Services
We offer professional services with utmost care and precision
Healthcare is constantly changing. So maintaining financial stability is challenging. Successful healthcare revenue cycle management strategies focus on front-end tasks to help claims move along. Many errors occur in the first stages of a patient’s account and these issues can carry through the revenue cycle to disrupt claims reimbursement.
Our Services
Demographic & Charge entry
Patient demographics form the core of the data for any medical institution. Registration process on patient demographic data such as: Patient name, Date of birth, Address, Phone number, Doctor information, Social security number (SSN) and Sex. Patient Demographic also contains Guarantors or emergency contact information, Health insurance information becomes a part of the patient's medical record. it is important because correct and quality entry of such information will directly impact physician’s monthly revenue. This sheet is also called as face sheet of a charge or claim.
Coding services
Medical Coding - is a little like translation. the medical coder would need to understand / read the patient’smedical chart recorded during the encounter. it would list the history, diagnosis, treatment provided, plan of care etc. These need to transferred into a set of universal medical codes. The AMA has a number of resources to help accurately bill procedures and services with Current Procedural Terminology (CPT®) and Healthcare Common Procedure Coding System (HCPCS) codes.The ICD (10th revision) is currently being used for coding.
Payment posting
Accurately posts payments from third-party carrier and patient payments to accounts. Posts/documents on accounts' rejections notices from third-party carriers. Performs daily reconciliation of payments posted to billing system to payment batch and resolves discrepancies. Posts payments and adjustments to proper patient invoices. Recognizes problems in payment amount.Reconciles ERA files and EOBs to corresponding EFT deposits and paper checks.
Eligibiligy & benefits verification
Successful billing depends on successful eligibility verification. To verify patient has active medical coverage for the date of service and their insurance plan covers for the services provided ensures that the provider will be paid for services rendered. This step is very crucial to ensure correct billing and reduce claim denials.
Accounts receiveble & denial Management
A significant asset of all healthcare providers is their accounts receivable services. we ensure all billing and collections activities meet state and federal compliance requirements. consistent follow up on unpaid claims utilizing monthly aging reports and filing appeals when appropriate to obtain maximum reimbursement. Conducts timely follow-up activities on assigned accounts to reduce outstanding account receivables.
Claims transmission and Rejections handling
Claims Submission / Billing- Once the claim has been properly completed, it must be submitted to the insurance payer for payment. Medical billers need to have access to the information they need about the insurance payer since there are so many variables for each insurance payer in determining how and when to submit a claim in a timely manner.