MEDICAL BILLING

98% First Pass Claim Acceptance

Our monthly first pass claim acceptance rate across all of our customers has consistently averaged 98% — 3% higher than the industry average!

Less than 10% Monthly Denials

Our monthly denial rate is less than 10% across all of our customers which is better than the industry average!

80% Electronic Submissions

Electronic submission helps us getting our customers paid faster. This function helps in fixing claims-related issues/denials faster as compare to paper submissions.

Clean Submission – Claim Scrubbing

Our state of the art claim scrubber has thousands of intelligently built rules. It automatically tries to fix most of the billing errors before submission.

Comprehensive Reporting

For staying on top of business we provide daily, weekly, monthly, quarterly & yearly practice analysis reports to our clients.

Fee Schedule Review / Analysis

We regularly review procedure fee plans to avoid any financial loss to our clients because of under billing and non-payable codes.

Denial Coding Audit

Our certified coders audit claims on a daily basis and suggest correct codes. In case of invalid coding we notify our clients immediately.

Patient Calls

We have a dedicated team for answering patient calls.

AR Follow-Up

We have billing professionals with a specialized skill-set for AR follow-up. We make sure that client’s AR is below MGMA standard in all buckets.

Weekly/Monthly Analysis

Our periodic reporting bundle will enable you in making more informed decisions for business improvements.

Out-of-Network Negotiations

Key to out-of-network billing is successful negotiations with insurances. We negotiate on client’s behalf for maximum reimbursement.

Out-of-Network Appeals

With our expert appeals team, we make sure that our clients are fully reimbursed. Our appeals framework is specially designed for out-of-network and Lab providers.

Check Forwarding Request

After claim submission we proactively send check forwarding request to out-of-network patients so that they may send the check to client as soon as they receives it from insurance.

Promised Money Details

We communicate with insurance companies and keep our out-of-network clients informed about promised money details

Out-of-Network Recoup Appeals

We send recoup appeals to recover the refund amount. We have a very high success rate.

CREDENTIALING AND ENROLLMENT

Credentialing:

We can handle any specialty including laboratories. Our experts send error free applications to insurances and do proper follow-up till the case is closed. Our first time application acceptance ratio is 95%.

Credentialing is the process by which the experience and qualifications of physicians and medical practices are evaluated and validated. Typically an objective evaluation that takes into account a practice’s licensing, education and training history, credentialing is critical for providers that wish to become part of a payer network. Providers must obtain credentialing to become part of a payer network. Without credentialing in place, a practice will be unable to provide care for patients covered by a particular insurance company. Provider credentialing is a verification of your experience, expertise, interest and willingness to provide medical care. Without successful credentialing, provider reimbursement for medical services can be delayed and, even, denied. The process of credentialing must be performed every time a new doctor is hired as well as recurrently afterwards to abide by the standards set by medical governing bodies and accreditation organizations. Medical credentialing can save your organization from many liabilities such as incompetent healthcare providers, risk of compliance violations, fiscal loss and unwanted lawsuits.

Enrollment:

EDI/ERA/EFT Setup We can assist you in setting up your EDI setups with insurance companies for electronic claims submissions, rejections, eligibility, payment information, denials and fund transfer. Re-validation we will make sure that our clients don’t miss timely re-validation that can result in delayed payments. Any change in address or TIN – we will update with insurance companies.

MEDICAL CODING

With an expert eye of our qualified coders we make sure that claims are error free.

AAPC Certified Coders

Our AAPC Certified Coders diligently follow the guidelines and procedures built from the most current and up-to-date industry standards, including:

  • CPT
  • ICD-9/10
  • HCPCS Coding

Coding Audits

Daily, monthly, quarterly and yearly audits are what distinguish us from rest working in the same space. For our clients we offer scheduled and on-demand coding audits without any cost

Cost Effectiveness

Using medical coding services is cost effective

ELIGIBILITY AND DEDUCTIBLE VERIFICATION

Insurance eligibility / deductible verification is the most important and the first step in the medical billing process. Insurance eligibility verification directly impacts the reimbursement. Insurance companies regularly make policy changes and updates in their health plans. Therefore, it is important for the medical billing company or the provider to verify if the patient is covered under the new plan to get maximum reimbursement. Confirming the insurance coverage facilitates acceptance of the claim on the first submission, whereas non-verification leads to several discomforts like rework, reduced patient satisfaction and increased errors other than causing delays and denials.

Verification process:

  • Verify patients’ insurance coverage with insurance by making calls to the payers and checking through their authorized online insurance portals.
  • Update the medical billing system with eligibility and verification details such as member ID, group ID, coverage period, co-pay, deductible, co-insurance and other code level benefits information including max allowed limits.

In case of issues regarding a patient’s eligibility, we inform the client immediately.
This process increase clients’ monthly revenue and reduce the rejections and denials.

TRANSCRIPTION

Matchless price is just one of the many reasons to choose us for your transcription service.

Highly Affordable Service Quality

Quality transcription combined with personalized 24/7 support and service. High quality at lowest possible rates is our aim.

High Accuracy

Quality assurance managers ensure each document exceeds 98.5% accuracy rating.

HIPAA Compliance

100% HIPAA compliance is our perpetual focus.