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
Get paid in full for the care you give
Medwiser runs billing, coding, denials and A/R for US clinics and practices, so your team spends its day on patients instead of payer portals.
- HIPAA-compliant processes
- BAA with every client
- Dedicated account manager
- HIPAA-compliant processesPolicies, training, access controls
- BAA with every clientSigned before we access any data
- Certified codersAAPC and AHIMA credentials
- US business hoursA named account manager
- Monthly reportingCollections, denials, A/R by payer
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 & Coding
Accurate codes and clean claims, submitted within one business day of the visit.
- Specialty-trained coders
- Claims scrubbed before submission
- Daily charge entry
A/R Recovery
Old balances followed up until they are paid or properly closed.
- Oldest balances worked first
- Payer follow-up by phone and portal
- Weekly aging report
Denial Management
Denials appealed fast and prevented from happening again.
- Every denial coded to its CARC reason
- Appeals with the right documentation
- Root-cause fixes upstream
Prior Authorization
Authorizations requested, tracked and approved before the patient arrives.
- Requirements checked at scheduling
- Requests submitted with clinicals
- Status tracked to a decision
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 in eight weeks
Free revenue review
We study your recent claims, denials and A/R aging under a signed BAA and show you where revenue is leaking.
Onboarding
We connect to your EHR and clearinghouse, confirm payer enrollments and agree on reporting.
Clean-up
Aging A/R is worked oldest first and open denials appealed while new claims go out clean.
Run and report
Your account manager walks you through collections, denials and A/R by payer.
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, reporting and credentialing.
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
Client stories
What practices say
Sample quote: Our denials dropped within the first quarter, and for the first time we understand our monthly numbers.
Sample quote: The team works inside our EHR, our old A/R is finally moving, and we get one clear report every month.
Resources
Latest from the billing desk
Practical guides on denials, A/R and payer rules, written by people who work them every day.
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?
Most practices pay 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?
We sign a Business Associate Agreement before accessing any data, limit access by role, and train every team member on HIPAA safeguards. Our Compliance & Security page explains each safeguard.
How long does it take to get started?
Most practices are live within two to four weeks of signing, depending on system access and payer setup.
Can we start with just one service?
Yes. Many practices 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.