AI Medical Billing Company for Independent Practices
Turn denied claims into recovered revenue.
Sterling's AI claim engine scrubs, predicts and auto-corrects every claim in real time, then an AAPC-certified coding specialist reviews it before it's submitted.
*Published third-party benchmarks (HFMA MAP Keys, MGMA, Kodiak Solutions), the standard we build around.
Aetna · coverage active0.2s
ICD-10 · CPT · modifiers1.1s
auto-corrected 2 issues0.6s
claim #48213 · paid0.3s
- HIPAA Compliance Certified
- BAA signed with every client
- U.S. Wyoming LLC
- No setup fee
- No long-term contract
- Works inside your EHR
Coding rules, by specialty.
Each specialty carries its own payer rules, bundling edits and modifier traps. These are the ones we bill every day.
Cardiology billing
TC/26 split billing, cath lab and EP claim scrubbing, plus a full CPT code library covering echo, PCI, ECG and remote monitoring.
OB-GYN billing
Global maternity packages, antepartum and postpartum splits, ultrasound bundling and the modifier rules payers argue about.
Orthopedic billing
RT/LT/50 laterality, global-period modifiers 24/58/78/79, NCCI arthroscopy bundling, DME and RTM claims.
Behavioral health billing
CoCM codes G0568 to G0570, prior authorization tracking and telehealth-compliant claim rules.
Fertility and IVF billing
ART cycle codes, embryology lab billing, Progyny and Maven benefit-manager rules and state mandate compliance.
Every specialty we bill
Not sure we cover yours? See the full list of specialties and the coding rules behind each one.
We work inside your systems
Our team logs into the software you already use, so there's nothing new for your staff to learn. 20+ EHR, EMR and PMS platforms, plus every major clearinghouse.
Don't see yours?
Every denied claim is revenue you already earned.
Sterling fixes it before submission.
Our AI reviews every claim against payer rules the moment it's created, then our billing team handles the rest, end to end.
Four stages. One clean claim.
Every claim runs the same AI-assisted path, with each claim reviewed by an AAPC-certified coding specialist before it goes out.
Verify
Real-time eligibility & benefits checks stop front-end rejections before the visit.
Scrub
AI validates ICD-10 and CPT codes, modifiers and payer rules on every claim.
Predict
Machine learning flags high-risk claims and auto-corrects them before submission.
Collect
Clean claims submit same-day; AI chases AR by recovery probability first.
Every step of your revenue cycle, covered.
Ten integrated services working together to stop revenue leaking out of your practice.
Eligibility Verification
Real-time coverage checks before every visit stop front-end rejections at the source.
Front EndBenefits Verification
Deductibles, co-pays and plan limits confirmed so patients know their responsibility upfront.
Front EndPrior Authorization
Submission, medical-necessity documentation and payer follow-up for faster approvals.
Front EndMedical Coding
Accurate ICD-10, CPT and HCPCS coding with AI validation on every claim.
Mid CycleCharge Entry & Billing
End-to-end billing from charge capture through claim creation and submission.
Mid CycleClaims Submission
AI-scrubbed clean claims submitted same-day, built to the HFMA MAP Keys 95%+ clean claim rate standard.
Mid CycleAR Follow-Up
30/60/90+ aging worked by AI recovery-probability score, so the biggest dollars get chased first.
Back EndDenial Management
Root-cause analysis, corrections and aggressive appeals that turn denials into payments.
Back EndPayment Posting
Automated ERA/EOB posting, adjustments and patient payment reconciliation.
Back EndReporting & Analytics
Weekly revenue reports, clean-claim rates, denial trends and real-time KPI dashboards.
InsightStraight answers before you choose a biller.
The questions owners and office managers ask us most, answered with official sources and no sales fluff.
Private practice billing
What full-service billing should include for a practice with one to a handful of providers, and how to keep control.
What medical billing costs
The four pricing models, what should be included, the fees to ask about, and what an in-house biller really costs.
Choosing a billing company
A checklist for comparing billing companies, the HIPAA agreement you need, and how to switch without losing cash.
Why claims get denied
What each common denial reason means, whose mistake it was, and what to do with a denied claim this week.
Prior authorization denied
Resubmission, peer-to-peer review and the appeal deadlines that apply by plan type.
Getting credentialed
Tax ID, NPIs, CAQH, Medicare, Medicaid and commercial contracts, in the order that keeps providers billing.
Claims not getting paid
How long payers have to pay a clean claim under Medicare and state law, and how to escalate when they do not.
How long credentialing takes
The Medicare processing standards CMS publishes, what slows other payers, and how to plan a start date.
Billing by state: New Jersey · New York · Texas · Florida · California
Credentialing guides: All credentialing · Checklist · CAQH · Medicare for therapists · Blue Cross Blue Shield · Nurse practitioners · Aetna · Cigna · Optum
Behavioral health billing by state (all states): New York · New Jersey · Illinois · North Carolina · Ohio · Texas · Florida
Free tools: Revenue leak calculator · Credentialing checklist (PDF) · Timely filing limits
What the numbers mean for your practice.
Every figure below is published third-party data: HFMA, MGMA, Kodiak Solutions and the AMA. This is the environment your claims are competing in right now.
Denials are getting worse, not better
The average initial denial rate climbed to 11.6% in 2025, up from 11.4% in 2024. Provider organizations lost more than $48 billion to final denials and bad debt last year, a 25% jump. Clinical denials, mostly prior-auth and medical necessity, drove almost all of it.
- ✓ 11.6% average initial denial rate (Kodiak Solutions, 2025)
- ✓ $48B+ net revenue lost to denials & bad debt in 2025, +25% YoY
- ✓ Prior-auth & medical-necessity denials = nearly all of the rise
Why it matters to you: every point of denial rate on your charges is cash tied up in rework, and rework more than half of practices never finish.
Prior authorization is a tax on your front office
In the AMA's 2025 survey of 1,000 physicians, 95% said prior authorization delays necessary care and 79% said it pushes patients to abandon treatment. Every one of those touches is staff time spent before a claim can even go out.
- ✓ 95% of physicians say prior auth delays necessary care (AMA, 2025)
- ✓ 79% report patients abandoning treatment over auth hurdles
- ✓ 26% report a prior-auth delay that led to a serious adverse event
Why it matters to you: Sterling runs authorization tracking and submission, so your front desk isn't the bottleneck between the visit and the payment.
The clean-claim bar that actually pays off
HFMA's MAP Keys, the industry-standard revenue-cycle KPIs, put the high-performer clean claim rate at 95% or better. The distance between a typical ~80% and a 95%+ rate is rework, delayed cash, and claims that quietly age past the appeal window.
- ✓ 95%+ clean claim rate = HFMA MAP Keys high-performer standard
- ✓ Every rejected claim adds days to your cash cycle
- ✓ Sterling scrubs every claim against payer rules before it's sent
Why it matters to you: this is the number we build every workflow around.
How long your money sits with the payer
MGMA's 2024 data puts better-performing practices at about 36 days in A/R against a 47-day median. HFMA calls 30-40 days healthy. Every day above that is your revenue working for the insurer instead of for you.
- ✓ ~36 days in A/R = MGMA 2024 better-performer benchmark
- ✓ 47 days = MGMA 2024 median practice
- ✓ Sterling works A/R by recovery probability, not just by date
Why it matters to you: shaving 10 days off A/R is cash flow you can actually plan a hire or an equipment purchase around.
You see the numbers, every week.
Most billing companies send a monthly PDF that tells you nothing. Here's what we report instead, and what we're accountable for.
Clean Claim Rate
What % of your claims are accepted on first submission. If it isn't climbing, we explain why.
Denial Rate + Root Cause
Not just how many were denied: which category, which payer, and what we changed to stop it.
Days in AR
How long your money sits unpaid, broken down by aging bucket.
Collections vs. Charges
What you billed versus what actually arrived, and where the gap is.
Appeals Won
How many denials we overturned, and how much that recovered.
Trend, Not Snapshot
Every metric tracked over time, so you can see whether things are actually improving.
See what this looks like for your practice with the 30-Day Free Trial. 30-Day Free Trial
How much are you leaving behind?
Move the sliders. See what Sterling could recover for your practice.
This is an illustrative estimate, not a guarantee. It models your numbers moving toward published industry benchmarks: denial rate toward the MGMA/Kodiak best-in-class threshold of under 5%, and days in AR toward the HFMA benchmark of 30-40 days.
Sterling vs. traditional billing.
Most billing companies fix errors after denials arrive. We prevent them before the claim leaves.
| Capability | Sterling AI | Traditional biller | In-house staff |
|---|---|---|---|
| Error detection | ✓ Pre-submission AI scrub | ✕ After denial | ✕ Manual, inconsistent |
| Denial handling | ✓ Predicted & prevented | ✕ Reactive appeals | ✕ Often written off |
| Clean claim rate | ✓ Built to HFMA MAP Keys 95%+* | Often well below | Inconsistent |
| Submission speed | ✓ Same day | 2-5 day batching | Varies with staffing |
| AR prioritization | ✓ ML recovery-scored | ✕ Oldest-first | ✕ Whoever has time |
| Reporting | ✓ Real-time dashboards | Monthly static PDF | ✕ Rarely produced |
| Cost model | ✓ % of collections | Flat fee + contract | Salaries + turnover |
| Coverage | ✓ No PTO gaps, no turnover | Business hours | ✕ PTO gaps |
*HFMA's MAP Keys put the high-performer clean claim rate at 95%+. That is the standard Sterling builds every workflow around.
Industry benchmarks, not guesswork.
Here's what we build toward, published third-party benchmarks for high-performing billing operations.
Mukesh Makwana
Founder & CEO, Sterling Global Solution LLC
- AAPC-Approved CEU certificates: 2026 CPT Update, 2026 ICD-10-CM Update
- CCO Academy Certified
- HIPAA Compliance Certified
- M.S. Microbiology
Everything practices ask us first.
Will this work with our existing EHR?
How does the AI actually reduce denials?
What does it cost?
Is Sterling HIPAA compliant?
What happens during the 30-Day Free Trial?
How long until we see results?
Do we have to fire our current biller?
Start your 30-Day Free Trial.
Eligibility verification (EV), benefits verification (BV), prior authorizations, and denial management at no cost for your first 30 days.
- ✓ Eligibility and benefits verification
- ✓ Prior authorizations and denial management
- ✓ No setup fee. No long-term contract.
- ✓ Free credentialing for 3 insurance payers for new billing clients
- ✓ Works inside your existing EHR
🔒 HIPAA compliant · Takes 2 minutes · A real person replies within 24 hours
Denial rate, AR aging, top denial reasons.
Exactly where revenue is being lost, and why.
What it's worth to fix, in dollars, not promises.
No pressure. No contract. Walk away if it's not for you.
See what you're leaving on the table.
Eligibility verification (EV), benefits verification (BV), prior authorizations, and denial management at no cost for your first 30 days.
No setup fee. No long-term contract.