Medical Billing Services | Revenue Cycle Management
Outsource your revenue cycle management, also known as medical billing services, and get guaranteed peace of mind!
If you're looking for a medical billing service, you've come to the right place. We're a full-service medical billing company that can help you with all your billing needs. We can provide you with a complete medical billing solution that includes everything from insurance claims processing to collections. We're here to help you get the most out of your medical billing and get the reimbursement you deserve.
Demographic Entry
- Patient registration and record updates.
- Following HIPAA Compliant process and providing remote access solution to keep control over the data.
- 24 hours Delivery TAT and 24x5 Availability
In general, we re-verify patient policy eligibility every time before billing a new encounter. We also provide comprehensive eligibility and benefit verification service that provides a complete report on whether the service is covered under the patient's Policy, annual deductibles, and Co-Pay situation so it can be collected upfront by the front desk. Pre-encounter verification determines if the verification is needed to perform the procedure so that due process can be done before the patient encounter.
Insurance Verification
Request for Authorization
Often, providers have to write off the services as the service was not certified/authorized. Providers need to follow the insurance protocols for any treatment he/she is going to render.
Here we offer a complete suite of authorization request services, from verifying whether the service requires authorization to finding out what paperwork would be required to complete the process. At last, we submit a complete authorization request to the insurance company and track it.
Pre-authorization means sure payment. If the provider fails to get the services pre-authorized, we also provide the retro authorization request submissions to get the service paid.
We have qualified and knowledgeable billing professionals who work on highly advanced technology to provide you with an impeccable solution that minimizes data-entry work using guidelines and billing software. Our charge Entry/Claim submission process comprises three significant steps to ensure the payer receives a clean claim.
- Pre-Entry Coder Verification, our expert team of experienced coders, verifies the codes submitted by providers and checks for any required modification
- Experienced billing professionals enter the charges for rendered treatment. Ensure necessary claim attachments are done, and all claims reach the insurance as required.
- Within 24 hours of submission, clearinghouse scrub reports are checked, and if any error is rectified, we re-submit for faster recovery.
Charge Entry and Claim Processing/Submission
Account Receivable / Denial Management
WE MAKE SURE;
Payable treatment is paid within 60 days of service.
Once we submit claims to insurance companies electronically or by paper mail, we ensure that claims reach the payer timely and get paid. We have simplified the process for our clients and classified Account Receivable resolution into 3 phases:
Phase I - Account Receivable Follow up
We want to recover your money as soon as possible. Hence, we start following up with the insurance company after 15 days of claim submission. This ensures that if any additional info is required or any other requirement is fulfilled, the provider gets paid timely.
Phase II – Analysis Second Review Requests/Appeals.
Our experienced A/R analysts begin this phase by discovering various or global issues for rejected/denied claims or for claims where the payer does not pay the contracted rate. We also check the filing/appeal limits of the major carriers.
Our team ensures that providers' bills get reimbursed according to the contracted fee schedule and that payers stick to their or state-mandated processing guidelines.
Phase III – Denial Management
Often payers deny the bill with erroneous reasons sometimes. They do it deliberately to delay the payment to the provider. Our phase III team ensures that every denial is appealed and the payers are pushed to pay the provider with penalty and interests if the case be.
All the payments/correspondence received are posted within 24 hours of receipt to ensure any deficiency in billing or insurance so the partial paid can be appealed, and the maximum possible amount can be collected from insurance companies.
After Primary insurance payments, if secondary or patient responsibility is left, the data is transferred to billing teams to bill accordingly.
We will keep working on your bill until marked as fully paid.
Payment Posting, Secondary and Patient Billing
