The North Carolina RCM Authority
Master Revenue in
North Carolina.
Charlotte.
Raleigh.
Greensboro.
Durham.
Operating a practice in the Tar Heel State means navigating BCBSNC complexities, expansive academic health networks, and strict Palmetto (JM) guidelines. We engineer 98% clean claim rates to ensure your cash flow never stalls.
Takes less than 60 seconds
98%
Clean Claims
9+
Years in AL
$2B
Revenue Managed
- HBS NC-GATEWAY
Palmetto (JM)
LCD Scrubber Rules
Synced
BCBS of North Carolina
Policy & Modifiers
Active
NC Medicaid
Provider Portal Sync
Scanning
Core Capabilities
The HBS Advantage in NC.
Beyond standard billing, we offer a comprehensive revenue cycle management ecosystem tailored specifically for North Carolina’s mix of sprawling academic health networks, research hubs, and essential rural clinics.
AI-Driven Scrubbing
Our proprietary rules engine preemptively identifies coding errors and Palmetto (JM) LCD mismatches before claims ever reach the payer, ensuring our 98% clean claim rate.
Dedicated NC Teams
You don’t get a generalized call center. You are assigned a dedicated pod of RCM specialists who strictly handle North Carolina accounts and understand the nuances of BCBSNC commercial plans and the transition to NC Medicaid Managed Care.
Transparent Analytics
Stop guessing about your financial health. We provide real-time, granular dashboards showing exact A/R aging, denial reasons, and daily cash flow projections.
Seamless Transition
How We Partner With You.
We designed our onboarding to be frictionless. We integrate with your existing systems without disrupting your daily patient care.
1
Deep-Dive Audit
We analyze your historical data to identify leaks in your revenue cycle.
2
EHR Integration
Secure, remote tunnels into your Epic, Cerner, Athena, or cloud EHR system.
3
A/R Rescue
Our specialists immediately attack your aging buckets (>90 days).
Maximized Profit
Clean claims go out daily. Revenue goes up. You focus on patients.
Operational Footprint
Statewide Integration.
We securely tunnel into your existing EHR remotely, providing world-class RCM support across the state. We understand the specific payer nuances in every major North Carolina region.
Charlotte
Primary Challenge: Massive concentration of competing health systems, complex multi-specialty practices, and high commercial plan density (BCBSNC).
HBS Solution: Advanced clearinghouse rules engines tailored for complex commercial networks and swift denial appeals to maintain high cash flow amidst competition.
Top EHRs:
Epic | NextGen
Raleigh / Durham
Primary Challenge: The Research Triangle Park brings a massive academic medical center presence, complex teaching physician rules, and multi-specialty referrals.
HBS Solution: Direct portal management and precise adherence to teaching physician guidelines (modifiers GC, GE) for maximum compliance.
Top EHRs:
Epic | Athena
Greensboro
Primary Challenge: Rapidly growing population leading to scaling issues for independent clinics and an influx of complex commercial policies.
HBS Solution: Rapid front-end eligibility verification and highly scalable A/R rescue teams to handle surging patient volumes without hiring extra in-house staff.
Top EHRs:
ModMed | eCW
Winston-Salem
Primary Challenge: Serving as a regional medical hub for surrounding rural counties, resulting in complex cross-network and Medicaid referral billing.
HBS Solution: Streamlined NC Medicaid portal synchronization and rapid front-end eligibility verification for referred out-of-network patients.
Top EHRs:
AdvancedMD | Kareo
Wilmington
Primary Challenge: Coastal demographics driving high Medicare (Palmetto JM) volume, chronic care management, and seasonal tourist influxes.
HBS Solution: Strict adherence to Palmetto LCDs, precise time-based CCM coding, and scalable RCM teams to manage summer tourist billing spikes.
Top EHRs:
Allscripts | Cerner
Rural NC / Appalachia
Primary Challenge: Rural Health Clinic (RHC) billing complexities, heavy reliance on Telehealth, and NC Medicaid Managed Care updates.
HBS Solution: Deep expertise in PPS rate reconciliation, mastery of Telehealth modifiers (95, GT), and specialized RHC modifier management.
Top EHRs:
Elation | DrChrono
Proven Results
North Carolina Success Stories.
Real data from practices across the Tar Heel State that transformed their revenue cycles by partnering with HBS.
Multi-Specialty Clinic
Charlotte, NC
Struggled with massive A/R aging > 90 days due to complex commercial plan pre-authorizations and Palmetto (JM) audits.
A/R > 90 Days
-75%
Monthly Cash Flow
+$135K
Orthopedic Center
Raleigh, NC
Plagued by high denial rates (23%) due to complex pre-authorizations and surgical coding errors tied to academic referrals.
Denial Rate
3.4%
Clean Claim Rate
98.5%
Secure Your NC Revenue Audit
Stop leaving money on the table. Our North Carolina specialists will analyze your revenue cycle and uncover hidden billing opportunities.