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.