• Dedicated Account Representative
  We assign a dedicated Account Representative to you to handle all aspects of your billing needs, entering charges, submitting claims, sending patient statements, following-up, and answering patient billing questions, and also function as the liaison between your practice and us. We will train your staff and educate them about all aspects of the billing process.

• Fee Schedule Review
  We will Assist in fee schedule review/updates annually (automated fee/profile schedule updates).
• Coding
  Providing assistance with CPT, ICD-9, and HCPCS coding to maximize reimbursement and minimize denials.
• Regulatory Requirements
• Advising physicians on any changes in HCFA requirements, CPT, and ICD-9, HCPCS coding to maximize their reimbursement.
• Assuring that all transactions are HIPAA-compliant.
• Billing
  Primary, secondary, tertiary insurance billing, electronic or on paper (including Worker's Comp).

Claims Follow-up and Collection

       Payer Follow-up

• Claims status –through online access of insurance carriers web portals
• Obtain & Update Insurance information from patients for filing claims
• Update the change in demographic details

       Re-filing claims

• Follow-up on low value accounts, resulting in receivable maximization
• Appealing claims
• Reporting and Follow-up on additional documents required by carriers for claim processing
• Denial Analysis
• Periodical Recommendations on analysis of the receivables and denials

      Self Pay Follow-up

• Calling Patients / Guarantors to recover the outstanding balances
• Process / Forward requests for itemized statements
• Follow-up / send statements for small value accounts

      Collections / Bad Debts Follow-up

• Aggressive follow-up with the guarantors – Outbound calls & initiating statements
• Obtain insurance information for filing of claims
• Transfer of balance to next responsible party

Full Accounting

• Post payments received to patient accounts (line item application allowing tracking of CPT reimbursement history).
• Post adjustments according to provider's Managed Care contract profiles, monitoring the profiles for reimbursement accuracy as outlined above.
• Statements
  Send monthly statements to patients and follow-up on non-payment by phone and mail (the patient billing cycle includes three statements)
• Soft collections, calling your patients with past due balances
• Reports
  Provide comprehensive monthly  reports that typically include a summary of charges, receipts, adjustments, and refunds by doctor and/or payer and/or practice location, payment summary and detail, aged receivables by patients, payers, and insurance by service date or dates posted. Submit and review the provider's monthly reports (a wide range of already-developed custom reports is available).