Eligibility Verifications

Insurance / Eligibility verifications is a very important process in overall revenue cycle management. If verifications are not followed it usually results in billing errors, increased denials and delays claim payment affecting overall cash flow.

Our services provide individual payer eligibility and benefits on real time. We use various tools to receive our verification providing you accurate information on deductibles, co-pays, out of pocket expenses, coverage benefits etc.,

Our service helps you to collect up front co-pays from the patient during their visit to your office. This helps you increase your upfront collections saving your staff and billers time. Our report is accurate and gives you detailed necessary information.

Medical Coding

We provide full time, short term or backlog clearing coding services to various healthcare providers. Our flexible coding service guarantees excellent quality and accurate coding for all the services that has been performed and documented.

Our certified coders are assigned to work on your projects based on the specialty and their experience. All coding reports are processed and coded within 24 hours from the receipt of reports. Our coders use various manual and online tools for their coding.

Our Medical Coding Services provide cost effective, practical procedural and diagnostic coding. Our Coding process results in cleaner claims, fewer denials and enhanced revenue. Correct coding is essential in enhancing revenue and decreasing compliance risk.

We provide both off-line and on-line coding.

Offline Coding:
We receive reports through our secured FTP site and provide you with the report consisting of Patient Name, Date of Services, ICD & CPT codes with necessary modifiers.

Online Coding:
We access your medical records online through a secured VPN connection. We instantly code them directly into your billing software.

Demographics Registration

Our demographics registration process captures accurate patient, guarantor and insurance information.

Our process includes the following checks:

. New patient or existing patient
. If new patient, capture all required information
. Existing patient – Update latest insurance, patient and guarantor information
Our accurate data processing ensures clean claims and does reduce denials drastically.

Charge / Claim Entries
Our charge entry process captures all relevant claim information like

. Date of Service
. Billing Provider
. Referring Provider
. Place of Service
. Type of Service
. Admission Date
. Authorization Numbers
. Referral Numbers
. Procedure Codes
. Diagnosis Codes
. Modifiers
. Number of Units etc.,
Our team has the ability to do manual charge entry and to auto generate claims from EMR/EHRs after review.

Cash/Payment Posting
We process payments from ERAs (Electronic Remittance Advices) and manual EOBS (Explanation of Benefits. We balance all our payment batches, accounting to every dollar received. We apply appropriate payment, co-pays, deductibles and process write-offs based on the health plan and participating agreements.

We capture every denial including No pays & Low pays. Our denial management and AR team work these denials on daily basis to bring in claims resolution.

Our accurate payment posting ensures timely secondary insurance and patient balances billing. We process all payment batches with high quality and productivity.

Account Receivables Management

Account Receivables is a vital part of any business. Our expert billers keep a good track of all patient accounts. We follow up with insurance companies and patients in a timely manner ensuring good cash flow for our clients at all times.

Our experienced follow-up staff knows how to deal with various insurance companies. We have dedicated full time resources working on your outstanding accounts. This ensures maximized collections for you.

We use various follow up methodologies derived from our experience dealing with different payers. Our collectors keep up with ongoing payer processes and constantly changing rules.