose up to
Billion in U.S
Because of poor billing practices
When hospital patients transition into outpatient settings, every coding detail & reimbursement rule must align or revenue is at risk. We manage these touchpoints before they become denial triggers.
Whether a patient is discharged to an SNF, HHA, or returns for services in a HOPD or ASC, each transition comes with billing risks that can snowball into denials. We bridge every stage of the care continuum, ensuring your inpatient billing aligns with the outpatient services that follow.
Discharge codes + PDPM compliance
When a patient transitions from an inpatient bed to an SNF, the billing process enters a new compliance phase, guided by the PDPM rather than the DRG system. Learn how our SNF billing services ensure smooth reimbursement continuity across the care settings
OASIS syncing + HHA PPS timelines
Patients transitioning into Home Health Care must be carefully evaluated for LUPA thresholds and episode timing. Explore our HHA billing solutions to see how we handle post-hospitalization complexities
3-Day Rule + bundling logic
Transitioning to a Hospital Outpatient Department (HOPD)? We audit whether any post-discharge services fall under the 3-Day Payment Window and ensure the outpatient charges are properly bundled or split, based on facility type & provider affiliation. Navigate to the outpatient
billing to further explore a required
solution.
E/M services coding + continuity of care billing
Physicians providing follow-up care must bill with precision, especially when visits occur within global periods or after complex surgeries. See how we support
private practices in managing
post-inpatient care.
Medicare Caps + POS codes
Outpatient rehabilitation often follows inpatient care, especially after orthopedic or neurological procedures. Understand how our therapy billing workflows support seamless transitions.
Encounter-level billing + FQHC compliance
For underserved or rural populations, FQHCs often take over the care continuum after patients are discharged. Explore how we ensure compliance and accurate encounter billing in FQHC
environments.
Every transition is a potential compliance risk, and every mistake is a lost dollar. Whether that’s an SNF, a clinic, or a home health setting, we integrate hospital billing with the next phase of care, making sure you stay ahead of denial cycles and maximize reimbursement across the care continuum.
Need help managing billing across inpatient and outpatient transitions?
Talk to a Revenue SpecialistExperience-Driven Precision for Complex, Cross-Departmental Revenue Integrity Billing for a multi-specialty hospital isn’t just complex; it requires structured coordination and deep billing expertise to navigate the intricacies of care delivery across diverse clinical departments. Our specialists work closely with coders, clinicians, and compliance teams to unify documentation, eliminate denials, and maximize reimbursement, all without disrupting clinical workflows.
Specialty Hospital
Acute Care Hospital
Psychiatric Hospital
Rehabilitation Hospital
Long Term Care
Chronic Disease
Stop struggling with siloed billing teams, missed revenue, & payer pushback. Let our multi-specialty billing team bring clarity, control, and financial performance to your hospital’s bottom line.
Two Distinct Paths & One Integrated Billing Strategy
MedsIT Nexus is a full service revenue cycle company, equipped with certified billing professionals, auditors, and compliance analysts who understand how clinical workflows translate into billing logic, especially when applied to hybrid hospital structures that combine inpatient departments, outpatient clinics, and off-campus sites. We bring the clarity hospitals need to accurately bill clinical services under CMS regulations, commercial payer rules, and internal financial goals
Schedule a Discovery Call Book Now
We assist hospitals in billing outpatient departments (HOPDs) as provider-based under CMS’s strict requirements outlined in 42 CFR 413.65
Accurate facility vs. professional component billing
Modifier -PO and 3-day rule compliance
Split billing across UB-04 and CMS-1500 forms
Documentation support for Provider-Based Status criteria
Revenue recognition aligned with OPPS and cost reporting
With the above expertise, we help you maintain compliance, whether you're managing a hospital-based clinic or aligning services with affiliated group practices operating under shared clinical and administrative structures.
When clinical services are billed independently from the hospital entity, such as Independent Clinics & Outpatient Sites, urgent care centers, or freestanding facilities, we ensure
Proper use of POS codes
Clear delineation of facility and professional fees
Accurate CPT/HCPCS coding for outpatient encounters
Alignment with commercial payer requirements and fee schedules
Seamless claim flow from encounter to remittance
We build workflows that align clinical intent with financial classification, ensuring billing clarity that withstands audits and prevents denials
With MedsIT Nexus' hospital billing revenue cycle partnership, your organisation will gain access to specialised expertise, scalable technology, and real-time revenue insights, without the burden of staffing, training, or turnover. Whether you operate a large urban hospital, a regional health system, or a multi-specialty facility, our hospital billing team will reduce denials and improve the time to cash across all payers.
Our outsourced hospital billing services are built to integrate seamlessly with your existing systems, teams, and financial goals, delivering measurable outcomes at every stage of the revenue cycle.
From charge entry and coding to claims submission, follow-up, and payment posting, we manage the full billing lifecycle with transparency and accountability.
Dedicated teams for inpatient, outpatient, surgical, ED, imaging, and ancillary services — ensuring accurate, department-specific reimbursement.
Proactive edits, payer rule monitoring, and real-time denial management workflows that reduce revenue leakage and accelerate cash flow.
Built-in processes for HIPAA, OIG, CMS, and payer compliance — plus audit response support when needed.
Leverage our skilled billing professionals, certified coders, and advanced RCM technology, with the flexibility to grow with your hospital’s needs.
Actionable dashboards and monthly performance reviews that give your leadership complete visibility into revenue performance, trends, and opportunities.
We understand that hospital billing is different due to enhanced regulation, complexity, and sensitive workflow disruptions compared to other provider types. That’s why our model is built around.
Healthcare providers trust MedsIT Nexus
medical billing services company
our revenue cycle experts Identify gaps & unlock higher profitability
42% Denial Rate Reduction for a Regional Hospital MedsIT Nexus reduced denials by 42% in six months by auditing coding accuracy, aligning charge capture workflows, and applying payer-specific edits, while training clinical and billing teams to prevent revenue leakage and accelerate reimbursement by 11 A/R days.
Dr. Ndidi Uka
A-plus Dentistry
"I want to thank MedsIT Nexus for their impeccable service. They are incredibly knowledgeable and work to make sure you receive the maximum reimbursement. Sam, my dedicated Practice Manager, is always available to answer my questions and keep my abreast on the status of my submitted claims. Being able to bill medical services has allowed me to offer the best care."
M. Techeira
Family Medicine
"We are an outpatient family medicine/ primary care practice. Have offices in NYC and Nassau County. MedsIT Nexus handles all our medical billing and insurance claims. We switched from another company and the process was hassle free, no fees and FAST which was important since we operate 6/7 days. They are always available to answer any questions. We definitely recommend!"
Memoona Waheed
Family Medicine & Pain Management
"After reviewing different medical billing companies, I came across MedsIT Nexus. Not only do they offer billing and coding services, but specialize in credentialing and unpaid claims. Their staff is knowledgeable, professional and are easily accessible- inquiries are answered quickly. Thank you MedsIT Nexus for helping us improve our healthcare practice at a competitive rate!"
S. Dhillon
Physical Medicine & Rehabilitation
"I am the manager at a private physical medicine & rehabilitation practice. We operate in 2 different boroughs in NYC through multiple clinics. MedsIT Nexus handles all our medical billing, coding, denials and prior authorizations for all procedures. We are pleased with their same day approvals as well. Their staff is easily accessible, fast & pleasant to work with."
Dr. Ndidi Uka
A-plus Dentistry
"I want to thank MedsIT Nexus for their impeccable service. They are incredibly knowledgeable and work to make sure you receive the maximum reimbursement. Sam, my dedicated Practice Manager, is always available to answer my questions and keep my abreast on the status of my submitted claims. Being able to bill medical services has allowed me to offer the best care."
M. Techeira
Family Medicine
"We are an outpatient family medicine/ primary care practice. Have offices in NYC and Nassau County. MedsIT Nexus handles all our medical billing and insurance claims. We switched from another company and the process was hassle free, no fees and FAST which was important since we operate 6/7 days. They are always available to answer any questions. We definitely recommend!"
Memoona Waheed
Family Medicine & Pain
" After reviewing different medical billing companies, I came across MedsIT Nexus. Not only do they offer billing and coding services, but specialize in credentialing and unpaid claims. Their staff is knowledgeable, professional and are easily accessible- inquiries are answered quickly. Thank you MedsIT Nexus for helping us improve our healthcare practice at a competitive rate!"
S. Dhillon
Rehabilitation
" I am the manager at a private physical medicine & rehabilitation practice. We operate in 2 different boroughs in NYC through multiple clinics. MedsIT Nexus handles all our medical billing, coding, denials and prior authorizations for all procedures. We are pleased with their same day approvals as well. Their staff is easily accessible, fast & pleasant to work with."
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Medical Billing Audit
Medical Billing & Credentialing
Medical Billing & Coding
Hospital AR Billing Management
Hospital Denial Management
Hospital Insurance Verification Services
