Appointment Scheduling
We can provide you 24/7 customer service to manage your patient appointments. Appointment scheduling or cancelling will immediately be entered either into your practice management software or into our own software based on your preferences.
Insurance Verification
Soon after the appointment is entered or on the day before the scheduled appointment or upon your request as is required our Coverage & Benefits Verification Team will call the insurance(s) and check your patient's complete eligibility, benefits, referral / authorization requirements & co-ordination of other plans. This is an important initial process in the revenue cycle management to filter and fix out most of the claim denials those come later.
Referral & Authorization Requests
If we are told at that the time of insurance verification that your patient's plan requires a referral or authorization, we would automatically initiate the referral or authorization request if it's not already done with the insurance companies unless or otherwise your office doesn't want us to do it automatically. Upon your request we can do this process at any time according to your patient's plan provisions. We will also check during every visit of your patient if the referral or authorization limitations are exceeded in one or other way.
Medical Coding
Not all the certified coders know the tricks to find out what you can be reimbursed for and what you cannot be. Lacking of skilled coding abilities leaves your works and efforts as if they were done for charity. Our trained certified coders are always here to code your services accurately and to make sure none of your works is left un-billed and unpaid.
Demographic & Charge Entry
Our data entry people are experienced enough to complete your demographic & charge entry faster and thus make sure the charges go out timely. Demographics & Charges entered are checked again by an auditor before the claim submission. This screening and the accuracy of our data entry process prevent many of the claim rejections and denials later and lead to faster reimbursements.
Claim Submission
Insurance companies have started reducing and changing their time span for submitting the claims for various reasons. We feel very bad about timely filing denials and we never let your claims denied for timely filing. Nothing is impossible for us; we can submit your claims electronically (EDI), by faxing, through certified mails and via online insurance portals. We choose the most convenient way of submission based on the time span, insurance acceptance and your participation level with the insurance.
EOB / ERA Posting
Your payment and denial EOB & ERA are posted to the practice management software as soon as they are received. We never wait until the month end to post them like others. Therefore claim denials are captured as quickly as possible and forwarded to our specialized denial management team for resolution.
Claim Rejection Management
On daily basis we check with the clearing houses for claim rejections and resolve them immediately. This process ensures all the claims are transmitted correctly. We don't do robotic claim re-submissions until the timely filing limit is exceeded like everyone else without knowing and resolving the causes and obstacles that prevented the previous claim submission from succeeding.
Claim Denials & Appeals Management
Claim denials are captured from the received EOB/ERA and by regular follow-up with the insurances. Most of the denials are resolved on the phone call with the insurance companies and those required special attention will be forwarded to our denial management team which is trained and experienced in resolving all types of denials for various specialties. This team has an abundant knowledge on various appeal processes and regulations for different states.
Insurance (AR) Follow-up
This is the most important process in revenue cycle management that ensures the cash flow of the practice. It is necessary to keep in touch with the insurance companies to be updated with their current trends and their policies causing new denials and to stop them from unnecessarily delaying the payment. We have understood the criticality of this process and we have enough experience in handling them.
Patient Billing, Calling and Answering
We generate statements and send to the patients for their co-payments, co-insurances, deductibles and for any other patient liability. Our in-bound customer service will answer any billing inquires received from your patients over the phone.
Provider Enrollment / Credentialing
Enrolling with an insurance company for EDI or for any other administrative purposes and Contracting with an insurance company are two different aspects. Contracting has both advantages and disadvantages on various platforms. Our Credentialing Team can explore your needs for contracting with a specific insurance and can better give you the insights of the process. We can do all the paper works on your behalf once it is decided to have a contract.