Medical Billing forHospitals & Health Systems
Enterprise-level RCM solutions for large healthcare organizations. Comprehensive billing services designed to handle the complexity of hospital and health system operations.
Hospital and health system billing is among the most complex in healthcare — combining professional and facility billing, DRG assignment, charge capture across multiple departments, and compliance with evolving CMS rules. MedSure's hospital billing division provides full-cycle revenue cycle management for hospitals, outpatient facilities, and ambulatory surgery centers — from charge capture through final payment.
Why Hospitals & Health Systems Choose MedSure
We understand the unique challenges hospitals & health systems face. Our solutions are designed to be affordable, flexible, and easy to implement.
Key Features
- Enterprise-level integration capabilities
- Advanced analytics and reporting dashboards
- Dedicated account management team
- 24/7 support for critical operations
- Scalable solutions for large organizations
- Custom workflows tailored to your system
Benefits for Your Practice
- Streamlined billing across all departments
- Increase revenue by up to 35%
- Faster claim processing and reimbursement
- Reduced denial rates and improved collections
- HIPAA compliant and secure billing processes
- Focus on patient care while we handle billing
Expected ROI for Hospitals & Health Systems
Real results from practices like yours
Comprehensive Billing Services
All the billing services your hospitals & health systems needs, delivered with personalized attention.
Revenue Cycle Management
Complete RCM services for all departments and providers
Medical Billing & Coding
Accurate coding services for all specialties and departments
Denial Management
Expert handling of claim denials and appeals at scale
Credentialing
Provider credentialing and payer enrollment for all providers
How It Works
Our proven process delivers results for your practice.
Charge Capture & CDM Review
We work with your HIM team to optimize your chargemaster (CDM) and implement charge capture workflows that capture every billable service. Missing charges are identified through charge reconciliation audits and clinical documentation review.
Coding & DRG Assignment
Our facility coders handle ICD-10-PCS procedure coding, DRG assignment, and APC coding for outpatient services. Clinical documentation improvement (CDI) queries are issued to providers when documentation doesn't support the appropriate DRG.
UB-04 Claim Submission & Payer Follow-up
Facility claims are submitted on UB-04 forms with required HCPCS, revenue codes, and condition codes. Our AR team follows up on all outstanding claims, manages Medicare cost reports, and handles complex multi-payer coordination.
Compliance & Audit Support
We provide ongoing compliance monitoring for facility billing: OIG work plan monitoring, RAC audit preparation, cost report preparation assistance, and internal coding audits. We help your facility stay ahead of regulatory changes.
Frequently Asked Questions
Get answers about our Hospitals & Health Systems services.
Do you handle both professional and technical/facility billing?
Yes. We manage both professional billing (physician services on CMS-1500) and facility/technical billing (UB-04 for hospital services). We coordinate billing across all components to ensure proper reimbursement for both the facility and professional components.
Can you help with clinical documentation improvement (CDI)?
Yes. Our CDI specialists work with your clinical staff to improve documentation completeness and specificity — particularly for DRG-sensitive conditions. Better documentation leads to more accurate DRG assignment and appropriate reimbursement for the complexity of care provided.
How do you handle Medicare cost report preparation?
Our hospital billing team includes specialists with Medicare cost report experience. We assist with cost report preparation, settlement estimates, and responding to MAC reviews. Proper cost report preparation directly affects DSH payments, bad debt reimbursement, and Medicare payment rates.
Do you handle swing bed, skilled nursing, and outpatient billing?
Yes. We bill for all facility types including acute inpatient, swing bed, skilled nursing facility (SNF), outpatient departments, ASC, and rural health clinics. Each facility type has unique billing requirements that our team is trained and experienced in.
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