Medical Billing and Coding Outsourcing Philippines
Charge entry, chart abstraction, documentation preparation, coding administrative support, claims submission (admin), payment posting, denial management (admin), AR follow-up (admin), patient billing support, credentialing assistance, and end-to-end RCM back-office services — delivered by HIPAA-aligned Philippine teams. Improve reimbursement accuracy, reduce AR days, eliminate billing and coding backlogs, and cut operational costs by 40–60%.
Medical Billing and Coding Outsourcing Philippines: Higher Reimbursement Accuracy, Faster Cash Flow, Lower Cost
Medical billing and coding outsourcing supports organizations across:
- Healthcare provider groups and physician practices
- Hospitals and integrated delivery networks (IDNs)
- Medical billing and RCM companies
- Telehealth and virtual care platforms
- Ambulatory surgery centers and outpatient clinics
- MSOs and healthcare management organizations
- Healthtech and digital health companies
- Specialty practices with complex coding requirements
- Payer-facing administrative and claims support teams
The Challenges & Our Solutions
CHALLENGES
- Increasing administrative strain
- Growing claims and coding complexity
- Rising denial rates tied to documentation gaps
- High labor costs for billers and certified coders
- Patient volume spikes and staffing shortages
- Constantly changing payer rules
- Compliance and audit pressure
MEDICAL BILLING AND CODING OPERATIONS DEMAND
- High accuracy
- Speed and consistency
- Strong documentation discipline
- Payer and compliance awareness
- Scalable administrative support
- Reliable turnaround times
- Data integrity across the revenue cycle
PHILIPPINE OUTSOURCING SOLUTIONS
- Specialized billing and coding administrative teams
- HIPAA-aligned workflows
- 24/7 operational coverage
- High clean-claim and documentation accuracy
- AI-enhanced RCM workflows
- Advanced reporting and analytics
- Up to 60% cost reduction
PITON-Global connects healthcare organizations with the Philippines’ top medical billing and coding outsourcing providers.
CEO Insight: Why Billing and Coding Thrive in the Philippines
Medical billing and coding are precision-driven, compliance-heavy, and workflow intensive. Philippine teams excel at the administrative foundation behind both, enabling faster reimbursements, lower denial rates, and stronger revenue integrity.
John Maczynski, CEO, PITON-Global
Complete Medical Billing and Coding Capabilities
Patient Demographics, Chart Abstraction & Charge Entry
- Patient demographics entry
- Insurance verification data entry
- Chart abstraction and encounter prep
- Provider and facility details
- CPT / ICD data entered as provided by clinicians
- Charge capture review
- Documentation alignment
- Clean-claim preparation
Coding Administrative Support & Validation (Non-Coding)
- Chart organization and prep for certified coders
- Documentation completeness checks
- Identifying missing signatures or notes
- Encounter timeline organization
- Pre-coding validation (admin only)
- Highlighting documentation gaps
- QA prep packets
Claims Submission Support (Administrative)
- CMS-1500 and UB-04 preparation
- Clearinghouse submissions
- Payer-specific rule checks
- Eligibility verification support
- Claims batching and corrections
- Resubmission workflows
Payment Posting & Reconciliation
- EOB / ERA interpretation
- Payment reconciliation
- Adjustment and zero-payment posting
- Payer mapping
- Batch processing
- Daily reconciliation
Denial Management Support (Administrative)
- Denial code identification
- Root-cause logging
- Documentation assembly
- Rebill preparation
- Draft appeals packet support
- Escalation routing
- Status tracking
AR Follow-Up (Administrative)
- Claim status checks
- Payer follow-ups (non-advisory)
- Documentation requests
- Timely filing prep
- Follow-up scheduling
- Payer response logging
Patient Billing & Support Services
- Billing inquiries
- Statement explanations
- Payment plan clarification
- Reminder calls and notifications
- Basic account support
Provider Credentialing Support (Administrative)
- Enrollment form preparation
- Payer portal updates
- Follow-up documentation
- Status checks
- Data entry
EMR / EHR Data Management
Experience supporting:
- Epic
- Cerner
- athenahealth
- AdvancedMD
- eClinicalWorks
- NextGen
- Kareo
RCM Analytics, Coding & Billing Reporting
- Daily and monthly RCM dashboards
- AR aging reports
- Coding backlog tracking
- Documentation error trends
- Denial and payer performance analysis
- Revenue capture insights
Sectors We Support
Healthcare Providers
- Hospitals
- Clinics
- Specialty practices
- Telehealth groups
- Urgent care centers
RCM Companies
- Medical billing firms
- Coding service providers
- End-to-end revenue cycle companies
Healthtech Platforms
- EHR providers
- Telehealth platforms
- Virtual care solutions
- Digital therapeutics
MSOs & IPAs
- Multi-provider networks
- Physician organizations
Ancillary Services
- Laboratories
- Imaging centers
- Rehabilitation facilities
AI-Enhanced Medical Billing and Coding
AI Performs:
- OCR and chart extraction
- Eligibility verification
- Documentation gap detection
- Claim scrubbing recommendations
- Predictive denial modeling
- EOB / ERA classification
- Payer rule validation
Philippine Teams Execute with Precision:
- Manual verification
- Data entry and validation
- Exception handling
- Documentation reconciliation
- Denial routing
- EMR updates
- Quality assurance
This hybrid AI + human model delivers speed, accuracy, and compliance.
Compliance & Security for Medical Billing and Coding Outsourcing
Certification
Purpose
- HIPAA Alignment
- PHI privacy protection
- SOC 2 Type II
- Operational security
- ISO 27001
- Information security
- HITECH
- Electronic PHI handling
- GDPR
- Global data protection
Medical Billing and Coding Case Studies
Case Study 1: Multi-Specialty Clinic (US)
Challenge: High denials, AR > 60 days
Solution:
Billing, denial management, and coding admin support
Results:
- AR days reduced from 62 → 38
- Clean claim rate improved to 97%
- Improved revenue cycle visibility
Case Study 2: Telehealth Provider
Challenge: Rapid growth and admin overload
Solution:
Claims support, coding prep, patient billing desk
Results:
- Claims backlog eliminated in 30 days
- Billing accuracy reached 99%
- Improved patient satisfaction
Medical Billing and Coding Outsourcing Rates (Philippines 2026)
Function
Rate (USD/hr)
Chart Abstraction / Charge Entry
$8–$12
Claims Submission Support
$10–$16
Payment Posting
$10–$16
Coding Admin QA Support
$10–$16
Denial Management (Admin)
$12–$20
AR Follow-Up (Admin)
$12–$20
Credentialing Support
$10–$16
QA Analyst
$14–$22
Team Lead
$18–$26
Why Healthcare Organizations Choose PITON-Global
- 25+ years outsourcing leadership
- Deep specialization in medical billing and coding admin outsourcing
- Access to HIPAA-aligned Philippine providers
- Expertise supporting providers, RCM firms, MSOs, and healthtech
- Proven improvements in accuracy and turnaround time
- Enterprise-grade compliance guidance
- Zero-cost vendor sourcing service
We help healthcare organizations build scalable, compliant, and high-performance medical billing and coding operations in the Philippines.
Medical billing and coding demand uncompromising accuracy, documentation discipline, and constant compliance awareness. When administrative gaps slow reimbursements or drive denials, revenue integrity suffers. Philippine medical billing and coding teams provide the operational backbone behind clean claims, faster AR cycles, prevents backlog accumulation, and enables healthcare organizations to scale efficiently while maintaining HIPAA-aligned compliance.
Ralf Ellspemann, CSO, PITON-Global
Frequently Asked Questions About Medical Billing and Coding Outsourcing in the Philippines
What services are included in medical billing and coding outsourcing in the Philippines?
How does outsourcing medical billing and coding to the Philippines improve revenue cycle performance?
Is medical billing and coding outsourcing in the Philippines HIPAA compliant?
How does an AI-enhanced medical billing and coding model work with Philippine teams?
What cost savings can healthcare organizations expect from outsourcing medical billing and coding to the Philippines?
In The News
Improve billing accuracy, eliminate coding backlogs, reduce denials, and accelerate reimbursements with specialized Philippine medical billing and coding teams.
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