Medical Coding

“Implement Modern tools, expert team – maximized revenue”

 

Accurate transformation of medical notes, diagnosis, procedures and equipment into alphanumeric codes along with corresponding modifiers result smooth medical billing reimbursement.

Healthcare reimbursement is becoming more and more challenging due to regulations, restrictions and limitations in place by Insurance companies. At Medicalbillingpros, our AAPC and AHIMA certified coders carefully follow the guidelines and procedures built from the most current and up-to-date industry standards, including:

 

CPT, ICD-10 and HCPCS coding both on the professional and facility charts

Insurance and governmental regulatory requirements

Payer-specific coding requirements

 

Services of coding for a glance

Updates on all coding in-sight and fee changes

Following CCI edits and LMRP standards for coding

Using appropriate Modifiers and PoS

Auditing codes

Our professionals result zero claims denied by the payor. That means both patient and physician receive the maximum reimbursement possible from the insurance company

Appointment Scheduling

“Discover the easiest way to keep your practice healthy”

Diligently managed and effective appointment scheduling is crucial for a healthy medical practice. Our professionals with expert knowledge in patient scheduling and insurance verification process will answer and remind your patients on their financial status well before they step in your office.

 

Your benefits

Reduce No Shows

Generates a healthy revenue cycle

Reduces Accounts Receivable staff hours

Streamlines cash collections by reducing write-offs and payment denials

Reduces unnecessary patient follow-ups, reminders and last minute appointment cancellations

Demographic Entry

“Avoid clerical errors to shorten reimbursement time Precise Patient, Physician and Pay or information captured is promising for a clean claim”

Our expert demographic entry teams obtain or validate all the basic information about a patient, physician and insurance. With years of experience our professionals are competent to reduce the number of claim rejection by providing as much of information possible well before the claim submission

 

Patient Information

Patient Employer Information

Patient Guarantor Information

Physician Information

Insurance Information

Charges Entry

“Specific Keys entered for a claim or bill determines the medical practice monthly revenue”

Our proficient charge-entry team plays a vital role by keying in the relevant charges for the codes passed through the coding and pre-coding department. Also, ensures that no up-billing done by assigning an incorrect charge for the codes. Our professionals does a commendable job by entering all the relevant information needed, and creates a claim ready for auditing, and then for transmission to the insurance company.

 

Charges are keyed in to the client’s medical billing system based on account specific rules

The pending or held documents are sent to the client for clarification, on a pre-determined schedule

Claim rejections and management

“Efficient clearing house management turn-on’s clean claim submission”

We designed a team to help our clients collect more money in less time. Our powerful team predominantly monitor all claims are first pass, eventually rejected claims are edited additionally based on the rejection reasons.

 

Reduce A/R days by correcting and resubmitting claims

Increase clean-claim rate with Medical Necessity and CCI Edits

Proof of timely Filing

Accounts Receivable

“Persistently managed Accounts receivable is the economic health of a medical practice”

Our expert Accounts receivable and Inventory tracking team with cutting technology reflects the growth of your practice. We know the time spent in accounts receivable phase of the revenue cycle should be tailored and that is what we do to increase your cash flow and reduce your outstanding claims. We have the expertise of best of breed technology and experienced professionals with excellent domain knowledge to understand what you need to manage your accounts receivables.

 

Our services include

Denial Management

AR analysis

Insurance follow-up

Self Pay follow-up

 

Professional on time reporting

Aging analysis

Procedure code analysis

Mixed pay or analysis

Cash collection analysis

Under payment analysis

Expected collection report

Accounts Reconciliations

“Even though it seems simple enough, Payment posting is an extremely essential feature of the revenue cycle”

Our team being aware of the sensitivity of this process understands that precise and effective payment posting process is essential for a healthcare office. Our payment posting team endeavors to provide clients with highly efficient and analytical services during the process. Our experts accurately carry out deposit functions and reconciling posting activities, we believe that streamlining the payment posting procedure is an effective way of improving our clients medical billing process particularly as the process affects many other Accounts Receivable functions of the practice. If applied accurately the process will go along providing a variety of benefits to the medical practice.

 

Key benefits

Exact payment posting, adjustments and denials helps analyze the revenue cycle better

Quickly identify reason for problems and resolve recurring problems

Primary payment posted correctly leads to accurate Secondary Payer Billing

Decrease in errors due to verification of all payments posted

Improved cash-flow & patient satisfaction helps handle new clients with ease

Denial Management

“Effective denial management is to prevent the same type of denials in future”

We realize a worthy denial management is not only gathering information, it is about systematical approach to gather more and more information to eliminate denials. Our stringent rule gathers lots of information and provides the feedback to provider and claims submission team to avoid the same denials in future.

Our professionals track every denied claim and can report this by payer, by procedure, by physician and by diagnosis. This same is presented in a manner that allows fast documentation of trends. With this powerful combination in hand, the Provider of medical service can then utilizes claim rules and edits that are specific enough to drive up the first pass claim and stop the pool of denied claims. Our proficient analysis described above also allows payers that are customary violators of clean claim rules to be identified and tracked. The gathered data and analysis will allow many opportunities for process improvements and revenue enhancement for the practice.

The above solution can optimize your medical billing and speed up your cash flow. As previously mentioned, our strong denial management solution can increase your collections by +30 percent or more

 

Explore increased cash flow

Categorize the root cause of denials

Support exact workflow priorities and forecast for follow up

Provide precise and timely statistics for Management and Clients

Track, Prioritize & Appeal denials

Avoid timely filing limit

Analyze the success of denial resolutions

Ascertain process improvements to avoid future denials

Patient Billing And Statements

“Crucial billing process to ensure medical bills gets well paid and zeroed out”

Huge insurance premiums – Higher deductibles, large co pays more co-insurance and insurance non covered services that are just not covered by most of the insurance careers, these leaves more patients to pay medical service balance to your practice.

Our dedicated professionals generate easy to understand patient statements based on your criteria, we never surprise patients. We will send out three patient statements, demand letter followed up with phone calls from our exclusive patient calling team as per guidelines. We provide your patients with the best possible customer service answering their questions, reading their EOB’s and coordinate with their insurance companies to get their claims resolved. Also, we work with your patients to set up a patient payment plans if needed and monitor the payments as per your criteria. We make sure all the payments are sent directly to your practice.

 

Key benefits

No more time consuming phone calls to your practice

Best possible customer service answering their questions

Continues flow of revenue from patients