Healthcare Systems

We provide complete billing services as well as customize services which to healthcare systems which include the following:

Insurance Verification Services

We ensure patients’ eligibility for insurance benefits and validate pre-authorization or referral requirements. After verification, we calculate deductible and co-payment amounts. Our services optimize cash flow, reimbursements, and insurance eligibility verification.

Demographics & Charge Entry Services

A critical stage in the billing process is charge entry, defining the payment amount for healthcare services. Patient Facesheet charges are accurately recorded in the patient’s account.

Precision in patient demographics entry is crucial, demanding a skilled team for error-free data input. Our healthcare billing services team ensures high-quality, accurate patient demographic and charge entry services.

Billing & Analysis

Our medical billing experts meticulously examine various patient file sources, including doctor’s transcriptions, diagnostic test reports, imaging reports, and other references, ensuring accurate verification of services rendered and assigning suitable codes.

Incorrect code submission can lead to continuous claim denials, underpayments, and a disrupted workflow. Such difficulties can result in unnecessary claim-related burdens and complex medical billing issues.

AR Follow-up Services

Following up on all accounts receivable instances can be a time-consuming and difficult effort. We pursue unpaid claims persistently to keep AR days to a minimum. Our accounts receivable management staff also ensures that refused and underpaid claims are appealed as soon as possible to guarantee that they are processed and reimbursed on time.

Collection Services & Denial Analysis

Claim denials can result in significant losses for companies; thus, they must keep track of them. Our healthcare systems collections services team determine the reason for denial, correct the errors, and resubmit the denied claims within timely filing limit.

If the claim is denied due to the lack of sufficient information, the gaps are addressed as soon as possible. Our healthcare system billing professionals and analysts can assist you in keeping track of denials, analyzing the cause of denials for improving the process, and reducing the number of denials.

Payment Posting

Payment posting is the first line of defense in recognizing payer issues. Denials for medical necessity, non-covered services, and prior authorization will be identified and assigned to appropriate team members to handle.

We look over ERAs and the scanned EOBs (Explanation of Benefits) to ensure that every detail about the payment is entered into the system. Following that, the data is appropriately updated into patient accounts.

Providers Credentialing

Provider credentialing is a vital stage in the revenue cycle and how a physician or provider gets associated with payers. The technique allows patients to use their insurance cards to pay for medical services consumed while also allowing the provider to get paid for the medical services provided.
Our billing team processes the faster payment by setting up ERA setup, gets more referrals, mitigates revenue leakage, reduces denial, and identifies the provider’s trend.

Out of network Negotiation

Our multi-layered balanced strategy dynamically saves the most for out of network claims. To achieve a streamlined approach, our out of network negotiation team insight easily integrates systems into current procedures.

To establish areas of substantial costs and adequate reimbursement, we use unique algorithms and comprehensive supplier databases. Our team works on each insurance plan claim and is working hard to achieve the maximum service reimbursement.