East Coast Company Serving Nationwide

About Us

Welcome To Pristine Billing

Pristine Medical Billing has built its reputation on being a medical billing company that partners with their clients to help them achieve their goals. We understand how each clinic is unique and can identify its needs. Maintaining and increasing revenue is the goal of every business and how it’s achieved is significant. We carry a niche of being able to adapt to different clinics in order to help them reach their maximum potential. If this is the type of help you are looking for, please call us today. Thank you.

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Our Services

  • Billing
  • Authorizations
  • Credentialing
  • Start-up Clinics
  • Covid-19 Medical Billing
Medical Insuranc Claim Form with calculator and stethoscope

THE FIRST

If you're a clinic that works mainly with paper, our services can incorporate both paper and an easy-to-use software program.

How it works:

1. Secure file transfer via Citrix for your Superbills.

2. Customized Superbills for your clinic that makes it easy for you to transfer the information.

3. Claims will be billed within 2 days of uploading.

4. Any information given to us by paper is converted into our system so that we can streamline your AR.

THE SECOND

If you're already set up with a billing program, we can utilize that program so no big changes need to be made.  You're already used to what you know and it'll be our job to adapt. 

If you're not set up with a billing program and/or in the process of looking for a new one, we can help get that started for you. 

How it works:

1. Training is offered at no extra cost for you and your staff to use this new program.

2. Notes can be streamlined into the system and we can review all encounters/claims/bills before submission.

3. Our staff can help you keep track of your notes in case there are any errors.

4. The timeline for this set-up is normally 1-2 weeks.

5. Claims will be billed within 2 days of completed notes.

6. AR Reporting is done through the program and your ease of access will allow complete transparency.

PRE AUTHORIZATIONS

Pre-authorizations are a headache and need constant attention. We work with your staff to ensure that the proper guidelines are followed before treatment or billing insurance companies.

How it works:

1. If patient requires authorization, your front staff can notify our office through our online chat system.

2. Authorizations requests are submitted on the day of notification.

3. Follow-ups are done through a system we set up with your front desk.

Woman with headset in front of computer in a call center

ANSWERING SERVICES

When your staff can't always be there to answer a patient's or insurance representative's call, we're here to help. We offer call-forwarding services so we can take the call for you.

If a patient needs to set-up an appointment, cancel an appointment, or is just running late, we'll let you know right away.

Credentialing ServicesPhysician Credentialing Process Flow

Our Credentialing Department has extensive experience and knowledge on the process. 

Easy form to fill out to start your credentialing needs!

Credentialing Fees

  • $200 per Application
  • $50 per De-Credentialing Application

Getting credentialed can take up to 90 days, and follow-up is required on a timely basis. Our credentialing department can take that headache off your shoulders. Please give us a call if you are looking for credentialing services.

Initial Credentialing

  • Upon receipt of completed application, client and provider receive a confirmation email and primary source verification process begins.
  • Completed file (PDF) uploaded to our client specific file includes a summary of all verified data, supporting reports and verification records.

WHAT YOU NEED TO GET STARTED AND HOW WE CAN DO IT:

Graphic of to do list and stopwatch

  • Whether you're looking to be in-network or out-of-network, you will need to start with a Group NPI. 
  • We provide guidance in everything from your clinic name down to where your reception table should go. 
  • Our Account Managers will visit you at your practice to ensure everything goes smoothly. 
  • After your EIN number is obtained, the registration process with all insurance companies begin. 
  • For out-of-network clinics, all registration takes 10-15 days. 
  • If your specialty is covered by Medicare, this credentialing process also takes place and finalized within 60-120 days. (The best part is you can still treat your patients and hold the claims until you are approved!)
  • Online accounts to track claims and check patient information are set-up with Availity, Navinet, and more. 
  • In the meantime, your module for billing will take about 1 week for it to get setup. 
  • We offer consulting services from A-Z and take care of the work you don't need to. 
  • As soon as you are registered, you will be able to treat your patients in no time

SET-UP FEES START AT $2,000.

CREDENTIALING IS $200 PER APPLICATION.

Covid-19 Testing Medical Billing

  • WE PROVIDE MEDICAL BILLING FOR ON-SITE/OFF-SITE PROVIDERS FOR COVID TESTING
  • VACCINATIONS
  • MONOCLONAL ANTIBODY INFUSIONS

How We Work

  • Establishing clear rapport with your front staff, daily, so you don’t have to worry.
  • Confirming that claims are clean and ready to go before submission pertaining to insurance plans that require authorizations or other prerequisites.
  • Taking patient phone calls or calling patients to help them better understand their bills and the billing process in general.
  • Checking AR on a weekly basis and reviewing accounts to make ensure nothing is missed.
  • Submitting patient statements, monthly, with follow-up phone calls.
  • If you’re Out-of-Network, we have the solution to tracking insurance payments to patients.
  • Reporting claims submitted on a weekly basis, and AR flow on a monthly basis.
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