Medical specialties
Primary and family care
Surgical and procedural
Dental, DME and labs
Revenue cycle · one rate
Front end · before the visit
Patients, insight and growth
Clinical documentation
Revenue operations
Voice automation
California medical billing services · Medicare · Medi-Cal · Commercial
PhysiAssist bills California claims to the rules that decide when you get paid: Noridian Medicare, Medi-Cal, and the state claim-payment clock that tightened to 30 calendar days in 2026. Coding, claim submission, payment posting, denials and AR follow-up, with a free audit of your recent California claims.
California clocks we track on every claim
California deadlines
| Clock | Rule | What we do |
|---|---|---|
| Plan payment window | Under AB 3275, plans must pay complete claims within 30 calendar days of receipt, or notify the provider within that window if a claim is contested or denied. It applies to claims received on or after 1 January 2026. Before that, the limits were 45 business days for HMO claims and 30 business days for PPO claims. | Calendar the 30-day due date on every claim and flag late payment. |
| Interest on late HMO claims | 15 percent per year, for emergency and non-emergency claims. | Calculate interest owed and request it when the plan does not pay it. |
| Interest on late PPO claims | Non-emergency claims: 15 percent per year, up from 10 percent. Emergency claims: the greater of $15 or 15 percent per year. | Calculate interest owed and request it when the plan does not pay it. |
| Interest penalty | If interest is not paid automatically, the penalty is the greater of $15 or 10 percent of the accrued interest on PPO claims. HMO non-emergency claims rose from $10 to the same amount, and HMO emergency claims now carry it too. | Track unpaid interest as a recovery item. |
| Self-funded plans | Excluded from these state payment rules. | Sort claims by plan type before applying the clock. |
Sources: California Medical Association on AB 3275, California DMHC guidance APL 25-007, CMS Jurisdiction E. Medi-Cal filing limits differ by program and managed care plan, so we confirm each one per plan. This is billing information, not legal advice.
Payers
| Payer | What to know | What we do |
|---|---|---|
| Medicare Part B | California is in Medicare Jurisdiction E, administered by Noridian Healthcare Solutions (with Hawaii, Nevada, American Samoa, Guam and the Northern Mariana Islands). | Check claims against Noridian policies before submission; work denials and appeals through the Noridian process. |
| Medi-Cal and Medi-Cal managed care | Filing limits differ by program and plan, with good-cause exceptions. Medi-Cal managed care plans are covered by the 30-day payment rule. | Confirm the limit per program and plan, submit early, and track plan deadlines. |
| Commercial HMO and PPO plans | State-regulated plans follow the 30-day rule for claims received from 1 January 2026, with interest when they pay late. | Calendar due dates and flag late or underpaid claims. |
| Self-funded employer plans | Excluded from the state payment rules. | Confirm plan type at verification and apply the plan terms instead. |
What is included
Certified coders code each chart to the payer rules, with a 24-hour chart turnaround and 99% coding accuracy on monthly internal audits.
Clean claims out the door the day charges post, checked against Medicare, Medicaid and commercial edits.
Payments posted against contracted rates; denials worked and appealed inside the payer windows.
Aging claims worked by payer and age, with late and underpaid claims flagged against prompt-pay terms.
Pricing is 2.8% to 5% of net collections, depending on specialty mix, claim volume, payer mix and how clean your current process is. The rate covers coding, claim submission, payment posting, denials and AR follow-up. Front desk, prior authorization, the reporting dashboard, patient statements, credentialing and digital marketing are quoted separately. See pricing.
Specialties
Also see denial management, medical coding and end-to-end revenue cycle management.
For claims received on or after 1 January 2026, California plans must pay complete claims within 30 calendar days of receipt, or notify the provider within that window if the claim is contested or denied (AB 3275). The old limits were 45 business days for HMO claims and 30 business days for PPO claims. Late HMO claims carry 15 percent annual interest, and late non-emergency PPO claims now carry 15 percent as well, up from 10 percent. We calendar each claim against its due date.
Noridian Healthcare Solutions is the Medicare Administrative Contractor for Jurisdiction E, which covers California, Hawaii, Nevada, American Samoa, Guam and the Northern Mariana Islands, according to CMS. We check claims against Noridian policies before they are submitted.
No. They cover health plans and insurers, including Medi-Cal managed care plans, but not self-funded employer plans. We confirm the plan type at eligibility verification so the right clock and terms are applied.
It depends on the program and the plan. For example, Drug Medi-Cal requires claims within six months of the date of service, with good-cause exceptions, according to DHCS. Managed care plans set their own contracted deadlines, so we confirm the limit for each program and plan before a claim is held.
No. Billing runs remotely through your EHR, clearinghouse and payer portals, and the payer rules come from where your practice and patients are, not from where the billing team sits.
PhysiAssist charges 2.8% to 5% of net collections, depending on specialty mix, claim volume, payer mix and how clean your current process is. The rate covers coding, claim submission, payment posting, denials and AR follow-up. Front desk, prior authorization, the reporting dashboard, patient statements, credentialing and digital marketing are quoted separately.
A certified coder reviews a sample of your recent California claims for coding, timely-filing risk, denials and underpayments, and sends a written report you keep.
A free California billing audit by a certified coder, with a written report you keep.