We handle the billing, so you can focus on patients.
Since 2016, Optima Care Billing has been the medical billing partner for physicians, clinics, and healthcare organizations across the U.S., helping them get paid accurately and on time. We're a team of certified billing and coding professionals who take the paperwork off your plate and keep your revenue cycle moving.
Helping healthcare providers simplify billing and get paid for the care they deliver
Running a practice means balancing patient care with claims, coding, denials, and collections. Most providers didn't go into medicine to chase payers. That's the part we take on.
We focus on the outcomes that matter to a practice: cleaner claims, fewer denials, faster reimbursement, and a clear view of where your revenue stands. We'd rather show you real improvement in your numbers than make promises we can't back up.
What you can count on
- Honest reporting. Clear monthly numbers, including what isn't going well.
- HIPAA-compliant processes. A signed BAA before we see any patient data.
- A named point of contact. Someone who knows your practice and your payers.
- No inflated promises. We won't quote results we can't verify for your practice.
Five principles behind every claim we touch
Hover or tap a card to see what each one looks like in day-to-day work.
What we work toward for every practice
Billing is ultimately about how your practice feels day to day. These are the outcomes we aim for with every client, and how we get there.
"I know exactly where our revenue cycle stands."
How we get there: monthly reports and a review call show every open claim, denial, and balance, so nothing is a surprise.
"I don't have to guess whether we're getting paid what we're owed."
How we get there: accurate coding, payment checks against expected amounts, and follow-up on every underpayment.
"Our team is doing more without adding more work."
How we get there: claims, follow-up, and patient billing questions come off your staff's plate, so they can focus on patients.
"We're not handling this alone."
How we get there: a partner who understands healthcare finance and stays current on payer and regulatory changes for you.
"Our cash flow is more consistent than it used to be."
How we get there: fewer preventable denials and steady A/R follow-up make payments more predictable month to month.
These describe the outcomes we aim for, not quotes from specific clients.
The people behind your claims
Your practice is supported by a team, not a single biller. Each role focuses on one part of the revenue cycle, so work keeps moving even when someone is out.
Every client gets
- A named point of contact who knows your practice.
- Backup coverage , so work continues during vacations and leave.
- Specialty-trained coders who know your codes and payers.
Certified coders
Assign CPT, ICD-10-CM, and HCPCS codes from documentation, by specialty.
Billing specialists
Enter charges, scrub and submit claims, and post payments every day.
Denial and A/R specialists
Work denials, file appeals, and follow up on unpaid claims until they're resolved.
Credentialing specialists
Handle payer enrollment, CAQH, and re-credentialing for your providers.
Account managers
Your named point of contact for questions, reports, and monthly review calls.
Compliance oversight
Keeps processes aligned with HIPAA and current payer and coding requirements.
The year we started helping practices get paid accurately and on time
Medical specialties we bill and code for
Revenue cycle services under one team
Compliant processes and a signed BAA with every client
Trust is the foundation of what we do
Billing touches protected health information at every step. We treat HIPAA as the way we work, not a checkbox on a sales sheet.
Business Associate Agreement
Signed with every client before we access any patient information.
Role-based access
Team members only see the data they need for the work assigned to them.
Encrypted file exchange
Documents and reports move through secure, encrypted channels, never plain email.
Ongoing HIPAA training
Every team member completes privacy and security training on a regular schedule.
Based in Albuquerque, serving practices nationwide
We work remotely inside your EHR and practice management systems, so practices across the U.S. get the same hands-on support from their medical billing partner.
- 1209 Mountain Road Pl NE, Ste H
Albuquerque, NM 87110 - Monday to Friday, 8 AM to 5 PM EST
- (505) 472-4627
- info@optimacarebilling.com
The kinds of practices we help
From solo physicians to multi-location groups, here's how we step in.
Real problems, handled the same way every time
Each example follows the same path: find where revenue is stuck, fix the cause, and keep it fixed.
- The challenge
- What we did
- What changed
These are illustrative examples based on common practice situations, not specific client results.
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Illustrative scenario
Cardiology group
4 providers · in-house billing- The challenge
- Echo and stress test claims kept coming back denied for missing authorizations, and professional and technical components were billed inconsistently between the office and the hospital.
- What we did
- Set up authorization checks before imaging visits, corrected 26/TC billing rules by location, and worked the open denials in order of appeal deadline.
- What changed
- Authorization gaps now get caught before the test instead of after the denial, and the front desk knows which visits need attention each morning.
-
Illustrative scenario
Behavioral health practice
12 clinicians · adding new LPCs- The challenge
- Newly hired counselors couldn't bill several payers yet, and some sessions were being billed with time codes that didn't match the documented session length.
- What we did
- Handled payer enrollment and CAQH for the new clinicians, reviewed time-based coding against notes, and began tracking authorizations and session limits.
- What changed
- New clinicians are enrolled and billing, and the team gets a heads-up before a patient reaches a session limit.
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Illustrative scenario
Urgent care center
2 locations · high walk-in volume- The challenge
- Claims piled up during busy seasons, and walk-in patients with outdated insurance led to a steady stream of eligibility denials.
- What we did
- Moved to daily claim submission, added same-day eligibility checks for walk-ins, and set up payer-specific rules for global versus itemized billing.
- What changed
- Claims keep going out daily even in peak season, and coverage problems are flagged while the patient is still at the counter.
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Illustrative scenario
Orthopedic practice
Switching billing companies- The challenge
- The previous vendor left behind a large backlog of claims over 90 days old, and nobody could say how much of it was still collectible.
- What we did
- Ran an A/R cleanup project separate from day-to-day billing, prioritizing claims by value and timely-filing deadline, while onboarding new claims in parallel.
- What changed
- The practice has a clear picture of what's collectible, and old balances are being worked without slowing down current billing.
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Illustrative scenario
Family practice
Solo physician · 1 front-desk staff- The challenge
- The physician was catching up on billing at night, and vaccine administration codes were often missed when vaccines were given during sick visits.
- What we did
- Took over the full revenue cycle, set up vaccine product and administration billing together, and started a short monthly review call.
- What changed
- Evenings are no longer spent on claims, and preventive services and vaccines are billed consistently.
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Illustrative scenario
Independent laboratory
High daily claim volume- The challenge
- Tests were denied for medical necessity, and incomplete requisitions left claims stalled for weeks while someone tracked down missing details.
- What we did
- Added diagnosis checks against payer coverage policies, set up requisition follow-up with ordering offices, and monitored clearinghouse rejections daily.
- What changed
- Fewer claims sit waiting for missing information, and rejections are corrected and resent quickly.
Our office is at 1209 Mountain Road Pl NE, Ste H, in Albuquerque, New Mexico. We work with healthcare practices across the U.S.
No. We serve practices nationwide and work remotely inside your EHR and practice management systems.
We've been helping physicians, clinics, and healthcare organizations with billing and revenue cycle management since 2016.
You'll have a named point of contact who knows your practice, backed by certified coders, billing specialists, and denial and A/R specialists.
Yes. We sign a Business Associate Agreement with every client, limit data access by role, use encrypted file exchange, and train our team on HIPAA privacy and security.
Let's talk about your practice. No pressure, no obligation.
Book a free consultation and we'll show you where your revenue cycle stands today, and how we'd help.