Maximize Profitability
Cleaning up old AR and managing denials requires prudent calculation from a medical billing company. We are a medical billing company that proactively works towards AR pile-up. The timely filing is considered as one of the main reasons for AR pile-up from one payer to another. We learn the pre-determined “TFL” of the payer and Submit claims accordingly.
1 – PATIENT REGISTRATION
The very first stage of a patient’s appointment should include the notation of the Patients’ Demographic Information as well as information about his/her Insurance, such as the insurance payer and policy number. Any information that will be useful and/or necessary in a claim situation should be detailed at the Patient Check-In.
2 – DATA ENTRY & DEMOGRAPHIC
Updating charges and Codes for every medical procedure is the key to a
successful & clean claim.
3 – CODING & CHARGE POSTING
Professional Medical Coders describe a Patients’ history with Codes which are used for filling Healthcare Claims and for the accurate diagnosis and recommendation of further procedures for the Patient long after the claims have been paid.
4 – CLAIM SUBMISSION
Medical billers need to have access to the information they need about the Insurance payer since there are so many variables for each insurance payers in determining how and when to submit a Claim.
5 – DENIALS & REJECTIONS
Clearing house rejections or Payer and Front-end Rejections are Billing problems that slow down your Cash Flow. These are process errors and can be reduced to ZERO. Rejections occur due to one or many errors on the claim form and are returned back to the biller by the payee because of these errors.
06 – PAYMENT POSTING
This step involves posting and deposit functions. At this point, the amount billed to the patient will be zero if it has been paid in full or it will reflect the amount owned by the patient. The insurance payers’ responsible should have been met by this step in the process.
7 – DENIAL MANAGEMENT
Our team will increase revenue by 30% or more, and speed up your cash flow. Denials can have an adverse effect on your cash-flow. Managing denials promptly and effectively will result in an increase in the Cash Flow and enhance the effectiveness of the billing process with higher first-level passes.
8 – AR FOLLOW-UP
Accounts Receivables at a Practice & Hospital were purely a departmental activity until some time ago. New and evolving payer plans, co-insurance agreements, patients’ co-pays, and the increases in patients with a high deductible health plan have exceedingly complicated the nature of Accounts Receivable.
9 – APPEALS
APPEALS are an important part of the Medical Billing Process. Appealing on a denied claim with sensitivity to its specific timeline is critical for the Healthcare Provider to recoup money. Moreover, if you are able to identify a pattern in claims that are denied, and the existing practice isn’t helping much when it comes to appealing on those claims, it means the physician or the Healthcare Provider is not aware of compliance issues or guidelines and the current billing processes is incorrect by default.