Charge Entry

The Medical billing process begins with filing claims for services provided to patients, entering charges/ creating bills is done electronically to shorten the revenue cycle days.

Patient Demographics and Medical codes applied to charts are appropriately verified. Every claim is verified to check: DOS, POS, Provider Info, Units, Modifiers, CPT code, Facility billed from, Referring Doctor in order to reduce the chance of claim rejection. Your fee schedule is taken into consideration and bills are raised accordingly.

Our Billers also submit claims to clearing house to make sure that 100% accuracy is maintained for all our clients. CMS 1500 forms are also generated to submit to government agencies.

Our Billers ensure layers of quality process before submission of claims that ensures 100% clean claims submission first time it include:

• Manual check is done by our billers in order to insure accuracy.
• Random quality audit using statistical data.

Payment Posting

Payment posting is a crucial step in billing process, looking at the sensitivity of this process, accurate and efficient payment posting process is indispensable for Physicians office. Our billers are known to be highly efficient and analytical in payment posting process.

Our Billers feel that reading EOBs is a skill and one must be aware of all the distinctions of payer communication when handling a payment posting account.

• Enter the allowed amount
• Paid amount and
• Patient responsibility information
• Then calculating the contractual adjustments
• This also helps the insurance follow up easier

Payment Posting is also evolving with ERAs (Electronic Remittance Advice) from payers, our billers support ERA posting by also verifying the payments posted.

Their specialty lies in working on the most advanced electronic remittance scenarios, including denials, underpayments, overpayments, multiple adjustments, automatic cross-over, secondary remittance, reversals, and more.

Before Our Biller closes the payment posting, they match patient payments accepted in the front-office to encounters entered in the back-office

The step wise assessment of Medical Billing is what makes our billers the specialist for your practice.

Account Receivables

Our billers believe that accuracy of the claim and the time spent on retrieving the payment are key points in optimized revenue collections. Off course we understand that Money waiting to be collected is Revenue loss. Our aim is to improve the client’s cash flow by reducing days in accounts receivable and improving profitability, by increasing collections ratio.

Our billers identify category/payer combinations and work on resolving the mix that results in the best collections. They prioritize the claims by dollar value and date of service. They organize the Account Receivables timeline wise (AR days between 30 to 45 days, 45 days to 60 days and beyond 60 days) and work on critical claims first.

Our billers are well versed in identifying patient accounts that require follow-up and take the necessary action to collect unpaid and partially paid claims.

Billers in our consortium run reports on account 21 days past due and call insurance companies to check claim status, re-file, or gather additional information. They keep the average age of account receivable at 25 days or less.

It has been observed that revenues for most clinics are stuck in this stage where Insurance Follow up is not a priority. Thousands of dollars are waiting to be collected but follow up with long hold periods on the phone with Insurance companies is tedious and must be minimized with efficient maneuvers of IVRs.

Our billers have spent years doing this, some of them have such established relations and great understanding of claim status that they don’t even pick up the phone to follow up. They know their jobs!

Denial Management

Denials are an epidemic to the financial health of most practices, and they have a need to be treated well in order to get you financial success. 10% of the physician revenue is estimated to be lost due to lack of denial management process.

Our billers are experts in denial management analysis. This helps in preventing denials and revenue losses in the first place. But if you do have denials from the past then let them be handled by our Billers and Coders and see them getting paid easily.

The process of Denial Management has only one key – ANALYSIS, once the root cause of denial is figured, correcting it and getting paid for it is not a task. The skill of a specialist is required to get the perfect analysis into a claim.

Our billers are specially trained to recover the collectibles from

1. Worker’s compensation
2. Medicare
3. Medicaid
4. Attorneys