Revenue Cycle Management

We specialize in end-to-end Revenue Cycle Management (Healthcare Ecosystem) Solutions. Billing needs for both professional and facility providers are catered to with quality of service being the focal point. We guarantee improved quality with significantly reduced cost and 100% compliance with the laws of the land.

 

Scheduling & Patient Registration: Maximum office productivity depends on efficient Patient Scheduling. We can schedule visits for patients, take care of Registration and other formalities at Patient Access for you.
Collections: We offer tailored end-to-end services in Collections and customizable Collections Management Solutions. Our elite team of Collectors certified by ACA (The Association of Credit and Collection Professionals) work relentlessly on increasing collections from your debtors whilst strictly adhering to legal and regulatory parameters.
Insurance Verification and Eligibility: Denials based on COB issues can affect reimbursement in the initial 90 days. We also verify patients' insurance and eligibility to reduce COB and coverage issues.
Self Pay Follow Up: We house patientÂ’s' accounts representatives with extensive experience and eloquence in communication skills to cater to the rising demands of Self Pay Follow Up. FDCPA and PTCT compliant training is imparted on our qualified Customer Service Personnel to help them deal with irate patients, skip tracing thereby reducing bad debt write-offs. We implement the use of Predictive Dialer for voice based services.
Medical Coding: Our elite team of Certified Professional Coders implement the principles of Correct Coding Initiative and medical necessity parameters in accurately coding CPT-4 Procedure Codes and ICD-9 CM Diagnosis Codes to prevent Compliance Risks or Revenue Loss. We are well-equipped for smooth transition into ICD-10 CM Coding scheduled for October 1, 2014.
Correspondence Follow Up: Correspondence from insurances, guarantors, patients, legal representatives of patients, in-house attorneys and collection agencies are responded and processed for faster resolution of aged AR without compromising on the compliance requirements.
Charge Capture & Demographic Data Entry: Patient demographics are duly verified thereby resulting in creation of accurate patient accounts, which ultimately benefits during Collections. All rendered services are captured accurately and efficiently and the Charge Description Master (CDM) is reviewed for correctness of Revenue Codes and CPT Codes for the services listed.
Accounts Receivables and Denial Management: Efficient rejection handling helps to identify any loop holes in the electronic billing system faster & enhances the effectiveness of electronic claims submission. We identify trends in billing leading to reduced denials and appeals are completed keeping a close eye on AR Outstanding Days for accelerated reimbursements.
Claims Transmission: Our systems are designed to meet all requirements set by the latest HIPAA 5010 standards for electronic claims transmission & validation. Any electronic rejections encountered in the front end are addressed on a priority basis for minimizing denials and enabling accurate processing of the electronic claims.
Payment Posting: Apart from manual payment posting we also specialize in electronic payment posting. Our Electronic Payment Posting methodologies and Regular Audits are instrumental in proper posting of payments by both insurances and patients with proper measures taken for excess payments and offsets.

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