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Scheduling , Registration, and Insurance eligibility verification
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Problem Areas:
- Verification of Insurance Information
- Incorrect and Incomplete Information
Solutions Offered:
- Efficient scheduling
- Complete information collection
- Verifications (insurance and eligibility)
- Prior authorization.
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Medical Coding
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Problem Areas:
- Coding Compliance
- CCI Edits
- Certified Coders/trained staff
- Above and Under Coding
Solutions Offered:
- Periodic Compliance updates to Coders
- Periodic Correct Coding Initiative (CCI) and Local Coverage Determination (LCD) updates
- Experienced Certified Professional Coders (CPC & CPC-H)
- Relative Value Unit (RVU) based coding
- Accurate determination of procedure, diagnosis, and modifiers
- Post coding quality check
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Demographic Entry and Charge Posting, Electronic Claims Posting
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Problem Areas:
- Wrong insurance information entry
- Wrong new patient demographic entry
- Wrong/un-posted charges
- Duplicate posting of charges
Solutions Offered:
- Our certified staff ensures all the insurance and demographic information are captured accurately and efficiently
- We have a vast experience with all major players including but not limited to Medicare, Medicaid, BCBS, HMO and PPO plans etc
- Crosschecking for all wrong and duplicate posted charges, and reposting them if necessary
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Insurance Follow up
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Problem Areas:
- Time consuming
- No proper follow up
- No specialization around payer specific denials
- Having problem working on account receivables
Solutions Offered:
- Experienced staff
- Separate teams for different payers
- Separate teams working on 30-60, 60-90, 90-120 and 120 and more days of aging
- Aging report generated every month, and followed upon
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Self Payment Posting
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Problem Areas:
- Lack of trained staff
- Lack of auditing
- Lack of reconciliation
Solutions Offered:
- Experienced staff having experience on different medical billing software
- Accurate payment posting with 100% reconciliation
- Calculation of contractual adjustment
- Timely submission of claims to secondary and tertiary payers
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Denial Management , Patient Bill Generation and Patient Calls Care
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Problem Areas:
- Failure to collect co-pays, co-insurance, and deductibles
- Generating patient bills
- Handling patient calls regarding insurance queries
Solutions Offered:
- Large no of patient accounts representative
- Customized letters and followup process
- Timely generation of patient bills and doing payment posting for self pay
- Large no of courteous patient accounts representative to handle the patient calls regarding insurance queries
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Phone : 301.576.1497