Our eligibility verification service involves a thorough process of checking patient insurance coverage before the delivery of medical services. This ensures that the patient's insurance plan is active and that the proposed medical services are covered under their policy. The process includes verifying patient details, checking coverage limits, and confirming co-pays and deductibles.

By verifying eligibility upfront, we prevent potential claim denials that could occur due to coverage issues. This proactive approach saves time and reduces administrative burdens, leading to smoother operations and improved patient satisfaction.

Prior authorization is a critical step in securing approval from insurance carriers for specific treatments or procedures before they are carried out. Our team handles the entire process, including gathering necessary medical information, submitting authorization requests, and following up with insurance providers.

Securing prior authorization helps ensure that the proposed medical treatments are covered by the patient’s insurance, thereby reducing the risk of unexpected out-of-pocket expenses for patients and minimizing the chances of claim denials.

Accurate capture and maintenance of patient demographic information are essential for efficient billing processes. This service involves collecting and regularly updating key patient data, including contact details, insurance information, and medical history.

Maintaining accurate patient demographics ensures that all billing information is correct, reducing errors in claims submission and improving overall billing efficiency.

The charge entry process involves accurately entering all medical service charges into the billing system. Our charge audit service includes regular reviews and audits of these entries to ensure accuracy and compliance with billing regulations.

Through meticulous audits, we identify and correct any discrepancies, ensuring that all charges are accurate and compliant with relevant regulations, thereby preventing potential billing issues and claim denials.

Our medical coding services involve converting healthcare diagnoses, procedures, medical services, and equipment into universal medical alphanumeric codes (ICD, CPT, and HCPCS codes). We also conduct regular coding audits to ensure accuracy and compliance with coding standards and regulations.

Accurate coding is crucial for correct billing and reimbursement. Our audits help maintain high coding accuracy, which minimizes claim denials and ensures regulatory compliance.

Remittance processing involves handling remittance advices from insurance companies, posting payments accurately, and reconciling accounts. Our team ensures that all payments are posted timely and correctly.

Efficient remittance processing helps maintain a steady cash flow and reduces the time spent on resolving payment discrepancies, thus enhancing the overall financial health of healthcare providers.

Our account receivables management service focuses on the efficient management of claims to ensure timely reimbursement. This includes tracking unpaid claims, following up with insurance companies, and resolving any issues that may arise. Effective account receivables management ensures that all claims are paid on time, reducing the days in accounts receivable and improving cash flow.

Denial management involves identifying the reasons for claim denials, analyzing trends, and implementing strategies to appeal and resolve these denials. Our team works diligently to understand and address the root causes of denials.

By effectively managing denials, we can recover lost revenue and improve the overall efficiency of the billing process, ensuring that healthcare providers receive the payments they deserve.

Our credit balance service includes regular review and analysis of accounts to identify and resolve credit balances. This helps in ensuring that accounts are accurately balanced and compliant with regulatory standards.

Proper management of credit balances prevents compliance issues and financial discrepancies, ensuring the integrity of the billing process and financial records.

We provide detailed reporting on billing and coding processes, utilizing data analytics to identify trends, issues, and opportunities for improvement. Our comprehensive reports offer insights into the performance of billing operations.

Through advanced analytics and reporting, we help healthcare providers optimize their billing processes, improve efficiency, and enhance overall financial performance.