Frequently Asked Questions

YTC Healthcare provides medical billing and revenue cycle services for physicians, private practices, clinics, hospitals and other healthcare organizations. Scope is set per engagement based on the organization’s specialty, claim volume, payer mix and existing internal billing structure. 

A medical billing company handles the administrative work that converts patient care into payment. That covers checking insurance coverage before a visit, assigning the correct codes, submitting claims, posting payments, appealing denials and following up on unpaid balances. The practice keeps clinical responsibility and the billing company handles the process around it. 

Revenue cycle management is the end-to-end handling of a provider’s financial process, from the moment a patient is scheduled to the moment the account is closed. It includes eligibility checks, coding, claim submission, payment posting, denial recovery, accounts receivable follow-up and reporting. Medical billing is one part of that wider cycle. 

Yes. YTC Healthcare manages the full revenue cycle, from eligibility and benefits verification through coding, claims submission, payment posting, denial management, accounts receivable follow-up and reporting. A practice can outsource the entire function or use YTC Healthcare for selected stages. 

Yes. A practice can hand over a single stage rather than the whole function. Common arrangements include coding only, denial management only, or accounts receivable recovery on aged claims while the practice keeps day-to-day submission in house. 

Yes. YTC Healthcare confirms coverage, benefits and authorization requirements as part of the billing process. These checks identify coverage and authorization issues before claims are submitted rather than after a denial has been returned.

Yes. YTC Healthcare’s coders apply ICD-10, CPT and HCPCS codes, the standard code sets used to describe diagnoses, procedures and supplies. Codes are selected to the level of specificity the clinical documentation and applicable payer requirements support.

Yes. YTC Healthcare prepares and submits claims through clearinghouse systems and monitors them through payer processing. Claims are checked against applicable payer requirements before submission, and the team monitors submission acknowledgements and processing status.

Yes. YTC Healthcare posts payments and compares each one against the contracted rate. A claim that has been paid has not necessarily been paid correctly, so underpayment is identified at this stage and reported separately from denial recovery. 

YTC Healthcare reviews the reason for each denial, makes the required correction and manages the appropriate appeal or follow-up. A denied claim is not resubmitted unchanged. Recurring denial causes are recorded so the underlying billing issue can be corrected at the stage that produced it. 

Yes. YTC Healthcare follows up on outstanding claims and balances and records the next action and date for each open account. The team works to an internal target of keeping accounts receivable under 40 days. 

Yes. YTC Healthcare reviews coding and documentation to identify risk before a payer does. An audit can be run as a standalone engagement or as part of an ongoing billing arrangement, and findings are reported with the specific documentation gaps that produced them. 

Yes. YTC Healthcare manages provider credentialing and payer enrolment so providers can bill without delay. Credentialing is also available separately from billing, which is useful for practices adding a provider or entering a new payer contract.

Yes. YTC Healthcare bills for cardiology, radiology, dermatology, pediatrics, behavioral health and durable medical equipment. Each specialty carries its own coding conventions and payer rules, and claims are handled by staff familiar with that specialty rather than by one general team.

Yes. YTC Healthcare bills United States commercial and government payers and Canadian provincial plans including OHIP. Each side is handled by staff familiar with that payer environment, and the applicable privacy framework is applied separately for each country.

YTC Healthcare records a baseline before an engagement begins and reports performance against it. Reporting shows first-pass acceptance, denial categories, accounts receivable ageing and underpayment recovery. YTC Healthcare tracks every claim against a target of 95% or higher first-pass acceptance, and works to an internal target of accounts receivable under 40 days. 

No. YTC Healthcare does not guarantee a collection rate, a denial rate or a cash flow outcome. Payer decisions and adjudication timelines are outside any billing company’s control. YTC Healthcare tracks every claim against a target of 95% or higher first-pass acceptance, and reports results against a baseline recorded before work began. 

No. Payer coverage depends on the specialty, the state or province and the enrolments already held by the practice. YTC Healthcare confirms which payers are covered during scoping, before any agreement is signed, rather than claiming universal coverage.