Services
Medical Billers and Coders.com is dedicated to the healthcare administrative services
that help physicians to streamline their practices. Our Billers can take care of
your end to end Medical Billing requirements services or can also support your practice
where the practice is overloaded.
Our billers provide services across:
a) Charge Entry
b)Payment Posting
c) Account
receivable
d) Denial Management
& Appeals
e) Physician Credentialing
The skill to provide these services has come with years of hands on experience and
dealing with government and commercial payers on a daily basis. They also leverage
their existing relationships to get your practice paid faster.
The local attention and customer satisfaction will truly give you the level of service
you are looking for.
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.
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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 nuances
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.
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Money waiting to be collected is revenue loss!
Our billers believe that accuracy of the claim and the time spent on retrieving
the payment are key points in optimized revenue collections. 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!
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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.
Billers in our association 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
- Worker's compensation
- Medicare
- Medicaid
- Attorneys
Denial claims also require "Appeals" – Appeals are requests and explanation of the
claim sent earlier and conditions on which the claim now is again eligible for payment.
Some appeals are time sensitive. Our Billers review your most commonly denied claims,
prioritizing both for volume and dollar value and file them in a timely manner.
Considering the cost of appealing claims (both in terms of time and money) also
helps our billers decide whether they must appeal the claim at all. So they will
not appeal every claim but know the fact that many practices lose great sums of
income every year because they don't appeal denied claims.
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Starting a new practice? Then you definitely need Medical Billers who are experts
in setting up practices or getting Physicians credentialed with various payers.
Our Medical Billers and Coders have been in the business of billing for so long
that they are trained on getting physicians introduced to new networks and payers,
some of them can also expedite the process of credentialing with government agencies.
These Billers are well versed with the process as well as right party contacts to
connect for the best credentialing offers. They are well aware of the market offering
of each payer and thus try to negotiate the best rates for your practices. Generally
these Billers can draw up the average fee charged by other specialists in your community
and consult with you about the fee charged by your practice.
Payer Contract Evaluations & Renegotiation –
Payer contracting, evaluation and renegotiations is very critical to every practice,
yet many practices only setup their contracts one time and allow them to automatically
renew without any negotiations.
Healthcare Providers, now more than ever before, need to do everything in their
power to collect and keep as much of their revenue as possible.Most offices has
never renegotiated their contracts and very few actually renegotiate them on an
annual basis. This simple fact means that practices are missing out on additional
revenue that can be substantial and greatly impact the practice. If interested in
learning what renegotiating your contracts could mean to your bottom line please
use the contact form on this page to receive some quick assistance.
Our billers will assist you to evaluate and renegotiate payer's contract which will
provide you quantifiable results that directly impact your bottom line.
Annual Credentialing Maintenance
Nurse Practitioner & Physician Assistant credentialing – Having new Nurse Practitioners
and Assistants but not being able to bill for them, surely affects your revenue
cycle. Getting them credentialed in time can save you a lot of trouble and revenue
loss. Our billers are experts in handling this, so let them handle it and you can
concentrate in your practice.
Medicare Enrollment Services – Most services would charge you the
most to get you enrolled with Medicare due to the complexity and time involved in
getting credentialed with Medicare, These billers are aware of the steps to enroll
a physician for the Medicare Program which will make your job easy.
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