The Ohio RCM Authority
Master Revenue in
Ohio.
Columbus.
Cleveland.
Cincinnati.
Dayton.
Operating a practice in the Buckeye State means navigating Anthem BCBS complexities, expansive academic health networks, and strict CGS (J15) 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 OH-GATEWAY
CGS (J15)
LCD Scrubber Rules
Synced
Anthem BCBS OH
Policy & Modifiers
Active
Ohio Medicaid
Provider Portal Sync
Scanning
Core Capabilities
The HBS Advantage in OH.
Beyond standard billing, we offer a comprehensive revenue cycle management ecosystem tailored specifically for Ohio’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 CGS (J15) LCD mismatches before claims ever reach the payer, ensuring our 98% clean claim rate.
Dedicated OH Teams
You don’t get a generalized call center. You are assigned a dedicated pod of RCM specialists who strictly handle Ohio accounts and understand the nuances of Anthem commercial plans and the transition to Ohio 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 Ohio region.
Columbus
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
Cleveland
Primary Challenge: Massive academic medical center presence (Cleveland Clinic), 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
Cincinnati
Primary Challenge: Proximity to the KY/IN borders requires meticulous cross-state billing and out-of-network processing for commercial plans.
HBS Solution: Advanced clearinghouse rules engines tailored for complex multi-state commercial networks and swift denial appeals.
Top EHRs:
ModMed | eCW
Dayton
Primary Challenge: Serving as a regional medical hub for surrounding rural counties, resulting in complex cross-network and Medicaid referral billing.
HBS Solution: Streamlined Ohio Medicaid portal synchronization and rapid front-end eligibility verification for referred out-of-network patients.
Top EHRs:
AdvancedMD | Kareo
Toledo
Primary Challenge: Aging demographics driving high Medicare (CGS J15) volume, chronic care management, and seasonal tourist influxes.
HBS Solution: Strict adherence to CGS LCDs, precise time-based CCM coding, and scalable RCM teams to manage summer tourist billing spikes.
Top EHRs:
Allscripts | Cerner
Rural Ohio / Appalachia
Primary Challenge: Rural Health Clinic (RHC) billing complexities, heavy reliance on Telehealth, and OH 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
Ohio Success Stories.
eal data from practices across the Buckeye State that transformed their revenue cycles by partnering with HBS.
Multi-Specialty Clinic
Columbus, OH
Struggled with massive A/R aging > 90 days due to complex commercial plan pre-authorizations and CGS (J15) audits.
A/R > 90 Days
-75%
Monthly Cash Flow
+$135K
Orthopedic Center
Cincinnati, OH
Plagued by high denial rates (23%) due to complex pre-authorizations and cross-border KY billing errors.
Denial Rate
3.4%
Clean Claim Rate
98.5%
Secure Your OH Revenue Audit
Stop leaving money on the table. Our Ohio specialists will analyze your revenue cycle and uncover hidden billing opportunities.