The Wisconsin RCM Authority
Master Revenue in
Wisconsin.
Milwaukee.
Madison.
Green Bay.
Appleton.
Operating a practice in the Badger State means navigating Anthem BCBS complexities, expansive rural healthcare networks, and strict NGS (J6) 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 WI-GATEWAY
NGS (J6)
LCD Scrubber Rules
Synced
Anthem BCBS WI
Policy & Modifiers
Active
Wisconsin ForwardHealth
Provider Portal Sync
Scanning
Core Capabilities
The HBS Advantage in WI.
Beyond standard billing, we offer a comprehensive revenue cycle management ecosystem tailored specifically for Wisconsin’s mix of academic health systems, dense urban networks, and essential rural clinics.
AI-Driven Scrubbing
Our proprietary rules engine preemptively identifies coding errors and NGS (J6) LCD mismatches before claims ever reach the payer, ensuring our 98% clean claim rate.
Dedicated WI Teams
You don’t get a generalized call center. You are assigned a dedicated pod of RCM specialists who strictly handle Wisconsin accounts and understand the nuances of Anthem commercial plans and ForwardHealth Medicaid.
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 Wisconsin region.
Milwaukee
Primary Challenge: Massive concentration of competing health systems, complex multi-specialty practices, and high commercial plan density (Anthem BCBS).
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
Madison
Primary Challenge: Massive academic medical center presence (WVU Medicine), 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 | Cerner
Green Bay
Primary Challenge: Aging demographics driving high Medicare (NGS J6) volume, chronic care management billing, and regional facility overlaps.
HBS Solution: Strict adherence to NGS LCDs, precise time-based CCM coding, and aggressive appeals for medical necessity denials.
Top EHRs:
ModMed | eCW
Appleton / Fox Cities
Primary Challenge: High volume of ForwardHealth (Medicaid) managed care plans and complex demographic billing rules.
HBS Solution: Mastery of Wisconsin ForwardHealth portal synchronization, specific MCO coding guidelines, and optimizing public health claims.
Top EHRs:
AdvancedMD | Kareo
Eau Claire
Primary Challenge: Serving as a regional medical hub for surrounding rural counties, resulting in complex cross-network and Medicaid referral billing.
HBS Solution: Streamlined ForwardHealth portal synchronization and rapid front-end eligibility verification for referred out-of-network patients.
Top EHRs:
Allscripts | Athena
Rural Wisconsin
Primary Challenge: Rural Health Clinic (RHC) billing complexities, heavy reliance on Telehealth, and Critical Access Hospitals.
HBS Solution: Deep expertise in PPS rate reconciliation, mastery of Telehealth modifiers (95, GT), and specialized RHC/CAH modifier management.
Top EHRs:
Elation
|
DrChrono
Proven Results
Wisconsin Success Stories.
Real data from practices across the Badger State that transformed their revenue cycles by partnering with HBS.
Multi-Specialty Clinic
Milwaukee, WI
Struggled with massive A/R aging > 90 days due to complex commercial plan pre-authorizations and NGS (J6) audits.
A/R > 90 Days
-73%
Monthly Cash Flow
+$126K
Orthopedic Center
Green Bay, WI
Plagued by high denial rates (22%) due to complex workers’ compensation claims and surgical coding errors.
Denial Rate
3.4%
Clean Claim Rate
98.5%
Secure Your WI Revenue Audit
Stop leaving money on the table. Our Wisconsin specialists will analyze your revenue cycle and uncover hidden billing opportunities.