Medical Billing Services in
South Carolina
We help practices across Charleston, Columbia, Greenville, Myrtle Beach & Upstate reduce denials, stay
compliant with SC Medicaid requirements, and improve monthly collections using specialty-focused workflows.
HIPAA Compliant
SC Medicaid Expertise
98% Clean Claim Rate
Why South Carolina Providers Need
Smarter Billing Support
South Carolina has a unique payer environment compared to other southern states.
Strict Medicaid rules, varying MCO requirements, and inconsistent documentation
practices often lead to avoidable denials
High denials from Healthy Connections Medicaid (authorization-sensitive)
Everyday NCCI/bundling edits with BlueCross BlueShield of South Carolina
Eligibility discrepancies in rural vs urban counties
Modifier issues with Select Health and Molina SC
Delayed payments from certain MCOs for high-volume specialties
Frequent documentation mismatches during telehealth claims
We make the entire process simpler, faster, and error-free.
Complete Billing Support for
South Carolina Practices
Medical
Billing
Clean claims, faster reimbursements, and billing accuracy.
Medical
Coding
Accurate ICD-10, CPT, and HCPCS coding with specialty-trained coders.
Billing
Audit
Identify hidden revenue leaks instantly
A/R
Follow-Up
Aggressive follow-up on 30/60/90+ day claims to reduce aging AR.
Credentialing &
Enrollment
Fast payer enrollments, CAQH updates, and NPI support.
State Licensing
Support
Hassle-free provider licensing and renewals across multiple states.
Denial
Management
Fix root causes, recover revenue, and prevent future denials.
Billing Platforms & Clearinghouses
We Support in South Carolina
We work smoothly inside your existing EMR, PMS, or
clearinghouse, no disruption, no retraining.
Common in South Carolina
Specialties We Support Across South Carolina
Specialties We Support
Across South Carolina
Each specialty uses custom coding rules, modifiers, payer edits & billing patterns
aligned with SC requirements.
South Carolina Billing Expertise
Built Around Local Rules
South Carolina providers face a unique mix of Medicaid managed care plans, strict
documentation checks, and payer-specific coding nuances
Where most billing companies apply generic workflows, we apply state-aligned
billing intelligence tailored for SC clinics.
Experienced with Healthy Connections
Medicaid, Select Health, Molina SC, and
Absolute Total Care
Deep knowledge of BCBS South Carolina
bundling & modifier rules
Correct use of Medicaid-required prior
authorization & visit limits
Optimized billing for rural vs metro payer mix
Faster enrollment for SC Medicaid &
commercial plans
Specialty-specific coders for SC high-volume
fields
Your practice receives predictable, stable monthly revenue.
South Carolina Medicaid
Billing Requirements
SC Medicaid Standards
Many services require PA under South Carolina Medicaid.
Some specialties have strict visit count limits.
SC Medicaid filing deadline is 365 days.
Progress notes must strictly match all billed codes.
Telehealth rules define locations, providers, and modifiers.
South Carolina Medicare Rules
(Palmetto GBA MAC)
Palmetto GBA processes Medicare claims in South Carolina.
Common issues include
Incorrect use
of Modifiers
25/59
NCCI edits
blocking high-
volume claims
Insufficient
documentation
causing claim
denials
Frequency limits
on chronic/
preventive
services
We correct these before submission.
Common South Carolina
Claim Denials (With Fixes)
Denial Code
CO-197
CO-16
CO-50
CO-109
PR-1
CO-45
Issue
Missing PA
Missing info
Not medically necessary
Not covered
Deductible
Exceeds fee schedule
SC Reason
SC Medicaid & MCOs
Rural clinics see this often
Molina & Absolute Total Care sensitive
Medicaid coverage mismatch
Medicare (Palmetto GBA)
BCBS SC reimbursement limits
Fix
Attach PA + notes
Correct demographics + eligibility
Add detailed notes + appeal
Re-verify plan + diagnosis
Collect upfront
Adjust & rebill
Major South Carolina
Payees We Bill For
Payer Name
Healthy Connections Medicaid
Select Health of SC
Molina Healthcare SC
Absolute Total Care
BlueCross BlueShield SC
UnitedHealthcare SC
Aetna SC
Cigna SC
WellCare SC
Humana
Type
Medicaid
Medicaid
Medicaid
Medicaid
Commercial
Commercial
Commercial
Commercial
Medicare
Commercial
Notes
Strict PA + documentation rules
Modifier-sensitive
High denials if notes are missing
Behavioral health volume
Bundling edits common
Coding edits
Precert required
Visit limits apply
Pediatric-heavy
Aging claims require a strong follow-up
Cities We Serve
in South Carolina
Charleston
Columbia
North Charleston
Mount Pleasant
Rock Hill
Greenville
Summerville
Goose Creek
Sumter
Counties We Serve
in South Carolina
Greenville
Charleston
Richland
Horry
Lexington
Spartanburg
Buncombe
Berkeley
Anderson
Beaufort
Aiken
Dorchester
Performance Highlights
98%+ Clean
Claim Rate
30–50%
Fewer Denials
Specialty-Aligned
Coding
HIPAA-Compliant
Workflow
Real-Time Revenue
Dashboards
Our Billing Workflow
for NC Practices
01
Eligibility Verification
& Medicaid Checks
02
Coding & Charge
Entry
03
Clean Claim
Review
04
Submission to
Clearinghouse
05
A/R Follow-Up
06
Denial
Management
07
Monthly Revenue
Reports
Ready to Improve Your South
Carolina Practice Revenue?
Let our billing team optimize your claims, fix denials, and strengthen collections.
What New York Providers
Say About Us
Dr. Emily S.
Dermatology
“They understand specialty coding better than most in-house teams.”
Laura P.
Urgent Care
“We recovered thousands in lost AR. Reporting is clean, simple, and accurate.”
Dr. Michael R.
Cardiology
“Collections improved within 60 days. Their denial management is the best we’ve seen.”
Dr. Sofia M
Behavioral Health
“Behavioral health denials dropped massively. Their team knows payer rules inside out.”
Dr. Emily S.,
Dermatology
“They understand specialty-specific coding better than most in-house coders.”
Laura P.,
Urgent Care
“We recovered thousands in lost A/R within weeks. Reporting is clean and accurate.”
Dr. Michael R
Cardiology
“Collections increased in the first month. Their denial correction is faster than any team we’ve used.”
FAQs (South Carolina-Specific)
Yes, solo, group, urgent care, pediatrics, behavioral health, multi-location practices.
Yes, Healthy Connections, Select Health, Molina, Absolute Total Care & more.
Most SC clinics see a 30–50% drop in denials within 60–90 days.
Yes, including Medicaid-approved modifiers & eligible locations.
We support 10 primary specialties, including family medicine, pediatrics, urgent care, OB/GYN, etc.
Epic, eCW, Athena, Kareo/Tebra, AdvancedMD, NextGen & more.
Yes, aggressive follow-up at 30/60/90+ days.
Yes, every SC Medicaid MCO is supported.
Address
4309 Schubert, Colleyville Texas, TX 76034
Phone Number
(737) 787 2147
Business Hours
Monday – Friday: 08.00 – 17.00 Saturday: 09.00 – 12.00
