Performance-Based 5% Fee
No setup fees, no per-claim charges, no long-term contracts. You only pay a percentage of what we actually collect — our incentives stay locked to your revenue.
Medical Billing Company Serving Virginia
Medical Billing Services in Virginia
Looking for a trusted medical billing company in Virginia? Nexus Claim Solutions RCM helps physicians, clinics and healthcare practices across the Commonwealth get paid faster — with HIPAA-compliant billing, certified coding and full revenue cycle management at just 5% of collections. From Richmond to Virginia Beach to Northern Virginia, we're the billing partner your practice can rely on.
Serving all of Virginia
HIPAA Compliant
AAPC-Certified Coders
No long-term contracts
HIPAA Compliant SOC 2 Certified AAPC-Certified Coders MGMA Member Legally Registered U.S. Company
Why Virginia Practices Choose Nexus Claim Solutions
The Medical Billing Partner Virginia Providers Trust
Virginia healthcare practices lose thousands every month to denied claims, slow reimbursements and underbilling. We plug those leaks — so you can focus on patients, not paperwork.
Virginia-Specific Expertise
From Virginia Medicaid (DMAS) and Cardinal Care to regional payers like Anthem and Sentara, our team knows the rules, timelines and quirks of billing in the Commonwealth.
98% Net Collection Rate
Our certified billers and coders consistently recover 98% of collectible revenue, keeping denials under 2% and days in A/R below 30 for the practices we serve.
HIPAA-Compliant & Secure
Every Virginia practice is protected by a signed BAA and our SOC 2-audited, HIPAA-compliant systems. Patient data is encrypted and access-controlled at every step.
Go Live in 2 Weeks
Fast, low-disruption onboarding. We handle credentialing review, EHR access and workflow setup so your front desk never skips a beat during the transition.
Full Transparency
Real-time dashboards and clear monthly reports show every claim, payment and denial. You always know exactly where your Virginia practice's money is.
Our Virginia Services
Complete Medical Billing & RCM Services in Virginia
One partner for the entire revenue cycle — every service your Virginia practice needs to capture more revenue and spend less time chasing payers.
Medical Billing
End-to-end claim submission, payment posting and A/R follow-up with a 99.5% clean-claim rate for Virginia providers.
- Charge entry & claim scrubbing
- Payment posting & reconciliation
- Aggressive A/R follow-up
Revenue Cycle Management
Full ownership of all nine RCM stages — from eligibility to final payment — so nothing slips through the cracks.
- All 9 RCM stages covered
- Real-time performance reporting
- Revenue leak analysis
Medical Coding
Accurate ICD-10, CPT and HCPCS coding by AAPC-certified specialists — fewer denials, cleaner claims, full audit defensibility.
- ICD-10, CPT & HCPCS
- Specialty-specific accuracy
- Audit & HCC support
Denial Management
Proactive prevention plus aggressive appeals turn denied claims back into paid revenue — denial rates kept under 2%.
- Root-cause analysis
- Appeal writing & tracking
- Recurring-denial prevention
Credentialing & Enrollment
Get enrolled with Virginia payer networks quickly and stay compliant — we manage CAQH and the paperwork so you can bill sooner.
- Initial & re-credentialing
- CAQH management
- Virginia payer enrollment
Front Desk & Patient Support
Trained staff handle registration, scheduling, eligibility checks and patient calls — a seamless extension of your Virginia practice.
- Eligibility & benefits verification
- Patient scheduling & reminders
- Professional call handling
Built for the Commonwealth
Billing Expertise Tailored to Virginia
Billing in Virginia isn't the same as billing anywhere else. Our team stays current on the Commonwealth's payer landscape, Medicaid program and filing rules so your claims are paid right the first time.
Virginia Medicaid & Cardinal Care
Deep experience billing through the Department of Medical Assistance Services (DMAS) and the Cardinal Care managed-care program, including its MCOs and prior-authorization workflows.
Regional & Commercial Payers
We bill Anthem Blue Cross Blue Shield of Virginia, Sentara Health Plans (Optima), Aetna, UnitedHealthcare, Cigna and more — with payer-specific edits that cut rejections.
Compliance & Timely Filing
We track each payer's timely-filing limits and Virginia documentation requirements so you never lose revenue to a missed deadline or avoidable technical denial.
Virginia Payers We Work With
Anthem BCBS of VirginiaSentara Health PlansOptima HealthVirginia Medicaid (DMAS)Cardinal CareAetnaUnitedHealthcareCignaHumanaMedicareTRICAREWorkers' Comp
Don't see your payer? We bill virtually every commercial, government and managed-care plan operating in Virginia. Ask us during your free assessment.
Statewide Coverage
Medical Billing Services Across Virginia
Wherever your practice is in the Commonwealth, we're your remote billing department. We proudly serve providers in these Virginia cities and regions:
Richmond Capital Region
Virginia Beach Hampton Roads
Norfolk Hampton Roads
Chesapeake Hampton Roads
Arlington Northern Virginia
Alexandria Northern Virginia
Fairfax Northern Virginia
Newport News Hampton Roads
Roanoke Southwest VA
Charlottesville Central VA
Lynchburg Central VA
Harrisonburg Shenandoah Valley
Hampton Hampton Roads
Suffolk Hampton Roads
Leesburg Loudoun County
Blacksburg New River Valley
…and every community in between. Tell us where you practice ›
How It Works
From Encounter to Payment in 4 Steps
A proven, transparent workflow that keeps your Virginia practice's cash flow predictable.
1
Eligibility & Intake
We verify patient benefits and coverage before the visit to prevent front-end denials.
2
Claim Scrubbing
Each claim is scrubbed against payer-specific edits and submitted clean the first time.
3
Payment Posting
Payments are posted and reconciled daily, with underpayments flagged instantly.
4
A/R & Appeals
We chase every unpaid claim and appeal denials until your revenue is fully recovered.
Ready to streamline billing for your Virginia practice?
Get Your Free Assessment
Results That Matter
The Numbers Virginia Practices Care About
Outcomes we consistently deliver for the providers we partner with across the Commonwealth.
98%Net Collection Rate
99.5%Clean-Claim Rate
<2%Denial Rate
<30Days in A/R
Specialties We Serve
Billing for Every Virginia Specialty
From solo practitioners to multi-provider groups, we tailor billing to the rules of your specialty.
Family Medicine
Internal Medicine
Cardiology
Orthopedics
Pediatrics
Behavioral Health
Mental Health & Therapy
OB/GYN
Dermatology
Gastroenterology
Urgent Care
Physical Therapy
Chiropractic
Podiatry
Pain Management
Why Outsource
In-House Billing vs. Nexus Claim Solutions RCM
See how a dedicated Virginia billing partner stacks up against running billing in-house.
What You Get
In-House Staff
Nexus Claim Solutions RCM
Net collection rate
75–85%
98%
AAPC-certified coders
Varies
Included
Coverage during PTO / turnover
At risk
Always covered
Salaries, benefits & software
You pay all
Included in 5%
Denial management & appeals
Limited
Full service
Transparent monthly reporting
Rarely
Every month
Client Testimonials
Virginia Providers Who Chose Nexus Claim Solutions RCM
Real results from healthcare practices across the Commonwealth.
★★★★★
"Our collections jumped almost 20% in the first quarter after switching to Nexus Claim Solutions. They understand Virginia Medicaid better than anyone we'd worked with before."
SR
Dr. Sarah ReynoldsFamily Medicine • Richmond, VA
★★★★★
"Denials used to bury our front desk. Now they're under 2% and someone actually appeals the ones that slip through. Days in A/R dropped from 52 to 26."
JM
James Morton, Practice Mgr.Orthopedics • Virginia Beach, VA
★★★★★
"As a solo behavioral health provider, the 5% model and the monthly reporting gave me back my evenings. Onboarding took less than two weeks."
AP
Dr. Aisha PatelBehavioral Health • Arlington, VA
Virginia Billing FAQ
Medical Billing in Virginia, Answered
The questions Virginia practices ask us most before getting started.
Do you provide medical billing services across all of Virginia? +
Yes. We serve healthcare practices statewide — from Richmond, Virginia Beach, Norfolk and Chesapeake in the east to Arlington, Alexandria and Fairfax in Northern Virginia, plus Roanoke, Lynchburg, Charlottesville and rural communities. Because we work as your remote billing department, location is never a barrier to faster, cleaner reimbursements.
Do you handle Virginia Medicaid (DMAS) and Cardinal Care billing? +
Yes. Our billers are experienced with Virginia Medicaid through the Department of Medical Assistance Services (DMAS) and the Cardinal Care managed care program, including the major MCOs. We stay current on Virginia-specific eligibility, prior-authorization and timely-filing rules so your Medicaid claims are paid the first time.
How much does medical billing cost in Virginia? +
Our core medical billing service is performance-based at 5% of collections — there are no setup fees, no per-claim charges and no long-term contracts. You only pay when we get you paid, which keeps our incentives perfectly aligned with your practice's revenue.
Which insurance payers do you work with in Virginia? +
We bill all major Virginia payers including Anthem Blue Cross Blue Shield of Virginia, Sentara Health Plans (Optima), Aetna, UnitedHealthcare, Cigna, Humana, Medicare, TRICARE and Virginia Medicaid / Cardinal Care MCOs, along with commercial and workers' compensation plans.
How quickly can a Virginia practice get started? +
Most Virginia practices go live within two weeks. Onboarding includes a practice assessment, credentialing review, EHR/PM access setup and a workflow walkthrough with your dedicated account manager — with no disruption to your front-desk staff.
Do you work with my EHR / practice management system? +
Almost certainly. We work with all major EHR and PM systems including Epic, Athenahealth, Kareo, AdvancedMD, eClinicalWorks, Practice Fusion, NextGen and many more. If you use a specialized system, we'll confirm compatibility during your free assessment.
Are you HIPAA compliant? +
Yes. We are a legally registered U.S. company operating on secure, audited, HIPAA-compliant systems with SOC 2 controls and AAPC-certified coders. Every Virginia practice we serve is covered by a signed Business Associate Agreement (BAA).
Free Virginia Practice Assessment
Ready to Get Paid Faster in Virginia?
Get a free, no-obligation assessment from a billing specialist. We'll review your current setup, pinpoint where revenue is leaking, and show you exactly how much more your Virginia practice could be collecting.
No long-term contracts • Setup in 2 weeks • Serving practices across Virginia