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Leading Revenue Cycle Management

Real-time Transparency

Provider
Credentialing

Appointment
Scheduling

Prior Eligibility & Deductible/Copay Verification

Preauthorization

Medical Coding
& Auditing

Charge
posting

Payment
posting

Denials Management & Account Receivable

Patient Statement Processing & Patient
Call Center

Provider Credentialing

  • Hasslefree applications submission
  • Enrollment with major payers in the state and maximizing network participation.
  • Regular followup and track of applications
  • Data management with complete PHI
  • CAQH Attestations
  • Peer to Peer Discussion for fast Approvals
  • Weekly follow up and update on the application status
  • EDI Enrollments through different softwares.
  • Add on Payer additions
  • Provider credentialing and contracting negotiations
  • Monitoring Provider reputation
  • NPI Creation and Maintenance
  • EFT implementation
  • CAQH Creation and attestation
  • Commercial & Government payer participation and maintenance

Appointment Scheduling

  • All the calls to the Clinic will go through our dedicated and experienced Call Center team.
  • Our Team will handle the entire scheduling part as well as support to the patients related to their Clinical and billing concerns.
  • 24×7 coverage
  • Call center email support

Prior Eligibility & Deductible/Copay Verification

  • Our Dedicated and experienced eligibility team will perform Eligibility for each patient before 48 hours of actual appointments.
  • All the Copay/Coinsurance/Deductible information provided to the front desk in advance to increase your Clinic cash flow.
  • Past due balances information to the front desk to reduce statement work and reduce patient AR.

Preauthorization

  • Entire Schedule will be audited 72 hours before the appointments and necessary authorization will be obtained by our dedicated team.
  • Peer to Peer solution with the complicated commercial payers.

Medical Coding & Auditing

  • Our team of Certified Professional Medical Coders will audit each and every encounter to meet compliance.
  • Quality Coding will be provided by our team for maximum reimbursement.
  • Fully compliant charts will be done along with Medical Necessity.
  • Regular internal audits to meet the practice goals.

Charge posting

  • Error free Charges will be processed within 24 hours of actual encounter.
  • Quality review by our experienced billers before claim filing to insurances.
  • Real time Clearing house rejections analysis and resolution.

Payment posting

  • Our Dedicated payment processing team is going to process daily EFT payments by reconciliation with the bank deposits.
  • Daily check deposits will be reconciled and processed through the system.
  • Patient payments and front desk deposits processing with quality for accurate patient ledger.

Denials Management & Account Receivable

  • EDI rejections will be worked on a real time basis.
  • Our AR team works within 24 hours on every denial received.
  • Each claim aged more than 30 days is worked to confirm the claim status if not paid in 1st cycle.
  • Our experienced Account Receivable team will make sure that no aging bucket exceed more than 4%

Patient Statement Processing & Patient Call Center

  • Account balances are maintained to reflect the accurate statements.
  • Patient statements are processed on the daily/weekly/monthly scheduling.