ModMed Billing Services to Cut Denials and Days in AR | Transcure
ModMed practices lose revenue when in-house billing slips, and some prefer an independent billing partner to ModMed’s RCM service. Transcure fills both gaps with AAPC-certified billers working directly inside your ModMed EMA and PM. With our ModMed EMR billing services, our certified billers and Transcure AI agents work together to:
- Recover collections from weak scrub rules, denied claims, and aging AR sitting in ModMed PM.
- Cut days in AR by working ModMed aging reports daily and appealing every denial promptly.
- Fix under-coding with certified coders reviewing every visit across dermatology, ophthalmology, orthopedics, and other specialties.
- Build custom scrub rules per payer so claims clear ModMed’s clearinghouse on the first pass.
- Handle ERA posting, ModMed Pay balances, and patient statements inside your ModMed EMA and PM.
Trusted by
500+ Physicians
Catering to
40+ Specialties
1100+ Certified
Medical Billers & Coders
End-to-End
RPA Billing Solutions
Up to 98% First Pass
Clean Claim Rate
What Is ModMed and How Does Its Billing Work?
ModMed, formerly Modernizing Medicine, is a cloud-based EHR and practice management platform built for specialty practices. EMA, the Electronic Medical Assistant, handles clinical documentation and suggests codes, while ModMed PM manages scheduling, billing, and financial reporting. ModMed serves 11 specialties, including dermatology, ophthalmology, orthopedics, ENT, gastroenterology, and urology.
ModMed PM relies on three built-in components that handle the core daily revenue cycle work:
- The clearinghouse interface inside ModMed PM supports automated claim file submission to payers and timely filing reminders.
- Custom scrub rules let you check claims against payer-specific edits before they reach the payer.
- ERA posting applies remittance advice to patient ledgers automatically, so payments reconcile without manual entry.
ModMed also offers Denial Assessment, ModMed Pay, and ModMed Scribe. In August 2026, it announced an agentic RCM AI Platform, already live in parts of ModMed RCM Services. These tools still need skilled billers to act on their output, so practices can choose ModMed RCM Services or Transcure for outsourced ModMed billing.
Is Your ModMed Billing Leaking Revenue?
Transcure pulls your last 90 days of denials, AR aging, and rejections from ModMed PM. Our free ModMed billing audit then shows exactly where collections are dropping across your practice. We review scrub rules and coding patterns to find under-coded visits and preventable claim denials.
How Transcure Helps ModMed Practices Struggling with Billing
ModMed gives specialty practices strong billing tools, but tools alone cannot fix revenue gaps. Transcure closes four common gaps with certified billers working directly inside your ModMed PM.
Custom Scrub Rules Left at Default
Many practices never customize ModMed scrub rules, so payer-specific edits slip through before submission. Transcure builds payer-specific scrub rules so claims clear the clearinghouse on the first pass.
Under-Coding Between EMA and PM
Reviewers report that ModMed under-codes visits and its billing codes often need manual editing. Our 1100+ AAPC-certified coders review every EMA encounter and fix modifiers before charges reach PM.
Denial Assessment Without Follow-Through
Denial Assessment flags claims likely to deny, but someone still has to work them. Transcure traces every denial by CARC code and files appeals inside your ModMed workflow.
ModMed Pay Balances Left Unworked
ModMed Pay offers autopay and text-to-pay, but unpaid patient balances still need follow-up calls. Transcure runs reminders, payment plans, and patient calls until balances close or reach collections.
What Is Included in Transcure's ModMed Billing Services?
Transcure handles ModMed medical billing services inside your PM, from eligibility checks to final patient balances. Our certified billers and AI agents work directly within your system across these nine areas:
How Does Transcure's ModMed Medical Billing Support Work?
Transcure puts certified billers inside your ModMed PM through five clear stages, without disrupting operations. Your practice keeps running while we log in, calibrate, and start clearing ModMed claims daily.
Step 1.
Discovery Audit
Your account manager reviews ninety days of denials, AR aging, and payer mix inside ModMed. DEXA flags every CARC and RARC pattern, so revenue leaks get mapped before claims move.
Step 2.
Secure ModMed Login and BAA Setup
Every engagement opens with a signed BAA under 45 CFR § 164.502(e) before ModMed access. Billers receive encrypted ModMed logins with role-based access you control, so PHI never leaves ModMed.
Step 3.
Custom SOP Workflow Build
Custom SOPs map to your ModMed setup, specialty, and whether you run EMA with PM. Scrub rules are rebuilt per payer, with modifier logic set for dermatology, ophthalmology, and orthopedics.
Step 4.
Claims Go Live
Your account manager hands off to production, and certified coders begin working encounters alongside CODIN. Each claim runs dual-pass scrubbing through ModMed scrub rules and Transcure's AI layer before submission.
Step 5.
Monthly Review and Rule Updates
Denial trends, days in AR, and net collections get reviewed against specialty benchmarks every month. LCD, NCD, MUE, and CCI updates flow into your ModMed scrub rules as they change.
Our Certifications
Every biller on your ModMed account holds AAPC or AHIMA credentials before touching any claim. Our operations team holds ISO and HIPAA certifications, protecting patient data inside your ModMed environment. CMS coding standards and payer submission rules stay current on every claim in ModMed PM.
Our Success in Numbers
Results vary by practice size, specialty and payer mix. Across Transcure clients, these are typical results:
Should You Use ModMed's Own RCM Service or Outsource to Transcure?
ModMed offers its own RCM service, ModMed RCM Services, which older ModMed materials call BOOST. It pairs billing specialists and certified coders with ModMed PM, and ModMed has started adding its new RCM AI Platform to the service. Here is how ModMed RCM Services and Transcure compare on the factors that move collections.
| Factor | ModMed RCM Services | Transcure |
|---|---|---|
| Team Assignment | Billing specialists and certified coders matched to your specialty, plus a client manager | Named, dedicated billers and coders per practice from day one |
| Coding Coverage | Certified medical coders included | 1100+ AAPC and AHIMA-certified coders, plus CODIN |
| Pricing | Not published on ModMed’s site; request a quote | 5% of collections, no onboarding fees, coding included |
| AI Agents | RCM AI Platform (agentic AI, human-approved) being added to the service | 7 dedicated AI agents working alongside your billers |
| Reporting Depth | Dashboards for aged A/R, net collection ratio, DSO | Monthly KPI reviews against specialty medians, no upcharge |
Which Specialties Does Transcure Support with ModMed Medical Billing?
Whether you run EMA with ModMed PM or gGastro with gPM, Transcure matches ModMed-trained billers to your specialty. Coverage spans dermatology, ophthalmology, orthopedics, and more, with payer policy depth and CMS compliance included.
Streamline Your Workflow with Transcure AI and ModMed
Transcure AI agents work alongside ModMed PM to automate billing tasks across your revenue cycle. ModMed Scribe speeds up documentation in EMA, and Transcure reviews notes before charges reach PM. ModMed’s Denial Assessment flags claims likely to be denied, and its newer RCM AI Platform adds AI agents for appeals and claim edits.
Transcure’s agents and billers work each flagged claim through to payment. This ModMed billing automation cuts manual touchpoints, speeds reimbursements, and raises first-pass clean claim rates. You get less rework and more collections, with zero disruption to your existing ModMed setup.
Why Should Practices Choose Transcure to Outsource ModMed Billing?
Practices choose Transcure because every ModMed commitment is written into operations. Six things separate Transcure from generic billing partners working inside ModMed.
A Dedicated Account Manager Per ModMed Practice
One manager handles every escalation, review, and workflow change in ModMed. You never deal with shared inboxes, ticket queues, or repeated explanations.
AAPC and AHIMA Certified Billers and Coders
Assigned billers hold AAPC or AHIMA credentials with ModMed-specific operational training. Generalist staff never touch your EMA encounters or ModMed PM claims.
Coding Included in Scope
Our scope covers CPT, ICD-10, and HCPCS coding through certified specialists. You never hire a separate coder or pay extra for coding.
HIPAA Compliance With an Executed BAA
Every engagement opens with a BAA under 45 CFR § 164.502(e). Your PHI stays inside ModMed, protected by role-based access you control.
Pay Only When Your ModMed Claims Collect
Pricing is 5% of collections, with no onboarding fees attached. Coding, AR recovery, and appeals stay included, keeping ModMed costs predictable.
Billers Trained in ModMed Specialty Workflows
Billers learn EMA templates and ModMed PM workflows for your specialty. Dermatology, ophthalmology, and orthopedic billing rules are built into every account.
Partner with the Best in Medical Billing Solutions
Practices rate Transcure highly on Google, GoodFirms, and Trustpilot. Our certified billers earn that trust by working inside ModMed PM and EMA every day.
Which EMR Platforms Does Transcure Bill Inside?
Transcure’s AAPC-certified billers work daily inside your current EHR, including ModMed, AdvancedMD, Epic, and athenahealth. Switching EMRs costs months of productivity, so we submit clean claims without changing your workflow.
What Practices Say About Our Medical Billing Services
Read how practices use our billing services to lift collections and cut denials. Their results come from certified billers working inside ModMed PM and EMA every single day.
Jackie Judd
Practice Manager
Wilson Creek Internal Medicine
As a practice manager, I was looking to streamline the medical billing process. I tried other companies, but they were all complicated and took too much of my time. Fortunately, I found Transcure. They excel in tailoring solutions to fit my requirements.
Amber Vaughan
Office Manager
Idaho Kidney & Hypertension Institute
We are a large practice with 15 providers. Transcure has been working with us for the last 5 years. This billing company has been a great asset to us. I work with Transcure and they provide everything I ask for. The team is friendly and very pleasant to work with.
Ashlee Rose
Practice Manager
Harding Memorial Healthcare
We’ve been working with Transcure for 8 years now and I just wanted to say how happy we are with their services. They always get back to us quickly and are very easy to work with. They get my bills paid in record time and help us to generate millions in revenue.
Frequently Asked Questions About ModMed Billing Services
Get answers to the most common questions practices ask about our ModMed billing services and Resolute workflow support.
Does ModMed offer its own medical billing services?
Yes, ModMed offers in-house RCM Services, also called BOOST, for practices using ModMed Practice Management. You can outsource to Transcure instead and keep billing inside your existing ModMed EMA setup.
Do I need to switch from ModMed to use Transcure?
No, our billers work daily inside your current ModMed EMA and PM, so nothing changes. Access uses encrypted logins with role-based permissions that you control, and PHI never leaves ModMed.
How much does outsourced ModMed billing cost?
ModMed does not list RCM Services pricing publicly, so practices must request a quote to compare. Transcure charges 5% of collections with no onboarding fees, and coding and appeals are included.
Can Transcure fix under-coding in ModMed EMA?
Yes, certified coders review EMA encounters and correct modifiers before charges move into ModMed PM. Documentation gaps trigger same-day provider queries, so under-coded visits get fixed before claims go out.
Is outsourcing ModMed billing to Transcure HIPAA compliant?
Yes, every engagement starts with a signed BAA under 45 CFR § 164.502(e) before any access. Role-based permissions stay fully under your control, and PHI never leaves your ModMed environment.
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