We verify that patients are eligible for benefits under their insurance policies and determine if their plans have any pre-authorization or referral requirements.

After this verification, we calculate the deductible and co-payment amounts. Our services improve cash flow, increase reimbursements, and ensure accurate insurance eligibility verification.

Charge entry is a crucial step in the billing process, as it determines the payment amount for the healthcare organization. Charges from the patient's FaceSheet are recorded into the patient's account.

Accurate entry of patient demographics is essential, requiring a skilled team to input precise data. Our billing services team ensures high-quality, error-free patient demographic and charge entry services.

Our team examines multiple sources, such as doctor's transcriptions, diagnostic test reports, and imaging reports, to validate services and assign the correct codes. We address potential issues like claim denials and underpayments to prevent disruptions in workflows and minimize billing complexities.

Handling accounts receivable can be complex and labor-intensive. We actively track and follow up on unpaid claims to reduce AR days. Additionally, our accounts receivable management team quickly appeals denied and underpaid claims to ensure timely processing and reimbursement.

Claim denials can lead to substantial losses, making it essential to monitor and address them effectively. Our collection services team investigates the reasons for denials, corrects errors, and resubmits claims within the appropriate filing deadlines.

When a claim is denied due to insufficient information, we promptly address any gaps. Our billing professionals and analysts work to track denials, analyze their causes, and refine processes to reduce the frequency of denials.

Payment posting serves as the initial defense in identifying payer issues. We address denials related to medical necessity, non-covered services, and prior authorization by assigning them to the relevant team members.

Our process involves reviewing ERAs (Electronic Remittance Advices) and scanned EOBs (Explanation of Benefits) to ensure that all payment details are accurately entered into the system. Subsequently, we update the data correctly in patient accounts.

Provider credentialing is a crucial step in the revenue cycle that facilitates the association of physicians or providers with insurance payers. This process enables patients to use their insurance cards for medical services and ensures that providers receive payment for those services.

Our billing team accelerates payment processing by setting up ERA (Electronic Remittance Advice), increasing referrals, reducing revenue leakage, minimizing denials, and analyzing provider trends.

Our strategic, multi-faceted approach maximizes savings for out-of-network claims. We seamlessly integrate our negotiation process with your existing procedures to ensure efficiency.

Using specialized algorithms and extensive supplier databases, we identify key areas of high costs and optimal reimbursement. Our team diligently works on each insurance claim to secure the highest possible reimbursement for services.