Revenue Cycle Management:
- Eligibility Verification – Ensure every patient is eligible before submitting the claim
- Authorization – Ensure every procedure has required authorization in place before claim submission
- Charge Entry – Ensure every charge has appropriate Date of Service, ICD, CPT, modifier combination, place of service, authorization & referring/rendering physician
- Workman Compensation Billing – Ensure every claim has required reports, Date of Injury, Authorization/Claim number before submission
- Payment Posting – Ensure ERA/EOB are posted accurately and secondary/patient billed
- Denials and Rejection Follow Up – Follow up on denials within 24 hours
- Appeal on denied claims – Appealing where required is important for prompt payment
- Secondary Insurance Billing – Attach primary EOB for secondary payment
- Patient Statement Generation – Ensure every patient statement is accurate.
- Daily Appointment Reminder to collect balances from the patient – Inform office about daily patient balances to be collected at the time of service.
Account Receivables Recovery
- We help you collect from the old accounts.
- We prioritize your A/R based on insurance and take up the claims which are close to Timely Filling on Priority Basis
- We use our specialized templates for appeals on Medical Necessity
Credentialing & Contracting
- Medicare (PECOS) Enrollment -Ensure the CAQH profile is accurate before starting any credentialing process. We help with PECOS enrollment as well.
- PPO – Credentialing – Cigna, Aetna, UHC, BS, Anthem, etc.
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