Medical Billing Services in Florida
Florida Practices Are Losing Revenue to Denials, Delays & Complex Payer Rules
Florida’s complex Medicaid managed care, high Medicare patient volume, and AHCA rules are causing healthcare practices to lose thousands of dollars in denied and delayed claims.
WeCare handles your entire revenue cycle, step by step, to recover your losses and prevent you from losing more.
Billing in Florida is Different
Healthcare Practices in Florida Need Expert Billing Support
A large retiree population is part of Florida’s healthcare environment. Healthcare providers face Medicaid regulations and a complex payer mix. Billing service providers in Florida who use generic revenue cycle management approaches may not be a good fit for practices in FL. Here are some reasons why practitioners in Florida need an expert billing solution.
Florida Medicaid Complexity
Medicaid in FL operates through managed care organizations i.e. (Staywell, Molina, WellCare, etc.) with different authorization needs, fee structure, and claim portals.
High Medicare Volume
In Florida, nearly 5.1 million people are covered by Medicare. Healthcare providers should expect more Medicare Advantage plans, more prior authorization requirements, and stricter documentation standards.
Florida-Specific Compliance Rules
The Florida Agency for Health Care Administration (AHCA) applies rules that are new for Florida providers, including Florida Statutes Chapters 456 and 641
Hurricane & Disaster Billing Provisions
Providers in FL must stay updated on FEMA declarations as Florida’s frequent hurricane seasons trigger special CMS billing provisions and deadline waivers.
Tourism-Related Claims Surge
Healthcare practices in FL must deal with unique out-of-state insurance billing, emergency billing, and out-of-network situations, as over 130 million tourists are treated in FL annually.
What We Do
We Provide Complete Revenue Cycle Management Services to Florida Healthcare Providers
If you are providing healthcare services in FL, focus solely on patient care. We will handle the financial side of your practice. We are with you for medical billing services support from the patient’s first visit to the amount received in your account.
Medical Coding (ICD-10 & CPT)
Chemo, therapeutic infusion, and hydration codes need to be recorded in the correct sequence. We correctly do that with accurate time documentation to support every claim.
Claim Submission
We submit claims electronically on the same day you encounter patients. Our team tracks the claim across all the commercial and government payers.
Denial Management
Claim denial is common in billing practices. We resolve claim denials by identifying root causes. After that, we resubmit the corrected claim with a formal appeal and the necessary documents.
Insurance Eligibility Verification
We verify insurance for every patient before you provide care to prevent claim denials, delays, underpayments, and surprise bills.
Prior Authorization Management
Payers in Florida do not cover all procedures under a single plan. We handle prior authorization for all the providers, including Sunshine Health, Simply Healthcare, and Molina.
Accounts Receivable (A/R) Recovery
Fewer days in AR can help grow your practice revenue. We keep your AR days below 60 and follow up on outstanding claims to recover the outstanding receivables.
Patient Statement & Collections
We collect payments from patients without disrupting practices’ relationships with them. Our expert team sends clear, HIPAA-compliant statements in a friendly way.
Revenue Reporting
We design a custom dashboard that shows KPIs, payer mix analysis, denial trends, and revenue forecasts. Practices in Florida can easily check the monthly performance of their facilities.
Compliance & Audit Support
After partnering with us, we monitor your practice compliance for AHCA, OIG, and CMS audits. We maintain audit-ready documentation.
Credentialing & Enrollment
We support provider enrollment for all Florida Medicaid managed care plans and major commercial payers.
Practice Management Consulting
We help Florida healthcare practices optimize workflows, integrate with their EHRs, and consult on the revenue cycle to grow revenue efficiently.
Dedicated Account Management
Every healthcare provider in Florida receives services from a dedicated billing manager after partnering with WeCare. The dedicated account manager knows the specialty, payers, and practice goals very well
Specialties We Serve
Medical Billing Support For All The Specialties in FL
Our certified billers hold specific training across 50+ specialties. No matter what care services you provide in Florida, when it is time to prepare and send claims to payers, we are here to handle it.
Working With Multiple Payers
We Know Florida Insurance Network And Bill For All The Care Services You Provide
WeCare works with major Florida Medicaid, Medicare Advantage, and commercial insurance payers. Our billing team understands each payer’s authorization rules, claim requirements, and reimbursement policies.
We work with different managed care plans (MCP):
Medicaid Managed Care Plans
- Sunshine Health
- Molina Healthcare
- Simply Healthcare
- Humana Healthy Horizons
- Aetna Better Health
- Community Care Plan
- Florida Community Care
- UnitedHealthcare Community Plan
Medicare Advantage & Commercial Payers
- Florida Blue (BCBS)
- Humana
- Aetna
- Cigna
- UnitedHealthcare
- Devoted Health
- WellCare
- AvMed
- Oscar Health
- Ambetter
- Tricare East
Testimonials
Trusted by Florida Healthcare Providers
Miami, FL
“WeCare transformed our cardiology practice’s billing. Our denial rate dropped from 22% to under 2% within 90 days, and our monthly collections increased by $48,000. Their knowledge of Florida Medicaid managed care plans is unmatched.”
Tampa, FL
“When I was handling complex surgical billing and prior authorizations, I needed a team that truly understood my specialty billing. WeCare’s ortho coding and billing team is exactly according to my expectation. They even handled our hurricane season billing extensions flawlessly last year.”
Fort Lauderdale, FL
“We are running a mental health practice in Florida, and it comes with complex billing rules that keep changing, and we were busy with patients and could not stay updated on the rules. WeCare keeps us compliant and profitable. Our A/R days decreased from 58 to 19. Now, we can finally focus on our patients.”
Miami, FL
“WeCare transformed our cardiology practice’s billing. Our denial rate dropped from 22% to under 2% within 90 days, and our monthly collections increased by $48,000. Their knowledge of Florida Medicaid managed care plans is unmatched.”
Tampa, FL
“When I was handling complex surgical billing and prior authorizations, I needed a team that truly understood my specialty billing. WeCare’s ortho coding and billing team is exactly according to my expectation. They even handled our hurricane season billing extensions flawlessly last year.”
Fort Lauderdale, FL
“We are running a mental health practice in Florida, and it comes with complex billing rules that keep changing, and we were busy with patients and could not stay updated on the rules. WeCare keeps us compliant and profitable. Our A/R days decreased from 58 to 19. Now, we can finally focus on our patients.”
Frequently Asked Questions
Questions? We’ve got you covered
Yes. Don’t worry. First, we identify the reason behind denials, for example, whether it is due to a coding error or a lack of medical necessity. After that, we fix billing and coding issues and follow up with insurance companies. Not only do we help you resolve denials, but we also help your practice prevent denials in the future.
Absolutely. WeCare manages the full revenue cycle.
Yes. We assist new healthcare providers with billing setup, payer enrollments, and revenue cycle processes from the beginning.
In most cases, yes. We work with many commonly used healthcare systems and adjust our workflow according to your practice setup.
Yes. We work with all the specialties, including cardiology, oncology, podiatry, pediatrics, orthopedics, mental health, urology, and more.
Yes
No. Just visit our official website and fill out the form there. We will audit your healthcare practice and guide you on what your practice needs.
Our billing team continuously monitors payer updates biannually, coding guidelines, and healthcare industry regulations to help practices reduce billing errors and reimbursement delays.
Yes. We follow HIPAA-compliant processes and security practices to protect patient and practice data.
You Should Not Lose Revenue Due To Billing Errors
Join a Florida healthcare provider group that recovered thousands in unpaid claims and cut denial rates dramatically with our claim management services.
No setup fees. No risk. Just results.