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80% to 90% of a physician’s income is cycled through medical insurance companies. In today’s regulatory environment, many physicians struggle to keep up with the latest regulations and developments in Revenue Cycle Management (RCM). Consider these questions:

• Am I maximizing reimbursement for the patients I see?
• Do I have a professional coder to catch items that may not be billed?
• Am I over-coding, risking future audits?
• Are my staff members constantly behind in claim submissions?

If these questions resonate with you, it might be time to explore our services. By partnering with us, you can ensure daily data entry and claim submissions, prompt payment postings, and reduced staffing burdens.

Step 1: With your agreement, we will review your practice requirements.

Step 2: We will sign a mutually satisfactory agreement.

Step 3: Our tech support team will contact your office manager and IT staff to set everything up.

Step 4: We will collaborate with your existing billing company and staff to ensure ongoing claims are not disrupted.

Step 5: We will guide you through the crucial setup process to ensure a seamless transition.

Step 6: Throughout the transition, we will focus on preventing any disruption to your cash flow.

Once you sign the service agreement, we can begin immediately. Depending on your current situation, we will work closely with your existing billing company and/or office personnel to minimize any disruptions to your cash flow.

Yes. Unless the nonpayment is due to legitimate reasons, such as a deductible, capitation, lack of coverage, or duplicate invoicing, we can reprocess the claim without requiring additional information. Our team will reach out to your office if further information is necessary. If the claim remains unpaid, we will follow up with an appeal.

Our experienced team will thoroughly analyze the denial to determine its validity. If the denial is warranted, we will consult with your office to write it off. However, if it’s a valid claim denied due to a technicality, we will clarify the issue with your office and reprocess the claim. We will continue to work on each claim until it has been paid or we receive a reasonable response from the insurance carrier.

We provide a comprehensive suite of medical billing services, including claim submission, payment posting, accounts receivable management, denial management, and patient billing. Our goal is to streamline the billing process and enhance your revenue cycle efficiency.

We prioritize the confidentiality and security of your patient data by implementing strict data protection measures, including staff training on HIPAA compliance, regular audits, and secure data storage practices. Our protocols are designed to maintain the highest standards of patient privacy.

Our highly skilled professionals analyze the reason for non-payment. If the denial is valid, we consult with your office to write it off. If the claim is valid but denied due to a technicality, we will clarify it with your office and reprocess the claim. We appeal to insurance carriers and work diligently until each claim is resolved.

According to the OIG, common risk areas in medical coding include coding errors, misrepresentations, and system integrity issues. Our experience shows that frequent coding errors stem from:

                •             Assigning incorrect codes

                •             Sequencing codes improperly

                •             Linking codes incorrectly

                •             Modifying codes inaccurately

                •             Adding modifiers incorrectly

                •             Correcting codes inappropriately

                •             Changing codes without justification

Yes, we can integrate our services with your existing practice management software to ensure a seamless transition and streamline your billing processes. Our tech team will work closely with your IT staff to facilitate this integration.

We encourage open communication and welcome any questions or concerns. You can reach out to your dedicated account executive or our support team anytime. We are here to provide assistance and ensure your satisfaction.

We have a systematic approach to billing patient balances that includes clear communication of patient responsibility, timely invoicing, and follow-ups on outstanding balances. Our goal is to facilitate prompt payments while maintaining a positive patient experience.

We utilize various metrics to evaluate our billing processes, including claim submission rates, payment turnaround times, denial rates, and overall collections. Regular analysis of these metrics helps us identify areas for improvement and enhance our services.

We take data protection seriously. A non-disclosure agreement is signed with you and a separate one with our staff. We maintain strict security protocols, including firewalls, VPNs, password protection, and limited access to sensitive data. Additionally, we have fire-proof cabinets and offsite storage facilities for documents, and our systems are equipped with antivirus software. Access to our premises is restricted to authorized personnel only, and we have 24-hour security surveillance.

Yes, as our client, you will have the opportunity to meet with a member of our management team on a monthly basis, and you can request additional meetings as needed. During these meetings, we will provide an overview of your medical billing performance and identify opportunities for improvement based on our industry expertise.

Absolutely! We encourage interaction between your office staff and our team who will be responsible for collecting your receivables. We believe that building strong relationships enhances collaboration and communication.

We stay up-to-date with changes in insurance policies and regulations. Our team monitors industry updates and communicates any relevant changes to your office. We will also adjust our billing practices accordingly to ensure compliance and minimize disruptions.

We only recruit individuals with a Bachelor’s degree. For specialized projects like revenue cycle management, we also hire employees with Master’s degrees in fields such as Business Administration, Engineering, Statistics, Finance, English Literature, Communication, and Research.

Our staff undergoes comprehensive training tailored to their roles in medical billing and coding. This includes training in regulatory compliance with HIPAA and Medicare regulations, proficiency in billing software and EMR systems, coding guidelines (ICD-10, CPT, HCPCS), and customer service skills for effective patient interactions. Ongoing education sessions keep our team updated on industry changes and best practices.

We understand the importance of meeting client needs and maintaining open communication. If, on the rare occasion, you are unsatisfied with our service, you may cancel your contract with us at any time, giving us 90 days’ notice. We are committed to rectifying any issues promptly and efficiently.

To protect your data, we implement several security measures, including non-disclosure agreements, firewalls, VPNs, and restricted access to sensitive information. Our systems are secured with passwords, and we have fire-proof cabinets and offsite storage for documents. We also employ antivirus software and have a robust surveillance system in place.

Feel free to send this content to your team, and let me know if you need any further adjustments!