Medical billing services at 1.5% of insurance collections
Eligibility Hub handles medical billing from eligibility to appeal: real-time 270/271 checks, insurance verification requests, Q code coverage checks, professional (837P) claims checked before they are sent, ERA posting, and denials worked to a decision with Medicare deadlines tracked. The full service costs 1.5% of insurance collections, meaning payments received from payers.
The short version
- Service fee
- 1.5% of insurance collections, meaning payments received from payers. Patient payments are not included.
- Credentialing
- Available. Delivered by our credentialing team. $99 per payer application (one provider, one payer), billed separately from the 1.5% service fee.
- Claim type
- Professional claims (837P)
- Medicare
- Eligibility checks need your Medicare EDI enrollment and HETS attestation
What we handle for medical practices
Every service shows its current availability. Nothing marked planned is sold as live.
Credential
Enroll providers with payers
Verify
Eligibility, benefits and verification requests
Authorize
Coverage checks, prior authorization, predeterminations
- Product and procedure coverage checkQ code with CPT, checked against payer product lists and your documentationLaunching after setupLaunching after setup
- Prior authorization and predeterminationsRequirements flagged and tracked; electronic 278 submission is plannedPartially availablePartially available
Bill
Scrub and submit claims
Post
ERAs and EOBs
Recover
Denials, appeals and AR follow-up
Connect
API for your own software
- APIConnect your own software, with separate test and live keysLaunching after setupLaunching after setup
Built for product-driven specialties such as wound care
The same chart data carries a skin substitute from verification to appeal.
Insurance verification request
Pre-filled from the chart with wound size, the suggested CPT family and best-fit product size, then sent to the manufacturer, distributor or biller.
Coverage check
Is the patient likely covered for this Q code with this CPT? Qualifies, needs documentation, not covered or unknown, with reasons and sources.
Claim checks
Units per square centimeter, JW or JZ modifiers where they apply, CCI and MUE edits and eligibility on the date of service, before the claim is sent.
Appeal packet
Measurements, standard-of-care history, application notes and photos from the chart, with a drafted letter for your review.
How switching works
Your current biller keeps billing during shadow mode.
Agreements
Business Associate Agreement between your practice and Vixel Agency, plus the service agreement.
Who acts: Your practice and Eligibility Hub
Days
Practice setup
You complete the setup wizard. We verify NPIs, payers and providers.
Who acts: Your practice, then Eligibility Hub
Typically 1 to 2 weeks
Shadow mode
Your current biller keeps billing. Every claim also runs through our checks on de-identified test data, and we compare results with what was actually paid or denied.
Who acts: Eligibility Hub
Typically 30 to 60 days
Enrollment
Claims and ERA enrollment move to our clearinghouse, timed with your current biller's notice period. ERAs can go to only one clearinghouse at a time.
Who acts: Eligibility Hub, with your signatures
Typically 2 to 6 weeks, payer dependent
Live service
Full service, a monthly scorecard, and open denials from the prior biller worked to decision.
Who acts: Eligibility Hub
Ongoing
Lengths are typical, not promises, and the phases are not added up into a launch date. Payers set their own timelines.
Questions
How much do your medical billing services cost?
The full service is 1.5% of insurance collections, meaning payments received from payers. Patient payments are not included. Credentialing is $99 per payer application (one provider, one payer), billed separately from the 1.5% service fee.
Do you bill Medicare?
Yes. Medicare eligibility checks need your Medicare EDI enrollment and HETS attestation, and Medicare appeal deadlines (120 days for redetermination, 180 for reconsideration, one year for reopening) are tracked.
Do you handle wound care and skin substitutes?
Yes. Insurance verification requests, Q code coverage checks, units per square centimeter on claims and evidence packets for appeals are all part of the hub.
Who signs appeals and payer forms?
Your practice's authorized person signs and files where the payer requires it. We prepare everything and track it to decision.
How long does switching take?
Agreements take days. Practice setup typically takes 1 to 2 weeks, shadow mode typically 30 to 60 days and enrollment typically 2 to 6 weeks depending on the payer. We do not add these into a promised launch date.
Review the scope before you begin
The full service is 1.5% of insurance collections, meaning payments received from payers. Patient payments are not included. See pricing or every service.
Last updated 2026-10-06