eClinicalWorks Billing Services

eClinicalWorks is the system we know best. Twenty years of medical billing and a large share of our book runs on eCW, which means we are not learning your software on your money. We log in, we work your queues, and we leave your build alone.

The charge that never became a claim

eCW will not bill an encounter until the progress note is locked. That single rule is the biggest quiet revenue leak in the product. A provider finishes a visit, gets pulled into the next one, and the note sits open. No note, no charge. No charge, no claim. Nothing in eCW escalates it — the encounter simply ages out of view while the front office assumes it went out.

We run the open-encounter and unbilled-visit reports on a fixed schedule, reconcile them against the appointment schedule for the same dates, and chase the specific providers holding the specific notes. Every visit on the schedule either becomes a claim, becomes a documented no-show, or gets explained. That reconciliation is the first thing we set up on a new eCW account, and it is usually the first money we find.

Claim statuses are a description, not a worklist

eCW tells you where a claim stands. It does not move it. Claims sit in submitted, rejected and denied states indefinitely, and a rejection at the clearinghouse never reaches the payer at all — so timely filing keeps running while the claim looks like it is in process. Practices routinely discover six-month-old rejections that were visible the whole time.

We work eCW by queue, daily. Rejections get corrected and retransmitted the same day. Clean claims go out within 24 hours of the charge. Denials are worked within 48 hours. Insurance aging is worked at 25 to 30 days, not at 90 when it is already hard. Our clean-claim rate is 98%, which is a function of scrubbing before submission rather than fixing after.

ERA auto-posting hides denials in plain sight

Auto-posting 835 files is the right setting to have on, and it creates a specific trap. A zero-pay denial posts automatically, the line closes, the balance moves, and the ledger looks tidy. The claim was never appealed. Nobody read the CARC or RARC. On a busy eCW database, a few hundred auto-posted denials a month can vanish this way and never appear on an aging report because the balance is no longer open.

We reconcile posted ERAs against remittance detail and pull every adjustment that is a denial rather than a contractual write-off. Then we categorize by reason code, work the appealable ones, and report the pattern back to you so the front-desk or coding cause gets fixed. See EOB vs ERA and denial management for how we run this.

Eligibility that actually gets checked, and read

eCW can run real-time eligibility and surface billing alerts at check-in. Two things go wrong with it. The check is skipped when the schedule is full, and the alert is dismissed by whoever is standing at the desk under pressure. The result is the same denial either way: coverage terminated, plan changed, wrong member ID, service not covered.

We verify insurance for every scheduled patient before the visit and we act on what comes back — not just record it. Verification is included at no extra charge, as is prior authorization tracking. Details on insurance verification and why authorization delays cost more than the denial itself.

Coding from your notes, in your eCW

We code from the documentation in the chart rather than from a superbill someone ticked in a hurry. That means correct E/M level against what is actually documented, correct modifiers, and medical necessity linked to the payer's coverage policy before the claim goes out. Under-coding and over-coding are both expensive; one leaves money behind and the other invites an audit.

Coding is included at no extra charge, and so are periodic coding audits. If your eCW fee schedule or item categories are mapped wrong — a common finding on inherited databases — we will show you the underpayments it is causing.

Reporting you can check us against

The failure mode of outsourced billing is losing visibility. We send a monthly Practice Performance Report at no charge: clean-claim rate, days in A/R, aging buckets, denial reasons ranked by dollars, payer mix and collections against charges. You can pull the same numbers out of eCW yourself and confirm them, which is the point. See days in A/R explained and our reporting.

We are HIPAA-compliant, we work under a signed BAA, and we access your eCW through your own credentials and your own permissions — no copies of your database, no exports we do not agree to.

Why practices on eClinicalWorks choose Synergy

You keep eClinicalWorks. You keep your logins, your templates, your schedule and your data. Nothing is migrated and nothing new is purchased — we work inside the system you already run. What changes is who works it: a 98% clean-claim rate, claims out within 24 hours, denials worked within 48 hours, insurance aging worked at 25–30 days, and free insurance verification, coding, credentialing and monthly Practice Performance Reports. Twenty years in business, a US and India team so your queues move overnight, HIPAA-compliant throughout, a 30-day free trial and a 90-day money-back guarantee. We're not your billing service — we're your Billing Department.

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