Frequently Asked Questions

Penta Solutions LLC is a U.S.-based medical billing and revenue cycle management (RCM) company. We manage the full financial workflow for healthcare providers — from eligibility and coding through claim submission, denial management, and collections — so your team can focus on patient care.

We support solo practitioners, group practices, multi-specialty clinics, ambulatory surgery centers, and hospital-affiliated groups. Our workflows scale from a single provider to large multi-location organizations across more than 25 specialties.

We serve providers nationwide across all 50 states. Our teams stay current with state-specific payer rules and Medicaid requirements so your claims are compliant wherever you practice.

No. We integrate with your existing EHR/PM platform — there are no forced migrations. If you are between systems, we can advise on options, but keeping your current setup is completely fine.

Most practices are fully onboarded within 2–4 weeks, depending on payer access and data handoff. Simpler setups can go live faster; we will give you a realistic timeline during your free audit.

End-to-end billing: charge entry, claim scrubbing, electronic submission, payment posting, patient statements, and follow-up on unpaid or underpaid claims — with transparent reporting at every step.

Yes. Our coding team holds AAPC/AHIMA certifications and codes to the latest CPT, ICD-10-CM, and HCPCS standards, with specialty-specific expertise and ongoing compliance training.

We consistently maintain a clean-claim rate above 98%, meaning the vast majority of claims are accepted on first submission — which means faster payments and fewer rejections.

Rejections are worked same-day where possible. Denials are triaged by root cause, appealed with supporting documentation, and tracked to resolution — while we fix upstream issues to prevent repeats.

Claims are submitted daily. Rapid, consistent submission shortens your reimbursement cycle and keeps cash flow predictable.

More than 25, including cardiology, orthopedics, behavioral health, OB/GYN, pediatrics, dermatology, gastroenterology, nephrology, urgent care, physical and occupational therapy, and many more. Visit our Specialties page for the full list.

RCM is the complete financial process of a patient encounter — from insurance verification and prior authorization through coding, billing, payment posting, denial management, and analytics. We manage every stage as one connected engine.

Through daily submissions, aggressive follow-up on aging accounts, proactive denial prevention, and clear escalation workflows. Most partners see a meaningful drop in average A/R days within the first quarter.

Yes. We manage patient statements, balance reminders, and respectful, compliant collections — along with clear support for patient billing questions.

You get transparent dashboards and scheduled reports covering collections, clean-claim rate, denial trends, A/R aging, and payer performance — so you always understand your practice’s financial health.

Credentialing verifies a provider’s qualifications and enrolls them with payers so they can bill and be reimbursed. It involves application submission, primary source verification, and payer approval.

Payer credentialing typically takes 60–120 days depending on the payer and provider history. We manage the entire process and keep you updated at each milestone to avoid delays.

Yes. We track re-credentialing deadlines, maintain and attest your CAQH profile, and keep payer records current so your enrollments never lapse.

Absolutely. We handle new provider enrollment, group linkage, EDI/ERA setup, and revalidation for Medicare, Medicaid, and commercial payers.

Most services are a transparent percentage of collections, so our incentives are aligned with yours — we succeed when you get paid. Project-based and flat-fee options are available for specific services like credentialing.

We keep terms flexible and straightforward. We will walk you through the agreement during onboarding — no hidden fees, and clear notice terms.

A dedicated onboarding lead handles kickoff, payer access, system integration, and workflow setup. We validate a test batch before going fully live to ensure a smooth transition.

Basic practice and provider information, payer details, access to your EHR/PM system, and a point of contact. We provide a simple checklist so nothing is missed.

Yes. We operate as a HIPAA Business Associate and sign a Business Associate Agreement (BAA) with every client. Compliance is built into our people, processes, and technology.

We use encryption in transit and at rest, role-based access controls, audit logging, secure facilities, and continuous staff training. Access to PHI is strictly limited to authorized personnel for billing purposes.

You do. Your practice retains full ownership of all clinical and financial data. We process it solely to deliver your services and return or dispose of it appropriately on request.

We maintain an incident-response plan with prompt investigation, containment, and notification in accordance with HIPAA Breach Notification requirements.

We work with all major EHR and practice-management platforms. We adapt to your environment rather than forcing a migration — see our Technology page for details.

Yes. You get real-time visibility into collections, denials, A/R, and payer performance through clear dashboards and scheduled reporting.

Integration with your existing systems is part of standard onboarding. If a specialized data migration is required, we will scope and quote it transparently up front.