Billing, Credentialing and Privileging Services 

Medical Billing Services

Outsource your billing services with medical billing experts you can trust. Medical billing is not a one size fits all solution. Finding the right partner that understands your practice, specialty and billing needs can be difficult. ArchProCoding matches you with a trusted representative that knows the industry and will optimize your reimbursement. We set ourselves apart because we do not just go after the easy money. ArchProCoding will work with your front office and clinical staff to reduce rejections and denials an ensure claims processes for faster reimbursement.

We are dedicated to providing medical billing services of the highest quality. Our mission is to reduce claim errors, decrease turn-around time on payments, increase reimbursement of claims, and to make sure each client is completely satisfied with our services. We accomplish this by providing superior customer service, personalized solutions, and medical expertise to maximize success for our team members and clients alike.

We employ Certified Professional Coders. Our coders go through frequent training and seminars with different payers to make sure they are up to speed with coding guideline changes. Coders review encounters and scrub them to make sure the claim is coded correctly. This may mean we identify under-coded, over-coded services, missing modifiers or an incorrect ICD-10 code.

Work to Ensure Claims Go Out Clean the First Time

Our unique medical billing processes and procedures can help your medical practice reduce rejections, payment delays, denials and other obstacles for receiving maximum reimbursements. We work to ensure that clean claims are delivered to payers the first time around. If rejections do arise our account receivable (AR) team will do the required research, edit and quickly resubmit the claims. In addition, we will update your system to minimize future rejections. If denials are due to lack of staff knowledge, we work to educate employees to reduce future denials.

Live Customer Service Representatives for Patient Collections

We have an award-winning customer service team to answer your patient's queries. This not only helps patient engagement with their medical practice but also encourages them to pay while they are on the phone with customer service representative. However, your business collects patient payments, ArchProCoding will simplify the process and increase your collections.

What Sets Us Apart from Other Billing Companies

  1. Assigned a dedicated account manager: (your Account Manager will know your account inside and out, from claims scrubbing, payments, AR, Appeals, Patient accounts, Collections, etc. and offer an end-to-end solution
  2. EFT & ERA enrollment management
  3. Superior Customer Service
  4. We do not just go after the clean claims, we work ALL claims.
  5. Live customer service representatives
  6. Staff training identified from denials
  7. We work with practices of all sizes
  8. Online account administration

By hiring ArchProCoding, your practitioners will be able to spend more time with patients and less time handling administrative work. Whether you're an independent physician or part of a large practice, outsourcing some or all of your medical billing process is a timesaver. It reduces your time spent verifying eligibility, overseeing claims and denials, and following up.

Let ArchProCoding save you money, reduce expenses and increase revenue.


ArchProCoding's credentialing team will ensure that your organization's credentialing files are completed with accuracy and in compliance with regulatory standards, so you can rest easy knowing your organization is in good hands.  

With customizable user-friendly reports, and 24/7 access to your data, you’ll be able to know in real-time where your organization’s providers are at in the credentialing process. 

In addition to CVO services, Arch Pro also offers assistance with mock audits and preparation for pending audits from different accrediting bodies such as The Joint Commission, AAAHC, NCQA, BPHC, and more.

Physician and Other Healthcare Provider Database: Currently, Arch maintains physician, dentist, and other healthcare provider credential files. The vast majority of practitioners maintained in Arch Pro files are physicians (MDs/DOs).   These files are processed for initial credentialing and recredentialing for PHO’s, hospitals, health care network, clinic, surgery center, federally qualified community health centers, public health service, and home health clients throughout the U.S.

Credential Verification Standards : ArchProCoding follows the credentials verification standards set by the National Committee on Quality Assurance (NCQA) for managed care organizations, the Joint Commission for hospitals and surgery centers, and Accreditation Association for Ambulatory Health Care (AAAHC) for surgery centers.  Some hospitals define higher credentials verification standards through medical staff bylaws than those required by Joint Commission. Arch Pro works with clients to meet the higher standards whenever possible. In addition to application processing and primary source verification, Arch Pro monitors expiring documents and licenses (DEA registration, insurance certificate, licenses) and obtains new documentation from providers.  Also, Arch Pro  monitors the HHS Office of Inspector General Medicare/Medicaid sanction reports and state licensing board disciplinary actions and notifies clients of any adverse information regarding practitioners on their current rosters.

Contracting and Delegation: Health care organizations delegate both the responsibility and liability for credentials verification, including National Practitioner Data Bank through a formal written contract for services. Arch Pro maintains professional and general business liability insurance for the protection of its clients. Arch Pro provides reasonable access to its operations and files by clients for auditing purposes.  Staff is available to meet with organization committees and officers on an as-needed basis. 

Credentialing and Privileging Maintenance Program: 

  • Coordinate and oversee licensure maintenance and expiration dates (medical, DEA, DPS, malpractice insurance) including notification to providers before expiration. (Provider is responsible for actual completion of the required renewal)
  • Maintain providers CAQH account and attest so file will stay current. This also includes submitting updated licensure and malpractice face sheets
  • Maintain provider credentials files according to applicable state applications, to include all personal, licensure, and demographic information
  • Complete reappointment applications and complete paperwork requests for hospital membership and privileges
  • Complete re-credentialing documentation for health plans
  • Act as a liaison between the provider and the hospital and/or health plans
  • Below are the services we provide under this program
    • Primary Source Verification Services: Arch Pro collects all information from Primary Sources and ensures that all provider data is verified and in accordance with the Joint Commission, NCQA, AAAHC, and other regulatory standards. The following items are verified according to an organization's bylaws: 
  • License to Practice
  • Work History
  • DEA
  • Board Certification
  • Medical Education
  • Malpractice Insurance Coverage
  • Application Processing
  • Sanctions against licensure
  • Medicare/Medicare Sanctions
  • NPDB Query
  • Malpractice Claims History
  • Hospital Affiliation Verification/Work Site Verification

Sanctions Monitoring and Reporting: Sanctions are disciplinary actions imposed against licensed providers and can have far-reaching consequences. OIG guidelines clearly state that healthcare organizations cannot employ sanctioned or excluded individuals. If an organization fails to disclose any excluded providers employed, the organization can be fined upwards of $100,000 per excluded employee. Now, more than ever, it is exceedingly important for organizations to take proper action to monitor their providers for sanctions and exclusions. Arch Pro helps healthcare organizations maintain compliance by identifying through The Office of the Inspector General: U.S. Department of Health and Human Services (OIG), The General Services Administration (GSA), and The Department of the Treasury (OFAC), on a monthly basis, providers who have been sanctioned or excluded from participation in state and federal healthcare programs. Potential matches are investigated by Arch Pro and results are returned to your organization immediately for processing.

Expiring Document Management: Expiration dates of time-sensitive credentials are monitored and updated on an on-going basis. Reminders are sent to providers on a client customized timeline. (120, 90, 60, 45, 30, 15 day marks are all options)

  • Primary State license
  • DEA License
  • CSR
  • Malpractice Insurance
  • Board Certifications
  • CPR
  • Driver License
  • CSR License
  • Hospital Reappointment Dates- No limit to hospitals tracked.
  • And many more, as required

Provider Enrollment

Provider Enrollment is a critical process. If your providers are not enrolled correctly, you will not get paid for services provided. Arch Pro works with providers to determine which insurance carriers and networks you would like to pursue participation status with. These carriers may include Medicare, Medicaid, commercial carriers and workman’s compensation carriers. Additionally, we apply for or update your CAQH database. Our enrollment specialist completes the applications for you and continues to track the status of your applications until you are loaded in the carriers’ databases. We provide ongoing updates to you and your staff throughout this process. All of your documents are maintained on our secure database. Your enrollment specialist will also obtain fee schedules from contracted carriers and provide you with those to be utilized in the billing process.