Medical Billing & Coding

We Provide Comprehensive Range of Healthcare Back-office Support Services to Medical Billing Companies Medical billing companies have benefited by outsourcing following healthcare back-office support services to us:

Revenue Cycle Management

Our RCM services offer medical billing companies a commercially proven, comprehensive and purpose-built revenue cycle solutions that streamlines and automates critical business processes starting from registration to reconciliation. Our specialized team strive to streamline revenue flow, increase acceptance/denial ratios, enforce accurate policies, facilitate compliance with regulations, deploy time-sensitive bandwidth, go after underpayments, among others.

Medical Billing

We use a perfect mix of proven billing methodologies, effective control mechanisms and highly trained staff to obtain accurate, complete and timely payment from all third-party payers.

Here is the entire gamut of functions covered by our medical billing services:

• Assistance with provider enrolment
• Eligibility and benefit verification
• Fee schedule review and analysis
• Secondary insurance billing
• Authorization request and tracking
• Account receivables management
• Posting of insurance and patient payments
• Old account receivables recovery
• Charge entry for all specialties
• Electronic and paper claims submission
• Extensive insurance follow-up
• Patient statement processing and mailing
• Denial review and management
• Appeal of all denied or low paid claims

Medical Coding

Our back-office services remove the pain of medical coding and auditing for medical billing companies, allowing them to focus their attention on things that matter the most. We tap into the expertise of our team of  AAPC certified coders and carefully knit with streamlined processes and high-end technology to create a coding workflow that minimizes errors, accelerates operational process, and reduces impact on your bottom line.

AR Management and Follow Up

We reduce overheads, increase productivity, and resolve disputes by offering following Accounts Receivable services to medical billing companies:

• Review and record invoices
• Prepare and mail invoices
• Prepare accounts receivable aging report
• Prepare and deliver customer statements and notices
• Follow up with patients, if requested

Denial Management

Our denial management services increase payment recovery for clients and partners by augmenting process management, improving root cause analysis, and preventing denials:

Our denial management services include:

• Clinical Appeals Service
• Complex Denials Service
• Government Appeals Service
• Comprehensive Denials Management Program
• Payment Variance Program

Medical Claims Processing

We offer fully-fledged claim processing services for medical billing companies and this includes:

• Medical Claim Data Validation
• Medical Claim Data Entry
• Medical Claim Data Indexing / Extraction and Archiving
• Medical Claims Administration Support Services
• Provider and Member Data Maintenance and Cleansing
• Medical Claim-related Finance and Accounting BPO Services (Billing, Accounts Payable Management, etc.)
• Data Processing of all Medical Insurance Claim Forms, including UB-04, HCFA, CMS-1500, UB92, Dental Claims Forms

Medical Claims Adjudication

Our claims adjudication services will help you fight fraud, contain costs and increase productivity by helping you with the following:

• Adjudicating entitlement
• Analyzing validity of claims/fraud detection
• Spotting duplicate claims
• Computing valid claims amount
• Extricating “data components” from raw claims
• Establishing medical service provider type
• Validating data against adjudicating engine
• Committing fully adjudicated claims

Insurance Verification Service

Our comprehensive insurance verification services can help you with:

• Patient Insurance Authorization
• Insurance Pre-Authorization
• Patient Insurance Health Benefits Eligibility
• Healthcare Prior Authorization
• We Also Excel in Providing Associated Services Such as: