Navigate California's complex healthcare billing landscape with Medtransic. As the nation's largest healthcare market with over 100,000 active physicians, California practices face unique challenges including Medi-Cal billing, Knox-Keene compliance, and diverse managed care contracts. Our experts deliver results.
Medtransic delivers comprehensive medical billing and revenue cycle management services to healthcare providers throughout California. Our team of certified medical coders and billing specialists understands the unique regulatory environment, payer mix, and healthcare challenges that California practices face. Whether you operate a solo practice or a multi-location clinic, our customized billing solutions help maximize reimbursement, reduce claim denials, and accelerate collections so you can focus on delivering quality patient care.
Why Partner with Medtransic in California
Healthcare providers across California choose Medtransic for our proven track record of delivering measurable results in medical billing and revenue cycle management.
98% First-Pass Acceptance Rate — Clean claims submitted within 24-48 hours, reducing rejections and accelerating payments
25% Average Revenue Increase — Our clients see significant revenue growth within 90 days of onboarding
45% Denial Rate Reduction — Proactive denial prevention with root cause analysis and targeted appeals
HIPAA-Compliant Operations — SOC 2 certified, fully HIPAA compliant with encrypted data handling
Dedicated Account Manager — A single point of contact who knows your practice, specialty, and payer mix
No Long-Term Contracts — Month-to-month flexibility with transparent pricing and no hidden fees
Why California Practices Choose Medtransic
Healthcare providers across California partner with Medtransic because of our proven track record of improving practice revenue and reducing administrative burden.
Medi-Cal Billing Expertise
Comprehensive Medi-Cal billing services including managed care plan navigation and fee-for-service claims processing.
Managed Care Optimization
Expert contract analysis and billing for California's extensive managed care network including Kaiser, Blue Shield, and Health Net.
Regulatory Compliance
Stay compliant with DMHC regulations, Knox-Keene Act requirements, and California-specific billing laws.
Multi-Location Support
Scalable billing infrastructure for California's large multi-site practices and medical groups.
See How Much Revenue Your California Practice Is Leaving on the Table
Get a free, no-obligation practice assessment. We'll analyze your claims, denials, and A/R to show you exactly where you're losing money.
California has robust surprise billing protections under AB 72 (2017) and AB 1611. Patients cannot be balance billed for emergency services or by out-of-network providers at in-network facilities. An independent dispute resolution process settles payment disagreements between providers and payers.
Statute of Limitations: 4 years for medical debt collections in California.
Timely Filing: Claims must generally be filed within 365 days, though individual payer contracts may impose shorter deadlines.
Surprise Billing Protection: California has enacted surprise billing protections for patients.
AB 72 surprise billing protections
Knox-Keene Act managed care regulations
DMHC oversight of HMO billing practices
Limits on balance billing for emergency services
Medical Billing Services We Offer in California
Our full suite of revenue cycle management services is available to healthcare practices across California. Each service is tailored to meet the specific needs of your practice and specialty.
Denial Management - Proactive denial prevention and aggressive appeals to recover lost revenue for California practices
Medical Coding - Certified ICD-10, CPT, and HCPCS coding by specialists familiar with California payer requirements
Accounts Receivable Management - Systematic follow-up on outstanding claims to reduce days in AR and improve collections
Provider Credentialing - Complete payer enrollment and credentialing for California insurance networks
Compliance Auditing - Regular audits to ensure your practice meets California and federal billing compliance standards
Patient Billing - Clear, professional patient statements and payment processing
Telehealth Billing - Virtual visit reimbursement following California telehealth regulations
Medtransic provides specialty-specific billing expertise for healthcare practices across California. Our coders are trained in the unique coding and billing requirements of each medical specialty.
Medtransic serves healthcare providers across every part of California with localized billing expertise.
Southern California: Los Angeles, Orange County & Inland Empire
Southern California is the largest metro healthcare market in the western United States. Cedars-Sinai, UCLA Health, and Kaiser Permanente anchor a sprawling network of hospitals and specialty clinics serving over 18 million residents with heavy Medi-Cal managed care penetration through LA Care and Health Net.
Practices in this region face diverse multilingual patient communication needs spanning Spanish, Korean, Mandarin, and Armenian, alongside a high volume of specialty practices competing for commercial payer contracts.
Key specialties in demand: Cardiology, gastroenterology, plastic surgery, oncology, orthopedics
Bay Area: San Francisco, San Jose & Oakland
The Bay Area is a tech-driven healthcare innovation hub anchored by UCSF, Stanford Health Care, and Sutter Health. The region's exceptionally high cost of living directly impacts practice overhead, making efficient revenue cycle management critical for independent providers.
Strong commercial payer markets from tech-sector employer-sponsored plans combine with growing biotech and pharma clinical trial billing demands that require specialized coding expertise.
Key specialties in demand: Dermatology, psychiatry, primary care, radiology, clinical research
San Diego & Border Region
San Diego's healthcare market is shaped by its cross-border patient population and significant military presence. Scripps Health, Sharp HealthCare, and UC San Diego Health serve a diverse metro area where TRICARE billing from Camp Pendleton and Naval Base San Diego represents a substantial portion of payer mix.
Medi-Cal border coverage issues and cross-border continuity of care create unique billing challenges that require specialized knowledge of federal and state coverage rules.
Key specialties in demand: Family medicine, urgent care, military medicine, orthopedics, behavioral health
Sacramento & Central Valley
Sacramento and the Central Valley are served by UC Davis Health, Sutter Health, and Dignity Health, covering a vast geographic area with significant healthcare access disparities. The region's large agricultural worker population relies heavily on Medi-Cal, and rural health clinic billing rules add complexity for providers outside metro areas.
Significant underserved populations drive demand for federally qualified health center (FQHC) billing expertise and Medi-Cal enrollment support.
Key specialties in demand: Primary care, pediatrics, OB/GYN, rural health, endocrinology
Our Track Record in California
Medtransic has a strong track record of delivering results for healthcare practices in California.
500++ practices served across California
120++ billing specialists dedicated to California accounts
18++ years of experience in California medical billing
98% first-pass claim acceptance rate
25% average revenue increase for California practices
45% average denial rate reduction
Frequently Asked Questions About Medical Billing in California
How does Medi-Cal managed care affect billing for California practices?
California's Medi-Cal program operates through managed care plans in most counties, each with its own authorization requirements, fee schedules, and claims submission processes. Plans like LA Care, Health Net, and Molina have different portals and billing rules. Medtransic maintains dedicated Medi-Cal specialists who track plan-specific requirements and ensure claims are submitted correctly to each managed care organization.
What is the Knox-Keene Act and how does it impact medical billing in California?
The Knox-Keene Health Care Service Plan Act regulates managed care plans in California and establishes requirements for timely claims payment, provider access, and grievance procedures. Health plans must pay or deny clean claims within 30 working days for electronic submissions. Medtransic monitors compliance with Knox-Keene requirements on behalf of our California clients and files timely appeals when plans fail to meet payment deadlines.
How does California's AB 72 surprise billing law affect out-of-network billing?
AB 72 protects patients from surprise medical bills when they receive non-emergency services from out-of-network providers at in-network facilities. The law caps patient responsibility at in-network cost-sharing amounts and establishes an independent dispute resolution process for payment disagreements between providers and plans. Our billing team applies AB 72 rules automatically when processing applicable claims.
What are California's telehealth billing rules?
California requires commercial payers to reimburse telehealth services at the same rate as in-person visits under the Telehealth Advancement Act. Medi-Cal has its own set of eligible telehealth codes and originating site requirements. Medtransic ensures proper modifier usage (95, GT) and place-of-service codes for all California telehealth encounters to maximize reimbursement.
What are the timely filing deadlines for California insurance claims?
California timely filing deadlines vary by payer, generally ranging from 180 to 365 days for commercial plans. Medicare requires filing within 12 months of the date of service, and Medi-Cal managed care plans typically require submission within 180 days. Medtransic submits clean claims within 24-48 hours and tracks every deadline to prevent revenue loss from late filings.
Does Medtransic handle Kaiser Permanente claims in California?
Kaiser Permanente operates as a closed system for most services, but California practices frequently encounter Kaiser patients for emergency, urgent, and authorized out-of-network referrals. Our team understands Kaiser's specific claims submission requirements and authorization workflows to ensure proper reimbursement for these encounters.
How much do medical billing services cost in California?
Medical billing outsourcing for California practices typically ranges from 4-8% of monthly collections, depending on practice size, specialty, and claim volume. Medtransic offers transparent, competitive pricing with no hidden fees. Most California practices see a net revenue increase after partnering with us because of reduced denials and faster collections. View our pricing plans for details.
How do I get started with Medtransic in California?
Getting started is simple. Contact us for a free practice assessment where we analyze your current billing processes and identify improvement opportunities. Our onboarding typically takes 2-4 weeks, during which we integrate with your existing EHR system and begin processing claims with zero disruption to your practice.
Get Started with Medical Billing Services in California
Ready to optimize your California practice's revenue cycle? Contact Medtransic today for a free, no-obligation practice assessment. Call us at 888-777-0860 or submit a contact form to speak with a billing specialist who understands California healthcare. Let us handle the billing complexities so you can focus on what matters most — your patients.