Orange County medical practices have a different payer mix than the rest of California. CalOptima dominates Medi-Cal, the commercial mix is heavier than LA’s, and CalOptima OneCare is its own beast. Most billing companies do not adjust. That is why your denials look the way they do.
Figures reflect 1st Medical Billing’s California book, trailing 12 months. Industry comparison: MGMA / HBMA published medians.
If a claim doesn’t get paid, we don’t get paid for it. No retainer, no per-claim fee, no monthly minimum. The math means we chase your denials like they’re our own.
We work CalOptima, CalOptima OneCare, Anthem, Blue Shield, Health Net, UnitedHealthcare, Kaiser commercial, and Medicare every single day. We know CalOptima’s CCS, GMC, and OneCare nuances. We know which OC commercial payers are slow-paying right now and which will negotiate underpayments.
Not a ticket queue. Not a chatbot. The owner is on the line, or one ring away. You’ll know your account manager by name within the first week.
Send us your last 90 days of remits and aging report. Within a week we’ll send back a written read on what’s leaking and how much we’d recover.
We confirm credentialing is current with every CA payer you bill. Anything missing, we re-credential. Clearinghouse handoff happens behind the scenes.
Charges from your EMR start flowing into our system. Aging AR is worked in parallel. We don’t write off old claims to “start fresh.”
A real meeting, not a PDF. Numbers, trends, denials worked, what’s blocked, what we’re recommending.
Send us your aging report and last 90 days of remits. We’ll send back a written read inside a week. A real human picks up the call you place.
