Meridian RCM provides complete revenue cycle management services for San Diego healthcare providers, including eligibility verification, prior authorization, medical coding, claims management, denial management, and A/R recovery. We help practices reduce denials, accelerate payments, improve collections, and strengthen overall revenue cycle performance.
San Diego is a Geographic Managed Care county, one of only two in the state, so Medi-Cal beneficiaries choose among several competing plans. That means a single practice bills multiple managed-care plans, each with its own rules. Layer in San Diego's large military presence and the TRICARE and VA coverage that comes with it, and accurate billing takes real local knowledge.
Meridian manages the entire revenue cycle for San Diego providers, from eligibility and prior authorization through coding, claims, denials, and collections. We know how San Diego's plans behave, so your practice spends less time reworking claims and more time seeing patients.
San Diego patients can be on any of several Medi-Cal plans. We verify which plan a patient chose and bill to that plan’s specific rules, so claims don’t bounce.
With a major military and veteran population, San Diego practices often bill TRICARE and VA-related coverage. We handle those distinct rules alongside commercial and Medi-Cal claims.
Claims are scrubbed against each San Diego payer’s specifications before they go out, and denials are worked and appealed instead of written off.
Our workflows account for California rules like AB 72 balance-billing protections and the state’s prompt-payment requirements.
We integrate with the EHR and practice management platforms San Diego 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 San Diego revenue cycle at any time.
You get the complete cycle, not a single service in isolation. Each links to its full service page.
We confirm coverage before the visit, including which of San Diego's several Medi-Cal GMC plans a patient chose, plus TRICARE where it applies, so claims aren't denied later.
Authorizations secured ahead of service and tracked to approval across San Diego's multiple managed-care plans.
Clean claims filed to each San Diego payer's exact specs, with scrubbing that catches errors before they cost you.
Certified coders apply accurate, compliant codes that hold up to San Diego payer and audit scrutiny.
Every denial worked, appealed, and root-caused so the same San Diego rejection doesn't keep recurring.
Aging San Diego accounts followed relentlessly to bring down days in A/R and collect what you're owed.
What decides whether a San Diego claim gets paid is specific to this county. We manage it for you:
Unlike most counties, San Diego lets Medi-Cal beneficiaries choose among multiple managed-care plans, so a practice bills several plans with different rules. Community Health Group is the county's community-based plan; others include Molina Healthcare, Blue Shield of California Promise, Kaiser Permanente, and Health Net.
San Diego's large military and veteran population means practices frequently encounter TRICARE and VA-related coverage, which follow their own billing and authorization rules. We handle these correctly.
We also bill the major commercial payers, such as Blue Shield of California, Anthem Blue Cross, and Health Net, to each plan's specifications.
We support practices that refer to and coordinate with San Diego's major systems, including Sharp HealthCare, Scripps Health, UC San Diego Health, Rady Children's Hospital, and Palomar Health, billing accurately regardless of where care is delivered.
We review a sample of your San Diego 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 the San Diego GMC plans, 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 Los Angeles practices, including:
San Diego is a Geographic Managed Care county, so your patients may be on any of several Medi-Cal plans, each with its own rules. We verify each patient's plan and bill accordingly, which prevents a common source of denials.
Yes. Given San Diego's large military and veteran population, we regularly handle TRICARE and VA-related billing alongside Medi-Cal and commercial claims.
No. Revenue cycle management is handled securely and remotely. What matters is whether your partner understands San Diego's multi-plan GMC market and payer mix, which Meridian does while serving practices across the county.
San Diego's Medi-Cal GMC plans (including Community Health Group, Molina, Blue Shield Promise, Kaiser, and Health Net), TRICARE and VA where applicable, and the major commercial payers, along with Medicare and others.
Most engagements are priced as a percentage of collections, so our incentives stay aligned with getting you paid. The rate depends on your specialty, 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 San Diego payers and your specialty.
No commitment. No obligation. Just clarity on your revenue.
