Medical Billing

Patient Scheduling

The Appointment Scheduling service is offered to provide doctors a convenient way to book more patients on a consistent basis. Scheduling is done as per the requirements of the office which include working hours, total providers, procedure type, locations, etc… The actual appointments are scheduled directly into the provider’s Practice Management system. For patients that are “no shows” or have missed their appointments a reminder call can be given on a routine basis to reschedule their appointment with the office. Also recall lists generated based on certain medical conditions can also be used to schedule patient visits. Appointment reminders are done by calling patients at a set time before the scheduled visit.

Insurance Eligibility Verification

Insurance eligibility verification is the most important and the first step in the medical billing process. Researches confirm that most of the claims are denied or delayed due to inadequate or incorrect coverage information provided by the patients during visits and current coverage information not updated by the office / hospital staff. This directly boils down to lack of or improper insurance eligibility verification.

Insurance companies regularly make policy changes and updates in their health plans. Therefore, it is inevitable for the medical billing company or the provider to verify if the patient is covered under the new plan to help achieve maximum benefits of insurance eligibility verification. Confirming the insurance coverage facilitates acceptance of the claim on the first submission, whereas, non-verification leads to several discomforts like rework, decreased patient satisfaction and increased errors other than causing delays and denials.

Our insurance verification team does effective verification of insurance thereby aiding dramatic reduction of the clients’ accounts receivable cycle. We ensure that all the claims sent to the insurance companies are “clean claims”, and that there is no delay in payment. Our insurance eligibility verification services ensure that the maximum benefits are achieved and time is saved.

Medical Coding

Every time a patient receives professional health care in a physician’s office, hospital outpatient facility or ambulatory surgical center (ASC), the provider must document the services provided. The medical coder will abstract the information from the documentation, assign the appropriate codes, and create a claim to be paid, whether by a commercial payer, the patient, or CMS.

Accurate medical coding is essential to the healthcare industry. It is how claims for payment are reported for appropriate reimbursement of provided medically necessary services. Above and beyond that, the granulated, specific data contained in medical codes provides a picture of a given patient’s health history. When collected in aggregate, this information is used by actuaries to determine how to allocate capital for future healthcare needs. It is also used to steer incentives to specific programs that encourage quality of care that focus the healthcare industry on providing services that are considered to be of benefit to the general population.

Medical Billing

  • Patient Registration
  • Charge Posting
  • Claims Transmission
  • Payment Posting
  • Statement Processing

Denial Management

Our A\R and Denial Management Specialists receive extensive training in AR follow-up. Aggressive follow-up starts 21 days after claim submission.

Our Specialists are chosen for their analytical skills and are provided with access to all the documentation required to make sure that the claim is paid on the first call. E.g. When the Insurance rep says that the claim lacks authorization number, our Specialists are taught to immediately retrieve the authorization number from our database and fax it while they are still on the call.

Within 24 Hours on receipt of EOB Denied claims are worked on, rectified and resubmitted.

EOB is posted on the same day and All Denials which require additional documentation, are sent to the Doctor’s office.

We are well versed with using correct appeal procedures in knowing Healthcare Laws and we specialize in working on old Account Receivables.

Account Receivables

  • Insurance Follow-up
  • Patient Follow-up

Specialties

  • Radiation Therapy
  • Obstetrics
  • Ambulatory Surgical Centre
  • Orthopedics
  • Pathology
  • ENT
  • Family Practice
  • Pediatrics
  • Gastroenterology
  • General Surgery
  • Gynecology
  • Infectious Disease
  • Internal Medicine
  • Cardiology
  • Neurology
  • Physical Therapy
  • Psycho Therapy