Services
Information Gathering
Patient Appointments and Gathering insurance information from the patient.
Medical Coding
Gathering medical records and abstracting & assigning CPT and ICD codes to medical records.
- We guarantee coding service accuracy through AAPC Certified Coders with years of experience desired by our clients
- Specialty-Focused Coders - Knowledgeable coders for each specialty.
Billing
Coded information is entered into the software, and a claim is generated and submitted to the insurance.
Eligibility Verification
The essential phase in medical billing and coding is insurance eligibility verification. Eligibility and insurance verification are critical to receiving accurate and timely information about insurance coverage and reimbursement.
Payment posting and Receivables Management
Following up with the insurance for the claims processing and posting the received payment by the insurance in the system and working on the denials. Moving the patient’s responsibility to the patient’s balance.
Account Receivable Services
The Accounts Receivables process ensures that companies receive their payments within a particular time frame, enhance their collection rates, and process invoices more quickly, contributing to their income. It also includes an examination of insurance contracts to ensure that healthcare providers are adequately reimbursed. It assists healthcare service providers to run their practices effectively and successfully.
Out of Network Negotiations
In out-of-network negotiation, we utilize our expertise to negotiate clients’ underpaid claims with insurance companies and third-party negotiation vendors.
Patient Billing
In patient billing, we generate the patient statements for the patient’s responsibility like co-pay, coinsurance, and deductible to the patients. Also, we resolve the patient’s questions and queries regarding the balances. Furthermore, if a patient comes with an inactive insurance policy or with a policy that requires the coordination of benefits updates that cause a delay in the payment. We communicate with the patient to provide the correct policy information.
Reporting
- Providing all necessary reporting to the client.
- Generating the monthly invoice, which contains the payment information for the entire month.
Credentialing and Contracting
- Credentialing and Contracting are the basis of the start of a clinic or healthcare facility. It also works as a root for a relationship with the insurance company. It is an important part of enrolling in an insurance company’s preferred provider network.
- Following are the steps followed by the credentialing department:
- Initial Credentialing (updating provider billing and pay to address with the insurance)
- EFT enrolment (creating a setup for electronic payment)
- Timely follow-up with insurance for application status
- Providing enrolment status to the client
- Re-credentialing (in case any of the provider’s information (i.e. physical address) changes then it’s the responsibility of the enrolment team to update any new changes with the insurance record.
- Fee Negotiation (Fixing the provider reimbursement rate with the insurance)
Document Management Indexing
- Document management services consist of indexing old charts scanning and indexing uploading data and images to an EMR/EHR
- To maintain all the data remotely by indexing using software.
- Direct the movement of data across multiple systems.
- Oversee the validation, organization, and maintenance of data.
- Audit and resolve all external errors.
- Update, maintain, and run reports.
- Provide customized reports.
Auditing
- All our certified coders have medical sciences qualifications which makes them perform better as compared to other certified coders.
- We are well experienced in auditing and reviewing all types of medical documents.
- We offer our clients periodic internal audits to improve the financial health of the practice and successfully pass through any kind of insurance audit.
- Our internal audits have successfully made our clients pass through the Medicare audits with more than a 98% success rate.
- Our auditors help the practice achieve maximum reimbursements by making sure no code or service gets missed.
- Our auditors also make sure to remain updated with the latest guidelines/rules to avoid any kind of discrepancies or flaws in the RCM.
Other Services
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