Claim Creation & Billing Services

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Accurate Claims. Cleaner Submissions. Faster Payments.

At Claims Esquire, we believe the quality of your claims determines the quality of your cash flow. Every error, every missing detail, and every incorrect code increases the chance of denial. Our Claim Creation & Billing Services eliminate these vulnerabilities by ensuring each claim is built with precision, validated for compliance, and submitted clean the first time.

Our billing specialists combine payer-specific knowledge, compliance standards, and real-time verification workflows so your practice experiences higher acceptance rates and accelerated reimbursements.

Where Most Practices Struggle in Claim Creation

Even strong clinical teams often face issues like:

  • Missing or inaccurate documentation
  • Incorrect CPT, ICD-10, or modifier usage
  • Improper charge allocation
  • Lack of payer-specific coding rules
  • Claims not submitted within timely filing windows
  • Incorrect place-of-service or taxonomy
  • Duplicate claim submissions
  • Unverified patient benefits

These preventable errors cost U.S. practices billions every year.
Claims Esquire prevents these losses.

What We Deliver in Claim Creation & Billing Services

Complete Claim Construction

We capture and validate every essential detail, including:

  • • CPT and ICD-10 coding
  • • Modifiers (based on payer rules)
  • • Place of service
  • • Rendering provider information
  • • Referring provider details
  • • NPI, TIN, taxonomy
  • • Payer-mandated fields
  • • Supporting documentation

Nothing is overlooked.Nothing is assumed. Every claim is built with accuracy and payer readiness.

1
Payer-Specific Validation

Different payers. Different rules. Different traps.

We run each claim through a payer-specific compliance checklist, ensuring:

  • • Correct edits for Medicare, Medicaid, and commercial payers
  • • Bundling/unbundling rules are followed
  • • Medical necessity requirements are met
  • • Modifiers are used exactly as expected
  • • Frequency limitations are respected

This reduces denials before they happen.

2
Eligibility & Benefits Verification

If benefits aren’t verified, the claim is at risk.

Our team validates:

  • • Coverage status
  • • Policy effective dates
  • • Deductibles
  • • Co-pay & co-insurance
  • • Prior authorization requirements
  • • Benefit exclusions

Only verified claims move forward.
This ensures cleaner submissions and fewer eligibility denials.

3
Timely & Compliant Claim Submission

Late submissions = automatic denials.

We ensure every claim is:

  • • Submitted within payer timeframes
  • • Delivered electronically (or paper-filed when required)
  • • Monitored for acceptance
  • • Rejected claims corrected and resubmitted same-day

Your revenue stays ahead of deadlines not behind them.

4
Rejection Handling Included

If a claim is rejected at clearinghouse or payer level, we:

  • • Identify the error
  • • Correct the issue
  • • Resubmit immediately
  • • Document the fix to avoid recurrence

Your practice never loses time or revenue due to avoidable errors.

5
Daily, Weekly & Monthly Billing Reports

We provide real-time visibility into:

  • • Total claims submitted
  • • Acceptance vs. rejection rate
  • • Charges posted
  • • Payer distribution
  • • Any claims needing attention

Clear data. Clear insights. Clear decisions.

6

Why Claims Esquire Is the Preferred Billing Partner

Cleaner Claims = Higher Approval Rates

Our rigorous checks reduce errors before submission.

Strong Understanding of U.S. Payers

UnitedHealthcare, Aetna, Cigna, Medicare, Medicaid, Blue Cross plans—we know how each of them thinks.

Faster Cash Flow

Clean claims get paid quickly. Simple as that.

Clean claims get paid quickly. Simple as that.

Your team focuses on care. We handle financial accuracy.

Compliance-Focused

HIPAA. OIG. CMS guidelines. We follow every rule every time.

End-to-End Billing Control

From creation to submission to rejection fixes we own the process fully.