Services

Comprehensive Revenue Cycle Management

Comprehensive Revenue Cycle Management

Comprehensive Revenue Cycle Management

Streamlined processes to ensure timely claim submissions and payments.
Dedicated efforts to reduce claim rejections to less than 5%, maximizing payments and increasing cash flow

Charge Entry and Claim Submission

Comprehensive Revenue Cycle Management

Comprehensive Revenue Cycle Management

Accurate entry of charges from coded documents into patient accounts.
Rigorous quality assurance checks before claim transmission to ensure a high claim acceptance rate.

Payment Posting

Comprehensive Revenue Cycle Management

Denial Management

Prompt posting of insurance payments from EOBs, ERA, EFT, and patient checks.
Reconciliation of bank deposits with payment postings, ensuring accuracy and transparency.

Denial Management

Secondary Claim Follow-up and Old A/R Recovery

Denial Management

Comprehensive analysis of claim denials to identify common issues.
Proactive measures to prevent recurring denials and improve claim acceptance rates.

Audit and Appeal

Secondary Claim Follow-up and Old A/R Recovery

Secondary Claim Follow-up and Old A/R Recovery

Thorough review of claims to ensure compliance with industry standards.
Efficient appeal processes to address and rectify claim discrepancies.

Secondary Claim Follow-up and Old A/R Recovery

Secondary Claim Follow-up and Old A/R Recovery

Secondary Claim Follow-up and Old A/R Recovery

Dedicated follow-up on secondary claims to ensure timely payment.
Strategic approaches to recover old Account Receivables, improving cash flow.

Rejection & Follow-up

Credentialing & Re-credentialing

Rejection & Follow-up

Detailed analysis of claim rejections to identify root causes.
Proactive follow-up to address rejections and resubmit claims for payment.

Reporting

Credentialing & Re-credentialing

Rejection & Follow-up

Comprehensive financial reports to provide insights into billing performance and revenue generation

Credentialing & Re-credentialing

Credentialing & Re-credentialing

Eligibility & Benefits Verification

Expertise in obtaining authorization for providers to accept insurance payments.
Streamlined re-credentialing processes to ensure continuous service delivery.

Eligibility & Benefits Verification

Eligibility & Benefits Verification

Eligibility & Benefits Verification

Comprehensive checks with insurance providers to confirm patient coverage.
Verification of patient benefits, co-pays, deductibles, and prior authorizations.

Prior Authorization and EDI Setup

Eligibility & Benefits Verification

Prior Authorization and EDI Setup

Efficient processes to obtain prior authorizations for specific treatments.
Seamless EDI setup to ensure electronic data interchange compatibility.

MIPS Reporting

Eligibility & Benefits Verification

Prior Authorization and EDI Setup

Expertise in the Medical Insurance Payment System reporting.
Ensuring compliance with CMS guidelines for quality care delivery and payment adjustments.