From Los Angeles to the Bay Area, California practices lose revenue to Medi-Cal denials, complex managed-care rules, and slow payer follow-up. Meridian runs your full revenue cycle so more claims are paid the first time and fewer dollars age out.
Meridian RCM provides end-to-end medical billing and revenue cycle management for healthcare providers throughout California. We handle eligibility verification, prior authorizations, medical coding, claims submission, payment posting, denial management, appeals, accounts receivable, and collections so your team can focus on patient care.
Our billing specialists understand California’s complex payer environment, including Medi-Cal and its managed-care plans, Covered California marketplace coverage, Medicare, and commercial insurance carriers. We navigate payer-specific authorization, coding, documentation, and claim submission requirements to keep claims moving and reduce preventable denials.
From verifying coverage before the visit to pursuing outstanding balances after a claim is processed, Meridian manages every stage of your revenue cycle. We identify billing problems early, follow up aggressively on unpaid and denied claims, and work to improve collections while reducing the administrative burden on your practice.
We handle Medi-Cal fee-for-service and Medi-Cal managed-care plans daily, so enrollment, coding, and filing rules that trip up other billers don’t slow your payments.
Claims are scrubbed against each California payer’s specifications before they go out, and denials are worked and appealed instead of written off.
We manage marketplace plans and their eligibility quirks, so patients covered through Covered California don’t turn into uncollected balances.
Our workflows account for California rules like AB 72 balance-billing protections and the state’s prompt-payment requirements, keeping you compliant and paid.
We integrate with the EHR and practice management platforms California practices already run, with no rip-and-replace to get started.
Clear dashboards on collections, denials, and days in A/R give you a live view of your California revenue cycle at any time.
We confirm coverage and benefits before the visit, including Medi-Cal and managed-care eligibility, so claims aren't denied later.
Authorizations secured ahead of service and tracked to approval, a frequent sticking point with California managed-care plans.
Clean claims filed to each California payer's exact specs, with scrubbing that catches errors before they cost you.
Certified coders apply accurate, compliant codes that hold up to California payer and audit scrutiny.
Every denial worked, appealed, and root-caused so the same California rejection doesn't keep recurring.
Aging California accounts followed relentlessly to bring down days in A/R and collect what you're owed.
The details that decide whether a California claim gets paid are specific to this state. We manage them for you:
California's Medicaid program is among the largest in the nation and runs much of its coverage through managed-care plans, each with its own enrollment, coding, and filing requirements. We keep your Medi-Cal claims compliant and moving.
Plans sold through the state's ACA marketplace come with their own eligibility and cost-sharing rules. We verify coverage up front so marketplace patients don't become write-offs.
We bill the major California commercial payers, such as Blue Shield of California, Anthem Blue Cross, Health Net, and Molina Healthcare, to each plan's specifications.
Our workflows reflect California-specific rules, including AB 72 protections against balance billing for out-of-network care at in-network facilities, and the state's prompt-payment standards enforced through the DMHC and the Department of Insurance.
We review a sample of your California claims, denials, and A/R to pinpoint exactly where revenue is leaking.
We map our workflows to your EHR and practice management system and confirm payer enrollments, including Medi-Cal, before go-live.
Claims go out scrubbed to each payer's specs, and our team works denials and appeals as they come in.
You get transparent dashboards and a dedicated point of contact, with continual tuning to keep denials down and collections up.
We manage the revenue cycle for a wide range of California practices, including:
Yes. Medi-Cal and its managed-care plans are part of our daily work in California. We manage enrollment, coding, and filing to each plan's rules to keep those claims clean and paid.
No. Revenue cycle management is handled securely and remotely, so a local office isn't necessary. What matters is whether your partner understands California's payers and regulations, which Meridian does while serving practices statewide.
We bill Medi-Cal, Covered California marketplace plans, and the major commercial payers such as Blue Shield of California, Anthem Blue Cross, Health Net, and Molina Healthcare, along with Medicare and others.
Our workflows are built to account for California-specific rules, including AB 72 balance-billing protections and the state's prompt-payment standards, so your billing stays compliant.
Most engagements are priced as a percentage of collections, so our incentives stay aligned with getting you paid. The exact rate depends on your specialty, claim volume, and services needed. Request a quote for pricing.
It starts with a free revenue cycle audit of your current claims, denials, and A/R. We show you where revenue is leaking and how we'd fix it, with no obligation.
Get a free, no-obligation revenue cycle audit. We'll show you exactly where revenue is slipping and how Meridian recovers it, for California payers and your specialty.
No commitment. No obligation. Just clarity on your revenue.
