Frequently Asked Questions & Practice Knowledge Hub

Yes, strictly zero hidden charges. Mednexa operates on a strict 2.49% contingency rate calculated solely on the actual revenue successfully collected in your practice bank account.

Unlike traditional legacy billing entities or clearinghouse aggregators, we do not bill for:

• Zero software user licenses, EHR integration bridge fees, or portal user seat costs.
• Zero clearinghouse submission charges or ERA/835 remittance setup fees.
• Zero setup fees or onboarding audit surcharges.

Mednexa absorbs the complete cost of administrative labor, clinical appeal letter authoring, and forensic investigations. You never pay a single dime on uncollected claims.

Our AAPC-credentialed coders and appeals attorneys exhaust all Level 1 and Level 2 carrier reconsiderations, including submitting certified documentation, medical charts, and operative notes. Only after exhaustive lawful appeals have been confirmed non-reimbursable (or non-covered per patient consent) is a file formally recommended for balance re-classification, without any fee charged to your clinic.

No long-term locks. We operate on performance-backed, month-to-month service agreements. We believe revenue cycle partners must earn your partnership every single billing cycle through clean collection velocity.

If our speed, first-pass clean claim rate (99.3%), or dedicated customer care manager fails to satisfy your operational standards, you may terminate with 30 days notice. We will conclude pending cycle remittances without penalty.

Our structured turnkey onboarding requires only 5 to 7 business days. Mednexa deploys a dedicated technical integration manager who configures SFTP channels, maps clearinghouse credentials, and aligns fee schedules entirely in the background.

Your front office and clinical staff continue scheduling, treating, and documenting patient care as usual. There is zero down-time, zero dual-entry requirements, and zero disruptions to your active daily clinic volume.

We maintain native, bidirectional workflow integrations across all major healthcare platforms in the United States, including:

Don't see your specific system? Our integration architects interface with any HL7/FHIR compliant system or custom proprietary relational database.

Zero changes to your daily routine. Physicians and mid-level providers chart in their familiar clinical EHR templates exactly as they have always done.

Mednexa securely extracts finalized superbills and provider documentation via encrypted bridges. Our AAPC-certified specialists append necessary procedural modifiers, audit medical necessity indicators, and submit electronic claims without requiring you to login to a third-party software container.

We combine dual-layer artificial intelligence validation engines with AAPC human specialty coder verification. Before any 837P or 837I claim bundle leaves our servers, it is vetted against:

• 4,200+ National Correct Coding Initiative (NCCI) unbundling and modifier edits.
• Local and National Coverage Determinations (LCD/NCD) matching ICD-10 medical necessity.
• Carrier-specific payer policy algorithms for UnitedHealthcare, Anthem BCBS, Aetna, Cigna, Humana, and Regional Medicaid.

Issues are corrected upstream within hours, resulting in an industry-leading clean claim rate that accelerates cash velocity by 14–21 calendar days.

Unlike standard billing services that casually write off denials or re-submit unamended claims to get rejected again, Mednexa enforces a strict 24-Hour Forensic Action Plan:

1. Root-Cause Determination: Electronic remittance advice (ERA 835) remark codes (CARC/RARC) are flagged immediately.
2. Clinical Brief Formulation: A certified billing auditor drafts tailored appeal arguments citing peer-reviewed clinical guidelines, LCDs, and physician op-notes.
3. Formal Escalation: We directly submit Level 1 reconsiderations and Level 2 carrier appeals, tracking responses through dedicated payer representative channels until funds are wired.

Yes, this is our core forensic specialty. Payers count on medical practices running out of time and patience to pursue balances over 90 days old.

Our dedicated AR Recovery Squad conducts an itemized forensic sweep across all unpaid claims falling within each payer's timely filing limit (typically 90 to 365 days). We resolve missing records, re-authenticate prior authorizations, re-link diagnosis codes, and recover substantial capital that clinics had already resigned to bad debt write-offs.

We treat data defense with military and banking-grade rigor. Protected Health Information (PHI) is isolated within a hardened, SOC-2 Type II certified cloud infrastructure governed under formal HIPAA and HITECH security rules.

Prior to receiving a single batch file or reading EHR charts, Mednexa executes fully comprehensive mutual Business Associate Agreements (BAAs), indemnifying your practice under federal healthcare privacy mandates.

You never have to guess where your revenue stands. Every Mednexa client receives 24/7 executive dashboard visibility plus custom monthly closed-loop briefings detailing:

• Net Collection Ratio (NCR) segmented by commercial vs. government payers.
• Days in Accounts Receivable (AR Days) indexed against MGMA regional benchmarks.
• First-pass clean claims rate trends and denial classification categorizations.
• Patient responsibility collections and self-pay statement reconciliation.

Your assigned Practice Account Executive schedules an optional 20-minute monthly financial review to address adjustments, changes in physician schedules, or emerging payer policy shifts.