Nexus IO provides customized physician billing services for healthcare practices across the USA. From insurance verification and coding to denial resolution and payment posting, we handle every step of the physician billing cycle. By outsourcing to Nexus IO, your practice benefits from high-claim pass rates, reduced administrative workload, and stronger financial outcomes, all while you focus on delivering quality patient care.
Collection Ratio
First Pass Clean Claim Rate
Reduction in A/R
Physician billing services play a critical role in managing the financial health of healthcare practices. As insurance regulations, coding standards, and payer requirements continue to evolve, outsourcing billing has become an essential strategy for improving reimbursement accuracy, reducing claim denials, and maintaining regulatory compliance.
Professional physician billing companies like Nexus io offer end-to-end revenue cycle management (RCM) tailored for both single and multi-site practices. These services are designed to handle every stage of the physician billing process with precision and speed, including:
With HIPAA-compliant systems and payer-specific billing expertise, physician billing providers ensure compliance while accelerating collections. These services help providers reduce administrative burden, cut overhead costs, and boost revenue, all while allowing more time to focus on patient care.
Coding Accuracy Rate
Revenue Growth
States Served
Clean Claim Rate
Across the USA, physicians face increasing pressure to maintain profitability amid a rapidly evolving and highly regulated healthcare environment. Many practices dedicate over 20 hours per week to billing and claims processing, yet studies show that nearly 80% of submitted claims still contain errors leading to delays, denials, and revenue loss.
Issues like medical coding inaccuracies, incomplete documentation, and constantly changing payer requirements can disrupt the entire revenue cycle, costing practices thousands in delayed or denied reimbursements. To minimize denials and ensure faster payments, physicians must understand the critical billing challenges that hinder financial performance.
Even highly organized physician practices experience claim denials often due to small but costly oversights. A misplaced CPT modifier, mismatched ICD-10 diagnosis, outdated insurance information, or duplicate charges can delay payments and impact your bottom line.
Nexus io provide physician billing and coding services that proactively identify and fix these issues through accurate charge entry, code validation, and real-time claims scrubbing. Our goal is to prevent denials before claims reach payers, make sure cleaner submissions and faster reimbursements.
Even minor coding and billing mistakes can trigger repeated rejections. The most frequent issues we resolve include:
At Nexus io, each physician claim is reviewed by certified physician billing specialists who stay updated with weekly changes to ICD-10, CPT, and HCPCS Level II coding guidelines. Our team continuously trains to adapt workflows based on evolving payer policies, ensuring alignment with the latest reimbursement standards.
We apply the correct CPT modifiers, validate active insurance coverage, obtain prior authorizations, and confirm that all documentation supports medical necessity. These proactive measures eliminate common billing errors, reduce denial rates, and produce clean, compliant claims resulting in faster reimbursements and improved revenue cycle performance.
Physician billing burnout is now considered an epidemic by the American Medical Association (AMA), with over 63% of physicians affected by administrative overload and billing pressure. From Electronic Health Record (EHR) upkeep to claim submissions, billing tasks continue to strain medical staff. To add to the pressure, there’s a 30% nationwide shortage of certified medical coders, making in-house billing even harder to sustain.
Nexus io offers physician billing services designed to relieve that burden. Our AAPC-certified coders ensure accuracy, speed, and full compliance with CMS billing guidelines, helping you eliminate errors and boost revenue cycle efficiency.
Key Features of Physician Medical Billing Services
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Insurance verification and eligibility checks are a critical first step in preventing claim denials and revenue leakage. At Nexus IO, we perform real-time eligibility verification for every patient, ensuring that coverage is active and payer requirements are met so providers can deliver care with confidence and avoid costly billing issues.
At Nexus io, we specialize in recovering aging accounts receivable (A/R) for physician practices, especially balances over 120 days old. Our experienced billing team conducts detailed audits of outstanding claims, using advanced A/R follow-up tools and collections workflows to pursue both insurance payers and patients.
Every practice faces different reimbursement barriers—so we customize our physician revenue optimization strategy to recover both high-value and low-balance claims. This ensures no revenue is left behind and your cash flow stays consistent.
Medicare’s Merit-based Incentive Payment System (MIPS) now enforces a 75 point performance threshold. Failing to meet this benchmark can result in up to a 9% reimbursement penalty, while exceeding it can significantly boost your revenue making MIPS reporting a critical part of your practice’s financial strategy.
As a physician billing and MIPS support partner, Nexus io helps providers optimize MIPS category performance through accurate coding, real-time quality reporting, and proactive denial reduction. Our team ensures full compliance with CMS MIPS requirements, enabling you to avoid negative payment adjustments, earn incentive bonuses, and protect your revenue cycle.
At Nexus io, we understand that each medical specialty faces unique billing challenges. That’s why we offer round-the-clock customer support tailored to your practice’s specific needs. Whether you’re managing complex oncology claims, dermatology coding, or cardiology reimbursements, our team is available 24/7 to provide expert guidance and fast resolutions.
Our achievements are a testament to our hard work team to deliver exceptional revenue boost results and gain the client’s trust in us.
What services does Nexus io offer for physician reimbursement support?
Nexus io provides end-to-end physician medical billing services: charge capture, coding, claim scrubbing, electronic submission, denial management, payment posting, and analytics. We also handle credentialing, payer contracting, and patient‐statement follow-up so every dollar earned reaches your practice quickly.
How does Nexus io ensure coding accuracy in physician billing?
Our AAPC-certified coders audit each encounter, apply the latest CPT and ICD-10 coding for physicians billing, and run edits through proprietary rules engines. With our dual-review spot checks, quarterly physician billing services compliance, and audits to keep error rates below industry benchmarks.
How does Nexus io help providers and patients understand EOBs?
As a physician billing company, Nexus io translates payer Explanation of Benefits into plain-language summaries, highlighting allowed amounts, adjustments, and patient responsibilities. Providers access annotated dashboards, while patients receive clear statements and live-agent support for any questions.
How does Nexus io streamline the prior authorization process?
Our PA team verifies medical necessity, compiles required documentation, and submits electronic requests through payer portals. With our automated status tracking, EHR and EMR billing integration, and billing portals/real-time analytics alerts reduce approval turnaround times and prevent last-minute procedure delays.
How does Nexus io prevent unbundling errors in bundled service claims?
Coding software cross-checks NCCI edits and payer-specific bundling rules, flagging services that must be billed together. When legitimate modifiers apply, our coders append them with supporting documentation, safeguarding revenue and compliance.
Nexus io place the utmost priority on our patient privacy, we ensure that our healthcare revenue cycle management services fully comply with HIPAA regulations; to protect patient’s data with strong security measures:
Looking for reliable support in managing your physician billing and revenue cycle?
Nexus IO is a trusted physician billing company delivering accurate, transparent, and fully compliant RCM services. We keep your team informed at every step from charge entry to final reimbursement.
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