1. End-to-End Revenue Cycle Management

• Patient Registration & Eligibility Verification: We ensure accurate patient registration and real-time verification of insurance eligibility to avoid billing errors and claim denials.
• Claims Submission & Follow-Up: We handle the complete claims submission process, ensuring claims are submitted accurately and promptly to payers, and follow up to ensure timely reimbursement.
• Payment Posting & Collections: We ensure that payments are posted accurately and work on collections for unpaid balances, improving the financial health of your practice.

2. Medical Billing and Coding

• Accurate Coding: Our team of expert coders ensures correct ICD-10, CPT, and HCPCS codes are used, reducing the risk of denials and ensuring timely reimbursements.
• Up-to-Date Coding Practices: We stay up-to-date with the latest coding guidelines and regulatory requirements to ensure compliance and accuracy in coding.
• Specialty-Specific Coding: Our billing solutions cater to a wide range of specialties, offering precise coding tailored to your practice's needs.

3. Claims Denial Management

• Claims Tracking & Monitoring: We track claims from submission to payment, ensuring that no claims are left unprocessed and identifying any potential denials early.
• Denial Resolution & Appeals: We address claim denials by providing detailed analysis, timely appeals, and proactive solutions to maximize reimbursement.
• Root Cause Analysis: We perform root cause analysis to identify recurring denial issues and provide long-term solutions to prevent future claim denials.

4. Payer & Insurance Relations

• Insurance Contracting & Negotiation: We assist in negotiating favorable payer contracts and ensure the terms align with your financial goals and operational needs.
• Compliance with Payer Guidelines: We ensure your practice meets payer-specific rules and documentation requirements to reduce the risk of claim rejections and denials.
• Multi-Payer Support: We manage claims from a wide range of insurance providers, including government programs (Medicare, Medicaid) and private payers.

5. Financial Reporting & Analytics

• Revenue Cycle Dashboards: We provide real-time dashboards and performance tracking to help your practice understand key financial metrics and make informed decisions.
• Detailed Reporting: Our in-depth financial reports provide insights into cash flow, aging reports, claims denials, and more to help you manage your practice’s revenue cycle effectively.
• KPIs & Metrics Tracking: We track key performance indicators (KPIs) such as days in accounts receivable (AR), claim rejection rates, and reimbursement rates to ensure your practice is financially healthy.

6. Compliance & Security

• HIPAA Compliance: We ensure full compliance with HIPAA regulations to safeguard patient data and protect the confidentiality of your practice’s information.
• Regulatory Updates: Our team stays updated with changing regulations in healthcare billing and insurance policies to keep your practice in compliance.
• Audit Support: We provide assistance with both internal and external audits to ensure all revenue cycle processes are transparent and accurate.