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Verified Partner FALL 2026 award Verified Partner · Fall 2026Business registration plus insurance or HIPAA documents checked by our team.

Quelin Healthcare Solutions

Verified BusinessBusiness registration checked by our team HIPAA CompliantHIPAA compliance documents checked by our team Certified TeamProfessional certification checked by our team
No reviews yet 5.0 on Google (8) Houston, Texas
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Certifications
  • CRC, Certified Risk Adjustment Coder
  • CCS, Certified Coding Specialist

About Quelin Healthcare Solutions

Quelin Healthcare Solutions is a medical billing, coding, and practice operations company based in Texas. Founded in 2011 by Amber Newman, the organization serves healthcare practices in Texas and across the United States. Amber Newman established the company after spending more than a decade working inside the healthcare revenue cycle. Her background includes reviewing and adjudicating claims on the payer side, conducting inpatient and outpatient coding audits across hospital and physician settings, and collaborating directly with practice administrators. She holds a Certified Coding Specialist credential from AHIMA as well as a Certified Revenue Cycle Manager credential. To date, Quelin Healthcare Solutions has processed over one billion dollars in claims across more than 50 medical specialties.

The company was built to address a clear gap in the market for accurate, accountable, and practical administrative support. Instead of focusing solely on software mechanics, the team brings a practical understanding of how medical practices and payer systems function in the real world. Whether working with solo practitioners or multi-specialty medical groups, Quelin Healthcare Solutions provides documented workflows, transparent reporting, and HIPAA-compliant operations.

Revenue Cycle and Medical Billing Services

Quelin Healthcare Solutions provides end-to-end revenue cycle management to help practices organize administrative demands and maintain clean claims. Their core billing services include charge entry, claim submission, payment posting, denial management, and accounts receivable follow-up. The team manages claims for commercial insurers as well as government programs, including Medicare billing and Medicaid billing. Every charge is reviewed for proper CPT, ICD-10, and HCPCS coding, along with correct modifiers and place-of-service details prior to submission.

When claim denials happen, the team investigates the underlying cause rather than simply resubmitting the claim. They identify recurring patterns and recommend practical workflow adjustments to stop future rejections. In addition, Quelin Healthcare Solutions performs inpatient and outpatient billing audits, documentation reviews, and detailed financial reporting. These assessments give practice leaders objective visibility into coding compliance, billing accuracy, and aging accounts receivable.

Credentialing and Virtual Administrative Support

In addition to revenue cycle management, Quelin Healthcare Solutions provides payer and license credentialing services. Their team coordinates initial provider and group enrollment, manages CAQH profiles, and handles ongoing revalidations for Medicare, Medicaid, and commercial networks. By maintaining structured documentation and following up regularly with payers, they help practices onboard new clinicians without unnecessary delays.

The organization also offers virtual administrative support to assist busy healthcare facilities. Virtual assistants manage patient scheduling, handle clinic inboxes, coordinate patient intake, and send appointment reminders. To stop billing issues before they start, the team conducts eligibility verification, checks patient referrals, and obtains prior authorizations before treatment takes place. Confirming active benefits and required approvals ahead of time removes one of the most common causes of delayed or unpaid medical claims.

Specialties Served

Quelin Healthcare Solutions works with medical providers across more than 50 specialties and diverse practice environments. The company supports cardiology, orthopedic surgery, oncology, gastroenterology, radiology, pediatrics, urgent care, and mental health or behavioral health clinics. Their experience also extends to primary care practices, home health agencies, and durable medical equipment suppliers.

Because payer guidelines, clinical documentation rules, and coding modifiers differ across specialties, Quelin Healthcare Solutions adapts its processes to the unique requirements of each clinical area. Their extensive background across both hospital and physician environments helps ensure accurate code selection and timely reimbursements across diverse medical disciplines.

Practice Workflow Optimization and Staff Training

Quelin Healthcare Solutions works with practices to improve internal operations through practice workflow optimization, operational consulting, and EHR or EMR integration and support. The company strongly emphasizes written, documented procedures. Having structured processes in place promotes consistency, simplifies staff onboarding, and establishes clear accountability across the administrative team.

The firm also provides practical staff training tailored to real workflows and genuine practice scenarios rather than abstract theory. Administrative and billing team members gain actionable skills they can apply immediately to reduce billing errors and streamline daily tasks. Quelin Healthcare Solutions defines the scope of every engagement clearly, keeps clients updated on progress, and communicates all findings and recommendations in clear, straightforward language.

Meet the team

1 person

Results & case studies

58%lower

Reducing Claim Denials and Improving Revenue Cycle Performance

Denial Rate: 36 15

Multi-provider outpatient Non Profit

Improved revenue cycle workflows and claim resolution processes, with verified results of insurance verifications, coding and billing corrections over 90 days

The challenge

The practice was experiencing recurring claim denials, delayed reimbursement, and inconsistent revenue cycle workflows. Challenges included claim submission errors, incomplete documentation, payer-specific billing requirements, and insufficient follow-up on outstanding accounts receivable. These issues created additional administrative work, reduced revenue visibility, and made it difficult for leadership to identify the underlying causes of payment delays.

What Quelin Healthcare Solutions did

A comprehensive revenue cycle review was conducted to identify opportunities for improvement across claims processing, denial management, coding accuracy, and accounts receivable follow-up. The approach included reviewing denial patterns, evaluating payer requirements, identifying documentation deficiencies, strengthening claim validation procedures, and developing corrective workflows. Additional measures included prioritizing outstanding claims, improving follow-up processes, and establishing performance monitoring to support consistent billing operations.

100000+now

From Revenue Losses to Six-Figure Monthly Collections: Behavioral Health RCM Recovery

Monthly revenue: 0 100000+

Outpatient behavioral health and PHP treatment center

Transformed a financially distressed behavioral health center from virtually zero monthly revenue to more than $100,000 in monthly revenue within six months.

The challenge

An outpatient behavioral health treatment center providing intensive outpatient and partial hospitalization program (PHP) services was experiencing significant financial losses due to recurring claim denials, incomplete payer credentialing, missing authorizations, and inadequate insurance verification. Patient eligibility was being checked without documenting actual coverage benefits, authorization requirements, or reimbursement limitations. These deficiencies contributed to unpaid claims, interrupted cash flow, and monthly operating revenue that was effectively zero or negative.

What Quelin Healthcare Solutions did

Quelin Healthcare Solutions implemented a comprehensive revenue cycle recovery strategy beginning with a review of outstanding claims, payer enrollment status, authorization requirements, and patient insurance benefits. During the first 90 days, the team secured required authorizations, verified actual patient benefits and coverage limitations, corrected billing deficiencies, and addressed credentialing barriers. QHS also provided direct provider education on documentation requirements, medical necessity, and payer-specific billing guidelines. Structured claim follow-up, verification procedures, and ongoing revenue monitoring were established to improve reimbursement and prevent recurring denials.

44%lower

Reducing Coding-Related Denials Through a Complete Coding Overhaul

Claim denial rate: 62 35

Nonprofit outpatient healthcare organization serving patients with HIV

Reduced claim denials from 62% to approximately 30–35% through coding audits, pre-billing reviews, and provider education, despite separate unresolved credentialing barriers.

The challenge

A nonprofit healthcare organization serving patients with HIV was experiencing a 62% claim denial rate, with outdated diagnosis and procedure codes, inadequate clinical documentation, and inconsistent coding practices contributing to reimbursement problems. The organization lacked dedicated professional coding oversight, and providers were relying on outdated billing information. Claims were submitted without comprehensive coding validation, resulting in preventable denials and delayed reimbursement. Additional payer credentialing issues were being handled by a separate organization.

What Quelin Healthcare Solutions did

Quelin Healthcare Solutions conducted a comprehensive coding and documentation audit and implemented a mandatory pre-billing chart review process. Claims were temporarily routed through manual coding validation before submission to ensure accurate diagnosis and procedure code assignment, documentation support, and compliance with current coding guidelines. The team reviewed provider documentation, identified outdated coding practices, corrected claim deficiencies, and established coding accountability procedures. Providers received targeted education regarding required documentation, coding specificity, and the importance of accurate clinical records. Ongoing quality reviews were incorporated into the billing workflow.

100000+now

Restoring Payer Enrollment and Generating Six-Figure Monthly Revenue

Monthly revenue: 0 100000+

Inpatient and outpatient behavioral health treatment facility

Resolved longstanding credentialing barriers and helped a behavioral health facility progress from virtually no insurance-generated revenue to six-figure monthly revenue within approximately six months.

The challenge

A behavioral health facility providing inpatient and outpatient treatment services had spent years paying a previous credentialing vendor without achieving complete payer enrollment. Applications remained incomplete, closed, or unresolved, preventing the facility from obtaining reimbursement through major insurance programs. The organization relied heavily on private-pay patients and was experiencing severe financial strain because it could not consistently bill Medicare, Medicaid, or commercial insurance carriers. Administrative deficiencies and inadequate application follow-up created prolonged barriers to revenue generation.

What Quelin Healthcare Solutions did

Quelin Healthcare Solutions assumed responsibility for reviewing and restructuring the facility's payer credentialing and enrollment operations. The team audited existing applications, identified missing documentation, investigated closed and inactive enrollment files, and submitted corrections and supporting evidence where required. QHS coordinated follow-up with Medicare, Medicaid, TRICARE, Blue Cross Blue Shield, and other applicable payers to resolve enrollment deficiencies and obtain necessary approvals. A structured tracking and escalation process was implemented to monitor outstanding applications, payer correspondence, certification requirements, and enrollment milestones. Significant enrollment progress was achieved within approximately 90 days.

92%higher

Increasing Clean Claim Performance from 50% to 96%

Clean Claim: 50% 96%

Independently operated outpatient medical practice in Ohio

Increased the practice's clean claim rate from 50% to 96% through accurate insurance verification, payer validation, coding review, and provider education.

The challenge

An independently operated outpatient medical practice in Ohio was experiencing recurring claim rejections, requests for additional review, and reimbursement delays. Billing responsibilities were being handled internally without a consistent process for verifying patient insurance benefits, payer identification, authorization requirements, or documentation accuracy. Incorrect payer information and inadequate pre-submission validation contributed to a clean claim rate of approximately 50%, creating unnecessary administrative work and delays in payment processing.

What Quelin Healthcare Solutions did

Quelin Healthcare Solutions conducted a comprehensive review of the practice's billing, coding, and insurance verification workflows. The team evaluated rejected and returned claims, identified incorrect payer information and payer identification numbers, verified patient benefits and authorization requirements, and reviewed supporting clinical documentation before claim submission. QHS provided individualized education to the practice regarding documentation standards, coding accuracy, and payer-specific billing procedures. Standardized pre-billing verification and claim quality checks were introduced to improve first-pass acceptance and reduce preventable rework.

333%higher

Increasing Urgent Care Collections from 15% to 65% in 90 Days

Collection rate: 15% 65%

Outpatient urgent care medical practice

Increased the urgent care practice's collection rate from 15% to 65% within 90 days, establishing more consistent revenue cycle operations during a two-year engagement.

The challenge

An urgent care practice was experiencing severe accounts receivable backlogs, with numerous outstanding claims exceeding 120 days. The practice's eClinicalWorks revenue cycle workflows were disorganized, including payment posting, secondary insurance billing, patient statements, copayment collection, and outstanding balance follow-up. Inconsistent account reconciliation and limited collection activity contributed to a collection rate of approximately 15%. Some older balances had become uncollectible because of timely filing restrictions and other collection limitations, creating substantial revenue leakage.

What Quelin Healthcare Solutions did

Quelin Healthcare Solutions implemented a structured accounts receivable recovery and revenue cycle improvement program. The team reconciled existing payments, reviewed outstanding balances by aging category, identified claims requiring correction or secondary billing, and prioritized recoverable accounts. Daily and weekly follow-up activities replaced inconsistent collection efforts, while payment posting, patient billing, and account reconciliation procedures were standardized within eClinicalWorks. QHS established dedicated account ownership, recurring performance reporting, and monthly financial reviews. Uncollectible balances were identified for appropriate write-off review, while actionable claims and patient balances were pursued through organized collection workflows.

Services offered

  • Claims Processing
  • Denial Management
  • Revenue Cycle Management
  • Medicare Billing
  • Medicaid Billing
  • Private Payer Billing
  • Out-of-Network Billing
  • HMO Billing
  • PPO Billing
  • Medical Billing & Coding
  • Billing Audits
  • Credentialing (Payer & License)
  • AR Management
  • Eligibility Verification
  • Prior Authorization
  • Virtual Administrative Support
  • Licensing & CLIA Enrollment
  • ICD-10 / CPT / HCPCS Coding
  • HCC Risk Adjustment Coding
  • Specialty-specific Coding
  • EHR / EMR Integration & Support
  • Insurance Contract Negotiation
  • Practice Workflow Optimization
  • Front Desk Virtual Support
  • Telehealth Billing
  • UB-04 Hospital Billing
  • Inpatient & Outpatient Billing
  • Behavioral Health Billing
  • Dental Billing
  • Medical Coding Audits
  • Chart Review Services
  • Provider Enrollment Assistance
  • Insurance Verification

Specialties served

EHR & software expertise

AdvancedMD Athenahealth eClinicalWorks Kareo NextGen Healthcare DrChrono Allscripts Practice Fusion Epic Systems Cerner Meditech CareCloud Office Ally OpenEMR PracticeSuite RXNT ChartLogic WebPT PrognoCIS eMDs CollaborateMD Medisoft Open Dental Therapy notes Theranest TherapyNotes SimplePractice Tebra ChiroTouch ModMed

Pricing

Percentage of collections From 5%

Quelin Healthcare Solutions charges a share of the payments it collects for you, so its fee grows only when your collections do.

$10k$250k$500k

Estimated monthly fee for each practice size, based on the percentages above. Your final quote depends on specialty, volume and services.

Hourly$35 / hourFor A/R clean-up, credentialing or projects
Per claim$6 / claimA flat fee for every claim submitted

Client reviews

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Reviews from Google

5.0 8 reviews on Google
See all on Google
May 17, 2026
Source: Google
5.0

Highly recommend this full RCM firm. Their expertise in medical billing, credentialing, audits, and revenue cycle management has made a huge difference for our practice.

View on Google
May 20, 2026
Source: Google
5.0

Excellent service overall. Their audits and billing support helped improve accuracy and reduce claim issues significantly.

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May 18, 2026
Source: Google
5.0

Great experience with this medical billing service. Their RCM support has helped streamline our entire practice, from billing to collections.

View on Google
Nov 28, 2025
Source: Google
5.0

This company a very good dependable billing services. They are easy to work with and are always available.

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Reviews and ratings from Google, shown as published on Google. They are not part of the BillerFirms rating.

Questions about Quelin Healthcare Solutions

Quelin Healthcare Solutions works with AdvancedMD, Athenahealth, eClinicalWorks, Kareo, NextGen Healthcare, DrChrono, Allscripts, Practice Fusion.

Quelin Healthcare Solutions offers Claims Processing, Denial Management, Revenue Cycle Management, Medicare Billing, Medicaid Billing, Private Payer Billing, Out-of-Network Billing, HMO Billing.

Quelin Healthcare Solutions is based in Houston, Texas and was founded in 2011.

Quelin Healthcare Solutions lists a percentage of collections (7%, 6%, 5% depending on practice size), a flat fee per claim, hourly rates as its pricing.

Yes. The BillerFirms team checked documents for these badges: Verified Business, HIPAA Compliant, Certified Team.