Our 11-Step Medical Management

Making you more. Faster. Easier.

All Of This For One Fee

We do it cheaper than our competitors and for less than you could in house.

Work Smarter With Us

 

Our 11-Step Medical Management Process gives you more time to focus on patient care and insures you receive optimal reimbursements. Our in-depth knowledge at every step of the process provides our clients with confidence to run their day-to-day operations while we handle their claims processing.

Step 1: Credentialing

It starts with you. We handle your provider enrollment. We also make sure your licenses are up to date. 

Step 2: Negotiating

You never have to negotiate with a provider again. We will maintain your contracts and re-negotiate them when it’s time. We also re-validate providers with carriers before expiration.

Step 3: Verifying

We save you time. We check your patient demographics and insurance eligibility online. Saving time. Increasing workflow. Making it easier. 

Step 4: Retrieving

We capture the charge. In 24 hours. 

Step 5: Claims Auditing

We use a 4 point in-house Audit Process:

  • Payor Guidelines
  • CCI Edits (Claims/Coding Audit)
  • Medics Elite Claim Scrub
  • Change Healthcare, WebMD, Advanced MD, IMSPro, and Centricity Clearing House Pre-Claims Submission Scrub

Step 6: Submitting

We upload charges every day to our Clearing Houses.

Step 7: Monitoring

We check and verify all electronic payments. We reconcile them to your Lockbox. And don’t worry about the underpayment of your contracts. We watch that too. 

Step 8: Re-filing

Twice? Three times? However many it takes. We mail all subsequent claims and keeping mailing them with eobs to your carriers.

Step 9: Contacting

We send statements monthly to your patients. If they have questions they call us - not you. If and when it’s time to go to collections we create the file and  implement your policies.

Step 10: Appealing

We handle your A/R follow up and deal with denials. We use carrier guideline to  quickly file appeals. We monitor all denials to track trends and then communicate with you about how to minimize them in the future.

Step 11: Reporting

Our customized billing reports are tailored to your practice. It’s data that’s meaningful to you - delivered every month to help make decisions going forward.