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.

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.

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!

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 collectables 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.

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.