As we focus on quality, our billing services are reliable and will increase your revenue since we put a dedicated billing manager for your effective operations. We offer below services with affordable business model at ease.
1. Patient Demographic Entry:
As one erroneous data entry can lead to the rejection of all the claims of a patient so our data entry professionals assure the accuracy of each entry of the patient information resulting in the successful processing of claim.2. Insurance Eligibility Verification:
Eligibility for each patient for every date of service is verified from website, IVR or live call so that claim gets processed in right way. This also includes the verification of coordination of Benefits as well.3. CPT and ICD-9 Coding:
We are proficient in CPT & ICD usage which ensure the reimbursable completion of Charge as per LCD/NCD guideline. We continuously update ourselves regarding any coding changes (ICD & CPT changes/ specially HCPC codes updates) to avoid your revenue cycle delay.4. Charge Entry:
Our Medical Billing professionals will create appropriate medical claims/bills according to billing rules pertaining to specific carriers and locations. All medical claims are created within agreed turnaround times.5. Claims Review Before Submission:
A systematic audit and checking of the completed medical claims is performed at multiple levels before submission. The medical claims are checked for valid and complete information, correct procedure and diagnosis codes and actuality of all other relevant information about the patient since incomplete/incorrect information is one the single most common cause for denial of medical claims.6. Submission of Claims:
The complete audited claims are submitted to payers electronically/paper (with necessary documentations if required) in a timely fashion.7. Payment Posting:
Payments are posted by Electronic Remittance Advise/Explanation of Payments with high proficiency & denied claims forwarded to Follow-up Team for further processing. Payments are also reconciled on daily basis to have the actual picture of payments.8. Accounts Receivables Follow-up:
This involves the aggressive follow up by our professional Medical Billing team in taking the correct action against denial/pending claims for reimbursement. This includes the argumentation/negotiation with insurance representative to get the claims paid in full. Appeals are also processed in a case if a claim goes out of timely filing limit.9. Denial Analysis:
Expert billing professionals analyze the denials & list down their resolution to have proactive work to be practiced for future claims. This includes strong documentation & effective communication between the denial & charges teams. Charges team uses such guidelines for improved results.10. Effective Communication With Reports:
Work status reports are sent to the client's office on a daily basis. Other weekly, monthly, biannual & annual reports are also compiled to show progress of business. Beside these, a dedicated account manager will be calling you for the following;. Daily Routine Queries/Questions
. Weekly Progress Meeting
. Monthly Progress Analysis
. Biannual/Annual Reports
This is lengthy and tedious work. There are many payers to work with, so the huge paper work varies from payer to payer, requiring the repetitive of work as well. Also you have to follow up & finally you may have to re-credential.
Keep off this hassle & let us do all credentialing for you. When we do it you can rest assure it that it will be done both correctly & in timely fashion!
Credentialing Included but not limited to:
• Hospital Enrollment Services
• Practice Setup, TAX ID registration
• Medicare and Medicaid Enrollment
• Credentialing or Re-credentialing with commercial insurance, networks, workers comp and government plans
• Contracting for commercial insurance, networks, workers comp and government plans
• Fee Negotiation for commercial insurance, networks and workers comp
• CAQH Application (new or update)
• Individual NPI Application (new or update)
• Group NPI Application (new or update)
• State License, DEA, CDS, etc
• EDI Enrollment Setups for 837 and 835
• EFT Setup
• Insurance Web Portals Management
This is most challenging and integral part of revenue cycle management for a provider. Mostly practices with in-house billing are trapped with this problem as doctor staff has to work with patients, front desk, dealing with medical records and working for limited hours only.
At AdroitMB, we have developed a four tier step by step process to clean up the AR and get rid of it and get maximum reimbursements.
1. Denial Management:
While posting payments from EOB’s/ERA’s; all denials are fixed and proper action is taken using the remark codes guidelines on the EOB’s so this help a lot to minimize the AR as much as possible.
Our experts had drawn excellent workflows or denial resolutions.
2. Insurance Follow Up:
The major portion of AR is due to unattended claims which have not been responded by the insurance as well. Our calling staff takes great care of such claims right after the payment cycle of a specific claim.
This allows us to find out the actual reason at the right time for faster reimbursement of pending claims.
3. Appeals Management:
The claims with less reimbursement, authorization denials, medical necessity denials and medical record denials etc. are sent to appeals department for making the perfect appeals leaving no chance for insurances to deny reimbursements.
4. Patient Collections
Many practices do not follow up with patients for their co-insurances or deductibles applied by the insurances. This seems an extra work other than billing but certainly this can bring a great revenue stream to a practice.
At AdroitMB, we do follow up patients, by generating patient statements and then do follow up by making calls and sending them collection letters too.
So if you are not paid properly and having backlog of aging claims; you need our AR Management Services, Call us today to get these services.
Are you satisfied your biller efficiency or yours billing company performance? Do you feel some confusion and less reimbursement on your valuable services?
You must have audit once a year if you are having such questions. AdroitMB can surely give you “Practice Billing Audit Services” and let you know transparently the grey areas of your practice billing.
Not only this, we will show you reports will have detail meeting and will present you the resolution of the problems.
For more details, please email to info@adriot247.com or call (786) 633-1516