Prior Authorization
CO-197 denials: how to stop missing prior authorizations
What the CO-197 denial code means, why it keeps happening, and the scheduling checklist that prevents most missing-authorization denials.
Medical billing & revenue cycle management
Clean claims and steady billing for the care you give
Medwiser supports billing, coding, denials and A/R for US clinics and practices, so your team can spend more of its day on patients and less on payer portals.
- HIPAA-aligned safeguards
- Trained medical coding and billing specialists
- Strict data access controls
- HIPAA-aligned safeguardsData handled only as each task requires
- Strict data access controlsRemote session security protocols
- Trained medical coding and billing specialistsWorking from provider documentation
- US business hoursA clear point of contact
- Denial and A/R visibilityTrends by reason code and age bucket
Services
Every part of the revenue cycle, handled
Hand us one service or the whole cycle. Each one runs inside your existing EHR and practice management system.
Medical Billing
Eligibility review, daily charge entry, coding support and electronic claim submission.
- Patient demographic and eligibility review
- Daily charge entry
- Clearinghouse rejection management
A/R Recovery
Aging balances reviewed by bucket, investigated and followed up with payers.
- Aging bucket review
- Authorized payer follow-up
- Timely filing deadline tracking
Denial Management & Appeals
Denials categorized by reason code, reviewed and traced back to their root cause.
- Categorized by CARC and RARC
- Coding and modifier review
- Root-cause trend analytics
Prior Authorization
Coverage verified, pre-auth requirements checked and documentation tracked before the visit.
- Coverage and benefit verification
- Service-specific requirement checks
- Clinical documentation tracking
Medical Scribing
Visit notes documented in real time, ready for your review the same day.
- Remote scribes in your EHR
- Notes ready the same day
- Documentation that supports coding
Credentialing & Admin Support
Providers enrolled with payers and kept current, so every visit can be billed.
- Payer enrollment and contracting
- CAQH profiles kept current
- Revalidation dates tracked
How we work
From first call to clean claims
Free revenue review
Standard BAA executed prior to system access. We then review recent claims, denials and A/R aging and show you where revenue may be leaking.
Onboarding
We connect to your EHR and clearinghouse, confirm payer enrollments and agree how we will keep you informed.
Clean-up
Aging A/R and open denials are worked while new claims go out.
Run and review
Your point of contact reviews denial trends and A/R by age bucket with you.
Who we serve
Built for practices of every size
From a single-provider clinic to a multi-location group, we fit the way your practice already works.
Independent clinics
One to five providers who want billing handled without hiring a billing department.
Group practices
Multi-provider and multi-location groups that need consistent coding and credentialing support.
Hospitals and facilities
Outpatient departments and facilities that need extra capacity for denials, A/R or authorizations.
Specialties we work with
- Family medicine
- Internal medicine
- Pediatrics
- Cardiology
- Orthopedics
- Behavioral health
- Physical therapy
- Urgent care
- Multi-specialty groups
Operational focus
Three priorities behind every account
Clean Claim Submissions
Eligibility, charge and coding details are reviewed against provider documentation before each claim goes out.
Denial Prevention
Denials are categorized by reason code and traced to their root cause, so recurring errors can be addressed upstream.
Aging A/R Resolution
Unpaid claims are investigated by age bucket and followed up with payers ahead of timely filing deadlines.
Resources
Latest from the billing desk
Practical guides on denials, A/R and payer rules for practice teams.
A/R Recovery
Days in A/R: what the number tells you and how to bring it down
How to calculate days in accounts receivable, what a healthy number looks like for a medical practice, and the four places aging A/R usually comes from.
Credentialing & Admin Support
Credentialing a new provider: a 120-day timeline
A practical, step-by-step credentialing timeline for adding a new provider to your practice, so they can bill from their first day with patients.
FAQ
Questions practices ask us
How do you price medical billing services?
Pricing is usually a percentage of collections, so we are paid when you are. We confirm the rate after a free review of your claim volume and payer mix.
Will we have to change our EHR or practice management system?
No. We work inside the systems you already use, with accounts and permissions your practice controls.
How do you keep patient data secure?
Standard BAA executed prior to system access. We then apply strict data access controls and remote session security protocols, in line with HIPAA-aligned safeguards. Our Compliance & Security page has more detail.
How long does it take to get started?
Timing depends on system access and payer setup. We agree a start date with you during onboarding.
Can we start with just one service?
Yes. You can start with denial management or an A/R backlog project and add services later.
Free revenue review
Find out what your practice is leaving unpaid
Send us a few details and we will show you where claims, denials and A/R are costing you money.