The Medical Billing handles medical billing and coding for practices in Miami, FL — from solo physicians and specialty groups to independent labs and clinics across Miami-Dade County. We take the full revenue cycle off your desk so your staff can focus on patients.
Medical Billing for Miami's Healthcare Market
Miami practices work alongside large systems such as Jackson Health System, UHealth – University of Miami Health System, Baptist Health South Florida and Mount Sinai Medical Center. That brings a steady flow of referrals and shared patients, but also more payer edits on referrals, authorizations and place of service. Our coders check those details before the claim goes out.
Florida Payer Rules We Handle for Miami Practices
- Medicare: Part B claims go to First Coast Service Options; Medicare Advantage claims go to the patient's private plan with its own authorization rules.
- Medicaid: Florida Medicaid is run by the Agency for Health Care Administration (AHCA), and most members are in Statewide Medicaid Managed Care (SMMC) plans.
- Commercial plans: we bill Florida Blue, UnitedHealthcare, Aetna and Cigna and the employer plans common in Miami-Dade County.
- Local detail: Most Florida Medicaid patients are enrolled in Statewide Medicaid Managed Care (SMMC) plans, and each plan has its own claim address, edits and timely-filing window.
What's Included for Miami Practices
- Insurance eligibility and benefits verification before each visit
- Medical coding (CPT, ICD-10-CM, HCPCS and modifiers) by certified coders
- Charge entry and claim scrubbing to catch errors before submission
- Electronic claim submission to Medicare, Florida Medicaid plans and commercial payers
- Denial management and appeals with root-cause tracking
- A/R follow-up on aging claims, worked daily
- Payment posting from ERAs and EOBs, including underpayment checks
- Credentialing and payer enrollment, including AHCA / Florida Medicaid provider enrollment
- Monthly reporting on collections, denials and days in A/R
Why Miami Practices Outsource Billing to Us
Most revenue is lost in small gaps: an eligibility check that was skipped, a denial nobody had time to appeal, a payment that was posted short. We close those gaps for Miami practices with a structured process and transparent reporting, and we start with a free audit so you can see the numbers first.
We also support practices in Coral Gables, Hialeah, Miami Beach and Doral, and across the rest of the state — see our Florida medical billing services or nearby pages for Tampa and Orlando. Specialty groups can read more about our laboratory billing and cardiology billing services.
Specialties We Bill For in Miami
Frequently Asked Questions
Do you provide medical billing services in Miami, FL?
Yes. We work remotely with physician practices, clinics, specialty groups and labs in Miami and across Miami-Dade County. We handle coding, claims, denials and A/R follow-up for Medicare, Florida Medicaid and commercial payers.
Which insurance payers do you bill for Miami practices?
Medicare Part B through First Coast Service Options, Medicare Advantage plans, Florida Medicaid and its managed care plans, and commercial payers such as Florida Blue, UnitedHealthcare and Aetna.
Do you work with practices near Miami?
Yes — including Coral Gables, Hialeah, Miami Beach and Doral. Billing is done remotely, so practices anywhere in Florida can work with us.
How much does medical billing cost for a Miami practice?
Most billing companies charge a percentage of monthly collections, commonly between 4% and 10% depending on specialty and claim volume. We give you a fixed quote after a free audit of your claims and A/R.
How long does it take to switch to your billing service?
It depends on how quickly payer and EHR access can be set up. We plan the transition so that existing A/R keeps being worked while new claims move to our team, and we share a timeline after the free audit.