Premier medical billing services for Philadelphia healthcare providers. The City of Brotherly Love is home to world-renowned medical institutions including Penn Medicine, Jefferson Health, and Temple Health, creating a sophisticated healthcare market that demands expert billing capabilities.
Medtransic provides expert medical billing and revenue cycle management services to healthcare providers in Philadelphia, Pennsylvania. Our certified billing specialists and medical coders deliver customized solutions that address the specific needs of Philadelphia-area practices, helping you maximize reimbursement, reduce claim denials, and improve your overall financial performance.
Metro Area: Philadelphia-Camden-Wilmington
Population: 1,603,797
Estimated Practices: 14,000+
Philadelphia is one of America's premier healthcare cities, home to world-renowned academic medical centers, the nation's first hospital (Pennsylvania Hospital), and a dense concentration of medical schools and research institutions. The market spans from cutting-edge academic medicine in University City to community health centers across North and West Philadelphia, with a growing suburban practice base in the Main Line and Bucks County.
Major Hospital Systems: Penn Medicine (University of Pennsylvania), Jefferson Health, Temple Health, Children's Hospital of Philadelphia (CHOP), Main Line Health, Einstein Healthcare Network
Understanding the dominant payers in Philadelphia is critical for maximizing reimbursement. Medtransic maintains current billing protocols for every major payer in the Philadelphia market.
The dominant commercial payer in the Philadelphia region, covering over 2.5 million members. IBX plans have specific network designations (Keystone, Personal Choice) with different reimbursement tiers and authorization requirements.
Major commercial and Medicare Advantage presence in Philadelphia. Aetna's local roots (formerly headquartered nearby) mean deep market penetration among employers in the Philadelphia metro.
Significant employer-sponsored plan coverage in Philadelphia and the surrounding suburbs. Cigna plans have specific pre-certification requirements for specialty services and advanced diagnostics.
Growing Medicare Advantage and commercial market share in the Philadelphia region with strict timely filing and authorization protocols.
Major Medicaid managed care plan covering Philadelphia's large Medicaid population through Pennsylvania's HealthChoices program. PA H&W has specific billing codes and authorization workflows.
These are the most in-demand specialties in the Philadelphia healthcare market. Medtransic provides specialty-specific billing expertise for each:
Medical practices in Philadelphia face specific billing challenges that require local expertise to navigate effectively:
We offer a comprehensive range of revenue cycle management services to healthcare practices in Philadelphia and the surrounding area.
Healthcare providers in Philadelphia partner with Medtransic for our proven ability to improve practice revenue and reduce billing complexity.
Specialized billing for Philadelphia's prestigious academic medical centers and teaching hospitals.
Expert navigation of Pennsylvania's Medicaid managed care organizations and billing requirements.
Handle billing across PA, NJ, and DE for providers in the greater Philadelphia metropolitan area.
Aggressive AR follow-up and denial management to recover lost revenue for Philadelphia practices.
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.
Get Free Assessment | Call 888-777-0860
Medtransic also serves healthcare providers in communities near Philadelphia, Pennsylvania:
Medical billing outsourcing in Philadelphia typically costs 4-8% of monthly collections. The rate varies based on specialty, practice size, and payer mix complexity. Practices with heavy academic medicine or multi-state billing may see rates toward the higher end. Most Philadelphia practices see net revenue improvements of 20-30% with Medtransic.
We maintain current billing protocols for Pennsylvania, New Jersey, and Delaware payers — essential for Philadelphia practices that routinely treat patients from all three states. Our team handles state-specific Medicaid programs, commercial payer requirements, and the regulatory differences across state lines, ensuring clean claim submission regardless of the patient's home state.
Yes. We have extensive experience billing for practices affiliated with Penn Medicine, Jefferson Health, Temple Health, and CHOP. We understand teaching physician billing rules, split-billing requirements, and the specific documentation standards required for academic practice compliance.
Absolutely. We specialize in Pennsylvania workers' compensation billing using the Medicare-based fee schedule with PA-specific modifiers and reporting requirements. This is particularly important for Philadelphia practices serving the city's construction, manufacturing, and public sector workforce.
Most Pennsylvania commercial payers require claim submission within 90-365 days, depending on the contract. Independence Blue Cross typically allows 365 days for in-network claims. Pennsylvania Medicaid requires filing within 180 days. Medicare allows 12 months. Medtransic submits clean claims within 24-48 hours of receiving encounter data.
Our typical onboarding for Philadelphia practices takes 2-4 weeks, including EHR integration, multi-state payer enrollment verification, and staff training. Most practices see measurable revenue improvements within the first 90 days.
Ready to optimize your Philadelphia practice's revenue cycle? Contact Medtransic today for a free, no-obligation assessment. Call 888-777-0860 or submit a contact form to speak with a billing specialist who understands Philadelphia's healthcare market.