Eligibility Verification and Pre-authorization

We provide complete eligibility verification and pre-authorization services (for procedures and drugs), co-pay / co-insurance estimation.

Medical Coding

Our experienced coders are familiar with ICD 10 and CPT and validate procedure codes. Our team also scrub procedure and diagnosis codes against correct coding initiatives and payer-specific edits to maximize the number of clean claims. We also provide charge capture audits and charge data reviews to ensure that all procedures, services, supplies and drugs have been captured.

Claim Management

We ensure appropriate and timely submission of claims and track claim status. We submit scrubbed claims either through any industry standard state-of-the-art clearing houses.

Payment Posting and Balance Billing

Our team of specialists post payments to patient accounts and identify claims for denial and underpayment recovery. Any unpaid / denied claims are identified for further action. Any balances as per the primary payer are either billed to secondary payers or the patients.

Denials and Underpayment Recovery

We welcome your hard-to-collect or outstanding claims to attempt complete recovery.  Our team pursues every claim to its logical conclusion and provides you with detailed reports on activities for each claim maximizing your revenue as well as visibility.

Patient Balance Collection

Using technology-assisted processes, along with patient advocacy to optimize collections we shorten lead times on collection of patient balances. We help you with daily visibility on patient balances as well as prepare standard bad-debt reports for your further actions.

RCM Analytics

We help you with infographic view of your practice’s claims, collections, receivables, and denials. We design reports to track finer details of claims. Our timely reporting system assists you to gain insights that can change into actionable plans to improve performance.

 

Call Center to Take Patient Calls

We have highly skilled people taking calls. They collect all the necessary information from patients that are important and relevant.

Dedicated RCM Client Service Manager

Eligibility Checking