Medical Billing Services

1. Patient Demographics Entry

Accurate patient demographic information is the foundation of successful billing. Our team meticulously enters and verifies patient details, ensuring that all information is accurate and up-to-date. This reduces the likelihood of claim denials and delays.

2. Insurance Eligibility and Benefits Verification

Understanding a patient’s insurance coverage is essential before providing services. We perform thorough insurance eligibility and benefits verification to ensure that you’re aware of the patient’s coverage details. This helps in avoiding claim rejections and ensures that patients are aware of their financial responsibilities.

3. Charge Entry

Our charge entry services ensure that all services rendered are accurately captured and billed. We understand the importance of timely and precise charge entry in the billing process. Our team is experienced in handling charge entry for various specialties, ensuring that every procedure, service, or item is billed correctly.

4. Claims Scrubbing and Submission

Before submitting claims to payers, we conduct a thorough review to ensure that all claims are clean and free of errors. Our claims scrubbing process includes checking for coding accuracy, correct patient and insurance information, and compliance with payer-specific requirements. This reduces the risk of claim denials and accelerates the payment process.

5. Clearinghouse Rejections Management

We work closely with clearinghouses to manage electronic claim submissions. Our team monitors the submission process, addresses any rejections promptly, and ensures that claims are processed efficiently. We also handle paper claim submissions for payers that require it.

6. Payment Posting (EOB, ERA, and Patient Payments)

Accurate payment posting is critical for maintaining a clear financial picture of your practice. We handle the posting of payments from Explanation of Benefits (EOBs), Electronic Remittance Advices (ERAs), and patient payments. Our team ensures that payments are posted correctly, and any discrepancies are promptly addressed.

7. Accounts Receivable (A/R) Management

Effective A/R management is key to maintaining cash flow. Our team follows up on outstanding claims, works on denials, and ensures that your accounts receivable are kept at a manageable level. We provide regular reports on A/R status and work diligently to resolve any issues that may arise.

8. Denial Management and Appeals

Denials are a significant challenge in medical billing. Our denial management services focus on identifying the root causes of denials and implementing strategies to prevent them in the future. We also handle the appeals process, working to overturn denied claims and recover revenue that might otherwise be lost.

9. Patient Billing and Statements

Clear and accurate patient billing is essential for maintaining good patient relationships. We generate and send out patient statements, ensuring that they are easy to understand and accurate. Our team also handles patient inquiries regarding their bills and provides assistance with payment plans if needed.

10. Credentialing Services

Credentialing is a critical step in ensuring that your practice can bill and receive payments from insurance companies. Our credentialing services help you navigate the complex process of becoming an in-network provider. We handle the paperwork, follow up with payers, and ensure that your credentialing process is completed smoothly.

11. Compliance and Auditing

We provide ongoing compliance monitoring and auditing services to ensure that your billing processes adhere to all relevant regulations. Our audits help identify potential areas of risk, allowing you to address issues before they become problems.

12. Revenue Cycle Reporting

Understanding your practice’s financial performance is essential for growth. We provide comprehensive revenue cycle reports that give you insights into key metrics such as charge entry, claim submission, payment posting, and accounts receivable. Our reports are customized to your needs and provide actionable insights to help you improve your financial outcomes.

13. Telehealth Billing Services

With the growing adoption of telehealth services, accurate and compliant billing for virtual visits is more important than ever. Our telehealth billing services ensure that your telehealth claims are submitted correctly, maximizing reimbursement while adhering to payer-specific guidelines.

14. Training and Support

We believe in empowering your team with the knowledge and tools they need to succeed. Our training services cover all aspects of medical billing and RCM, ensuring that your staff is up-to-date on the latest best practices. We also provide ongoing support to address any issues that may arise.

15. Consulting Services

In addition to our billing services, we offer consulting services to help you optimize your practice’s financial performance. Whether you need help with workflow optimization, staff training, or implementing new technology, our experts are here to guide you