A one-stop center for all your credentialing, contracting and billing needs. Our billers are proficient in various fields such as credentialing, contracting, all aspects of billing from patient registration to sending clean claims, dealing with denied and rejected claims appropriately. They are HIPAA compliant and stay updated on the rules and regulations of insurance companies.
Our services include but are not limited to the following:
Provider Enrollment and Credentialing for Medicare,Medicaid, Aetna, Anthem, BCBS, CIGNA, Humana, UnitedHealthcare etc.. just to name a few popular insurances on the market.
When we take up your Credentialing needs, we save you hundreds of hours in getting the task done with our regular follow-up calls with the payors. Phone calls, follow-ups, submitting all applications, e-mails and faxes are done for you. Once the credentialing is done, you will see a marked increase in patient referrals.
Becoming an in-network provider with different insurance companies brings you a wider customer base. We prudently analyze and effectively negotiate payor contracts for the practice to sustain viable revenue. Our experience in dealing with payor contracts and fee schedules will help you get the maximum payment from the payors.
We set up accounts with each payor websites that enable you to login and view claims, eligibility etc.
Coming to the actual revenue cycle management, our software assists you in setting appointments, instant insurance eligibility checks, creating superbills after the patient encounter, charge entry, claim submission, collecting copay and payment posting. We deal with follow up for denied or rejected claims. Follow up of AR is done meticulously. Our software boasts of various reports that give you an insight into your financial health.
You can set up appointments for all the providers in your practice in advance. There are different appointment types that you can choose from. The appointment types and times can be tailored to fit your practice’s or provider’s needs.
It is of utmost importance that the insurance be verified each time for a patient walking in for an appointment. The eligibility check can be done when the appointment is taken or when the patient is at the front desk.
Superbills can be created after the patient is checked out. The valid and appropriate ICD-10-CM codes and CPT codes can be entered which will then be viewed by our billers for creating claims.
Our billers create claims based on the superbills received. We review each code before creating the claim to avoid any errors.
The diagnosis and procedure codes as well as pertinent patient information is thoroughly checked once again before the claim is submitted. Previous or current payment balances are attached to the claim before submission. Claims are filed electronically as well as by paper.
Payment Posting is done after the receipt of EOB’s / ERA’s. Any balance amount is invoiced to the patient. Any claim denials or rejections are called in to the payor to ask for clarification. If there is a possibility of getting better payment, the denied / rejected claims are sent in for appeal and the follow up done appropriately.
Reports such as Insurance Aging, Patient Aging etc.. can be generated to view the financial status of the practice.
The dashboard in the home page displays the most current AR, appointments for the day as well as a screenshot of primary, secondary and tertiary claims that have been sent and accepted. We use advanced technology and have professionals who will ensure that your practice gets the best returns. Your focus can then be your patients while we strive to make your practice a success. You will not be suffocated with paperwork and other administrative duties because we are here to help you get that done with minimal involvement from your side.