Every session you bill should reach payment.
MedgenixPro handles claims, coding, and denial follow-up for behavioral health practices — inside the EHR and clearinghouse you already use, with a dedicated team who knows session limits, prior auth, and telehealth modifiers cold.
General billers miss the details that matter for your claims.
Time-band coding, not habit
90832, 90834, and 90837 each require the CPT code to match documented session length — bill the wrong band and it's a clean denial, not an appeal.
90791 vs. 90792 mix-ups
The non-medical diagnostic eval and the medical eval get confused constantly — one is billed by therapists, the other only when a real medication assessment happened.
The "golden thread" gap
Diagnosis, symptoms, intervention, and documented response all have to connect clinically — a broken thread is a medical-necessity denial waiting to happen.
E/M levels built on guesswork
Psychiatry E/M codes (99202–99215) need to be supported by documented medical decision-making or total time — not old-style bullet-point counting.
Controlled substance compliance
PDMP queries and documented informed consent for psychotropics are required at each visit — missing either is a critical failure on any audit, not a minor note.
Telehealth POS & modifiers
The correct place-of-service code and modifier (95, 93, FQ) shift by payer, and controlled-substance telehealth prescribing carries its own DEA/HHS rules on top.
Your billing, run end to end.
From the first claim to the last denial follow-up — one team, one point of contact, with a structured QA process behind every encounter before it ever reaches a payer.
Claims submission
Accurate, timely claims for therapy, medication management, and intake evaluations — coded to the correct time band and eval type from the first submission, not corrected after denial.
Denial management
Every denial is worked, appealed, or clearly explained — including medical-necessity and documentation denials, not just technical rejections that bounce back automatically.
Eligibility & prior auth
Benefits verified and authorizations tracked before they become a denial, including session-limit renewals and controlled-substance prior auth requirements.
Coding & documentation QA
Every encounter is checked against a structured audit — CPT time bands, eval-code accuracy, E/M support, controlled-substance documentation — before the claim goes out.
Credentialing support
Payer enrollment and re-credentialing handled, so new and existing providers can start billing sooner instead of waiting on paperwork.
Payment posting & reporting
Payments are posted promptly with regular reporting, so you always know your denial rate, your recoverable revenue, and exactly where things stand.
We work inside the systems you already have.
No new software to learn, no migration. Your EHR and clearinghouse stay exactly where they are.
Free denial-rate audit
Send a de-identified export of your last 90 days of claims. We return your denial rate, top denial reasons, and estimated recoverable revenue within 3 business days.
Access & onboarding
We're set up as authorized users inside your existing EHR and clearinghouse, under a signed Business Associate Agreement.
Ongoing billing & follow-up
Claims go out accurately the first time. What gets denied gets worked — with regular reporting so you always know where revenue stands.
Built for patient data from day one.
- Signed Business Associate Agreement (BAA) with every practice before any data changes hands.
- PHI encrypted in transit and at rest, with access limited to staff assigned to your account.
- Offshore processing fully disclosed in the BAA, with equivalent safeguards contractually required.
- Individual staff logins, role-based access, and immediate revocation when someone leaves an account.
Entity structure
US contract accountability, global delivery.
Before you send anything over.
Every engagement starts with a signed Business Associate Agreement, and PHI is encrypted both in transit and at rest. Access is limited to the specific staff assigned to your account, with individual logins and immediate revocation if someone leaves. We're happy to share our BAA and data security summary before you send any claims data.
The denial-rate audit is free, with no commitment. Ongoing billing is typically priced as a percentage of collections, which we'll walk through once we understand your claim volume and current denial rate — no flat setup fees.
No. We work as authorized users inside the EHR and clearinghouse you already have — no migration, no new software for your staff to learn.
MedgenixPro LLC (Wyoming, USA) holds the contract and is directly accountable for compliance. Claims processing is performed by our operations team in India as a disclosed subcontractor under the same BAA, with equivalent security requirements contractually enforced — a delivery model used widely across the RCM industry.
Start with the free audit — there's no commitment attached to it, and you keep the findings either way. If you move into a paid engagement afterward, we'll agree on notice terms upfront so you're never locked in without a clear path out.
The audit itself takes 3 business days. If you move forward after that, onboarding — getting us set up as authorized users in your systems — typically takes about a week, depending on how quickly access can be granted on your end.
See what's actually happening to your claims.
Send 90 days of claims data. Get a clear, one-page breakdown back — free, no commitment, no sales call required to see it.
Get your free denial-rate auditTell us about your practice.
Send your details and we'll follow up about your free denial-rate audit — usually within one business day.