medical billing

MEDICAL BILLING SERVICES FOR OUT-OF-NETWORK SURGEONS

Billing is only one piece. Experience is knowing how the rest fits together.
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medical bills
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Precision Billing is Where NSA Success Begins.

Medical billing for OON surgeons is more than claim submission – it is the foundation that determines whether a claim qualifies for federal or state surprise billing protections or whether additional reimbursement can be pursued through other alternative pathways. CHRMS’ billing workflows are engineered from the ground up to ensure that every eligible claim is positioned to maximize reimbursement from the moment it is submitted.

Our team combines regulatory insight, operational accuracy, and legal awareness to prepare claims that not only meet billing requirements — but also align with the precise conditions required for the proper claim pathway.

Reimbursement isn’t a transaction. It’s an integrated system of interdependent decisions, rules, behavior and consequences that determines whether (and how much) a provider ultimately gets paid.

CHRMS manages that system end to end.

MEDICAL BILLING SERVICES FOR OUT OF NETWORK SURGEONS

End-to-End Revenue Management

CHRMS’ Medical Billing program includes a number of specialized components, all designed to support NSA escalation when needed.

comprehensive appeals

Comprehensive Appeals

GAP authorizations

GAP Authorizations

single case agreements

Single Case Agreements

clinical coding assesments

Clinical Coding Assessments

NSA management

NSA Management

Expertise Evolved for a New Era.

For more than a decade, CHRMS has been the trusted partner for out-of-network surgeons nationwide. Our deep experience across multiple specialties gives us a clear advantage — we understand what causes payment delays, underpayments, and denials, and we know how to prevent them.

Our billing infrastructure integrates:

  • Surgical coding accuracy
  • Documentation alignment
  • Regulatory compliance
  • Eligibility assessment at intake
  • Real-time audit checkpoints for NSA applicability

This ensures that claims are not only billed correctly, but also “NSA-ready” — meaning they contain the data and structure required to enter federal or state dispute processes when insurers underpay.

technology in operating room
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people examining billing
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The CHRMS Billing Difference

With CHRMS, billing is not the end of the process — it is the starting point of a defensible strategy that may lead to NSA or state dispute resolution, negotiated outcomes, single case agreements, or other appropriate reimbursement pathways based on the claim.

Most billing companies stop at claim submission. CHRMS prepares every claim as part of a larger legal-regulatory strategy.

Our Competitive Advantages:

  • Decades of out-of-network specialization with proven strategies for claim reimbursement success.
  • Billing workflows that flag, validate, and prepare NSA-eligible claims at intake
  • Flexible escalation pathways based on the needs of each claim.
  • Affiliation with Cohen Howard, LLP to ensures legal-ready documentation
  • Regulatory alignment under ERISA, NSA, and state laws
  • Historical payor data identifying patterns relevant to disputes
  • No-cost access to regulatory experts and attorneys
  • No upfront cost — your success is our success

Out-of-network? Thinking about it? Let’s talk.