Transparent Pricing. No Setup Fees. No Hidden Charges.
California practices need more than claim submission. They need a billing team that knows how to find the reason a claim stopped moving.
Dastify Solutions provides full-service medical billing services in California. We support solo physicians, specialty clinics, group practices and larger provider organizations.
Our team works inside your approved billing environment. You keep your EHR and clinical workflow. We manage the revenue-cycle work defined in your service scope.
Medi-Cal Billing Support
Medi-Cal is not one uniform billing workflow. California uses fee-for-service and managed-care delivery systems. Plan availability and operating requirements can vary by county.
Our implementation begins with a payer matrix for your practice. We document the plans you bill. We also document the portals, electronic payer IDs, authorization steps and escalation routes used by your team.
—Experience
Many denials begin before claim submission
A denial may appear to be a coding problem. The real cause can be inactive coverage, an authorization mismatch or an enrollment error. We trace it to the first failed step and address the workflow.
Clearinghouse acceptance does not mean the payer approved the claim
A claim can pass the clearinghouse and still fail during payer adjudication. A rejection may need a data correction. A denial may require records, a corrected claim or an appeal.
A clean-claim rate cannot explain the whole revenue cycle
A clean-claim rate does not show whether the payer used the correct contracted rate. It also misses pending claims. We review payments, adjustments, denials and open A/R together.
Denial management must change the next claim
Appeals can recover revenue but cannot prevent the next error. We group denials by payer, provider, location, code and cause. The findings improve upstream workflows.
Transparency in process matters. Here’s exactly how a claim moves from capture to cash.
Goal
Our goal is to help California providers reduce avoidable claim errors, improve billing workflow visibility and spend less time chasing payer follow-up manually.
| Control point | What our team checks | Why it matters |
|---|---|---|
| Coverage and plan | Eligibility date, product type, member data and payer route | Prevents billing the wrong plan or inactive coverage |
| Authorization | Approval number, service dates, units, rendering provider and location | Reduces authorization-related denials |
| Provider identity | Billing NPI, rendering NPI, taxonomy, TIN, group assignment and service facility | Prevents enrollment and provider-mismatch errors |
| Coding | ICD-10-CM linkage, CPT or HCPCS code, modifier, units, place of service and NCCI edits | Supports accurate, defensible claim submission |
| Claim response | Clearinghouse status, payer acknowledgment and adjudication result | Separates rejections, pending claims and denials |
| Remittance | ERA or EOB payment, adjustment, patient responsibility and denial reason | Identifies underpayments and unresolved balances |
| Follow-up | Claim status, timely-filing risk, appeal route and next action | Keeps collectable claims from aging without ownership |
For electronic professional claims, the 837P carries the claim data to the payer. The ERA or standard remittance returns adjudication and payment information. Claim Adjustment Reason Codes and Remark Codes help explain why payment changed or failed.
The response determines the next action. That may be a correction, documentation submission, payer call, reconsideration or appeal.
Eligibility and Benefits Verification
We verify coverage, plan status and payer routing before billing. For Medi-Cal managed care, we also confirm the plan and effective date. Eligibility does not replace authorization or enrollment checks.
Medical Billing and Coding Support
We review diagnosis and procedure coding against the available documentation. We check modifiers, units, place of service and claim-specific requirements. The treating provider remains responsible for the clinical record.
Claim Scrubbing and Submission
We check for missing data, conflicting fields and payer-format issues before submission. If the clearinghouse rejects a claim, we identify the failed edit. We correct and resubmit when the required information is available.
Payment Posting and Underpayment Review
We post and reconcile payments, adjustments, denials and patient responsibility. We flag possible underpayments against available contract information. Final payment obligations depend on the provider’s payer contract.
Denial Management and Appeals
We use the payer response and claim history to categorize denials. The next action may be a correction, record submission, reconsideration or appeal. Recurring patterns are reported to the practice.
A/R Follow-Up and Recovery
We segment open balances by payer, age, value and status. Claims near a deadline receive priority. Each account has a documented status, payer response and next action.
Credentialing and Enrollment Support
When contracted, Dastify supports CAQH maintenance, applications, revalidations and enrollment tracking. We check NPI, taxonomy, location and group assignment. The payer controls approval and effective dates.
Revenue-Cycle Reporting
Reports show claims, payments, denials, A/R aging and follow-up status. They can be segmented by payer, provider, location or denial category.
Dastify introduced eligibility checks and claim validation. We also added status monitoring, ERA reconciliation and structured payer follow-up. Within 60 days, the denial rate moved from 16% to 10%. The clean-claim rate moved from 88% to 98%. Monthly revenue moved from $400,000 to $550,000.
Automation supports rules-based work such as eligibility checks, claim validation and ERA posting. Billing professionals manage the exceptions, denials and payer responses that require judgment.
Dastify has served more than 100 U.S. providers across 42 states. Our case studies publish the client type, baseline, measurement period and outcome. Your audit creates a practice-specific baseline.
We work inside your approved system when compatibility and access allow. Your clinical team can keep its workflow.
The scope defines who owns each task. Reports show what was submitted, paid, denied, corrected, appealed or left in A/R.
Dastify uses HIPAA-compliant workflows for protected health information. Onboarding addresses role-based access and secure transfer. Patient records should never be submitted through a public form.
Support
Dastify supports more than 50 specialties, including cardiology, orthopedics, neurosurgery, behavioral health, podiatry and physical therapy.
We also work with more than 50 EHR, EMR and practice-management systems. Compatibility and access requirements are confirmed before onboarding.
Process
Transparency in process matters. Here’s exactly how a claim moves from capture to cash.
Audit the baseline
We review 90 days of claims, denials and A/R aging.
Map the workflow
We define ownership across eligibility, coding, submission, posting, denials and follow-up.
Build the payer matrix
We document payer IDs, portals, authorization steps and escalation routes.
Configure secure access
We confirm system permissions, data transfer and reporting requirements.
Manage claims and responses
We submit claims, resolve rejections, post payments and work denials.
We show recurring problems and recommend workflow changes.
Transparency in process matters. Here’s exactly how a claim moves from capture to cash.
— Get The Answers You Need
Workflow changes can begin after implementation. Financial results depend on payer timing, documentation, authorization, old A/R and appeal deadlines. The audit sets the baseline.
Get Started
Dastify Solutions will review 90 days of billing performance. You will receive a written breakdown of the issues affecting your revenue cycle.
Book your free 45-minute billing audit. There is no forced EHR switch and no long-term commitment.
