Medical Billing & A/R Follow-up Services
Get Paid Correctly the First Time
Our outsourced medical billing services and medical billers are the conduit between patients, physicians, and payers, facilitating the payment function between all three parties.
Efficient Billing Begins With Strong Financial Policies
Set yourself up for success before the patient encounter even starts.
A clear and transparent financial policy sets protocols for managing billing and insurance information, establishes reasonable charges for services, and helps patients understand their financial responsibilities, ultimately reducing conflict at the time of payment.
On the other hand, a poorly designed financial policy negatively impacts the patient experience and ends up costing a practice significant time and expense through uncollected fees, repeat statements, and sometimes even collections actions.
For this reason, we’ll review and update your Patient Financial Policies, including those related to your Collections, Small Balance & Refund Policy, to collect as much of the patient responsibility before billing begins.
To keep things running smoothly:
- We review your customary fee schedule annually for adequacy and fairness for all insurance carriers and as it relates to the No Surprise Bill Act for your patients with non-participating insurance coverage.
- We facilitate the set-up of reasonable payment plans for patients in accordance with your patient payment policies.
- We manage the collections process by alerting patients through Final Notices before referring accounts to your collection agent or attorney.
Clean Claims Keep Revenue Flowing
Insurance claims are always scrubbed and filed before release to the insurance claims clearinghouse.
Attention to detail throughout every step of this process is essential, and our decades of experience have made us excellent at noticing even small but potentially impactful issues.
Our Medical Billers ensure every claim is free of errors and fully compliant, speeding up accurate reimbursement.
For example:
- We verify that POS codes align with the type of care provided.
- We ensure up-to-date use of CPT-4, ICD-10, and Modifiers, including special requirements of third-party payers that may use substitute or HCPCS codes.
- We confirm that services are correctly grouped or bundled according to payer guidelines.
We post payments within two days of receipt, most through the use of electronic auto-post technology, while reviewing the payments for accuracy and proper application and reporting of funds.
Clean claims are even more critical for specialists because your billing involves particularly complex coding, higher-value claims, and stricter payer requirements.
Our expertise and continuing education promote efficient and accurate billing, which reduces denials, making follow-up in many cases unnecessary.
We’re not some spare-change-chasing billing and collections team bending over to pick up pennies in front of steamrollers; our extensive experience shows the best path to improving your revenue cycle is to make sure the coding is correct on the front end, with the claims then scrubbed and submitted timely and the A/R follow-up on the back end is dogged & effective.
Our expert Medical Billers are the backbone of revenue cycle management, ensuring payments are received according to insurance agreements while facilitating communication between patients, providers, and payers.
We actively manage your claims from charge entry to final resolution because physicians and medical providers deserve fair and accurate payment for their services.
We handle the appeal process for denied and underpaid claims, ensuring timely resubmissions through direct carrier calls or formal written appeals when necessary.
Our customized monthly, quarterly, and annual reports give you totally transparent visibility into the financial health of your practice.nials, making follow-up–in many cases–unnecessary.
Trust That Our Follow-Up Is Timely And Thorough
When we do need to follow-up on a claim, we’re prepared to support our submission.
We Stop The Slow Drip of Unbilled Opportunities
Your nagging feeling that you’re leaving money on the table might be right…
By auditing claims for accuracy and alignment with insurance policies, we help practices avoid missed revenue while maintaining the highest standards of compliance.
Our team meticulously reviews encounter notes, cross-referencing them with the corresponding codes to catch any legitimate services that may have been overlooked, ensuring that claims accurately reflect the care provided.
We closely examine procedure and diagnosis codes to confirm they align with the services rendered, applying the correct modifiers to prevent unnecessary denials and ensuring that all billable procedures are captured, verifying that all appropriate pre-authorizations, referrals, and medical necessity requirements are met.
We also ensure secondary payers are billed when applicable and confirm that follow-up visits, post-operative care outside global periods, and extended services are properly documented and submitted.
By regularly auditing claims for accuracy, we help practices avoid missing revenue opportunities while maintaining full compliance with payer requirements.
You Have Financial Goals.
We Help You Achieve Them.
Talk to us about meeting your practice’s financial goals with end-to-end RCM solutions.
