Emergency Rooms

We offer comprehensive billing services and customized solutions for healthcare systems, covering the following areas:

1. Insurance Eligibility Verification Services: During this process, we ensure that patients are eligible for benefits under their insurance policy and verify whether pre-authorization or referrals are required. We calculate deductibles and co-payments to optimize cash flow, reimbursements, and insurance eligibility.

2. Demographics & Charge Entry Services: Charge entry, a critical step in the billing process, determines the payment amount for healthcare organizations. Our skilled team accurately enters patient FaceSheet charges into their accounts, ensuring high-quality and error-free demographic and charge entry services.

3. Billing & Analysis: Our medical billing team meticulously reviews various sources in a patient’s file to verify services performed and assign appropriate codes. Incorrect code submissions can lead to claim denials and underpayments, causing disruptions. We address these issues promptly to minimize claim-related burdens.

4. AR Follow-up Services: We diligently follow up on all accounts receivable instances, minimizing AR days. Our management staff ensures prompt appeal of refused and underpaid claims to guarantee timely processing and reimbursement.

5. Collection Services & Denial Analysis: Claim denials can result in significant losses, so we track and analyze them to correct errors promptly. Our team assists in improving processes and reducing denials by addressing gaps in information and appealing denied claims within filing limits.

6. Payment Posting: Payment posting is crucial for recognizing payer issues. We meticulously review ERAs and scanned EOBs to ensure accurate entry of payment details into the system and subsequent updating of patient accounts.

7. Providers Credentialing: Provider credentialing is a vital stage in the revenue cycle. Our billing team facilitates faster payments, sets up ERAs, increases referrals, reduces revenue leakage, and identifies provider trends.

8. Out of Network Negotiation: Our multi-layered strategy efficiently maximizes savings for out-of-network claims. Using unique algorithms and comprehensive databases, we negotiate with insurance plans to achieve optimal service reimbursement, integrating seamlessly into current procedures.