• ICD-10 Coding:
Accurate diagnosis coding following the ICD-10 standards to
ensure
proper documentation and billing.
• CPT Coding:
Utilizing Current Procedural Terminology (CPT) codes for
documenting
medical procedures and services.
• HCPCS Coding:
Using the Healthcare Common Procedure Coding System (HCPCS) for
coding
services, procedures, and equipment not covered by CPT codes.
• Charge Entry:
Accurately entering charges for medical services provided, based on the documentation.
• Claims Submission:
Efficiently submitting claims to insurance companies and government payers, both electronically and via paper.
• Electronic and Paper Claims:
Handling claims submissions through electronic means or paper, depending on the payer’s requirements.
• Eligibility Verification:
Verifying patient insurance coverage and benefits before rendering services to ensure eligibility.
• Pre-Authorization:
Obtaining necessary pre-authorizations for specific procedures or treatments to avoid denials.
• Follow-Up on Denied Claims:
Identifying and correcting denied claims and resubmitting them for payment.
• Patient Billing and Statements:
Sending out bills and statements to patients for their financial responsibility.
• Collections:
Managing overdue accounts and pursuing outstanding payments to improve cash flow.
• Payment Posting:
Accurately applying payments to patient accounts to maintain up-to-date financial records.
• HIPAA Compliance:
Ensuring all practices comply with the Health Insurance Portability and Accountability Act (HIPAA) to protect patient privacy.
• OIG Compliance:
Adhering to Office of Inspector General (OIG) guidelines to prevent fraud and abuse.
• Regular Audits:
Conducting regular audits to ensure billing and coding accuracy and compliance.
• Revenue Cycle Consulting:
Analyzing and optimizing the revenue cycle to improve financial performance and operational efficiency.
i. Claim Management
ii. Patient Billing & Payments
iii. Revenue Cycle Analytics
iv. Compliance and Regulatory Support
v. Denial Management
vi. Patient Scheduling & Registration
vii. Integration with Electronic Health Records (EHR)
• Staff Training:
Providing training for medical office staff on billing and coding practices to enhance accuracy.
• Compliance Training:
Educating staff on compliance and regulatory requirements to ensure adherence to laws.
• Denial Analysis:
Analyzing the reasons for claim denials to identify trends and issues.
• OAppeals Processing:
Handling the appeals process for denied claims to increase the chances of payment.
• Denial Prevention:
Implementing strategies to prevent future denials and improve claim approval rates.
• Patient Billing Inquiries:
Handling patient questions and concerns regarding their bills to improve satisfaction.
• Payment Plans:
Setting up payment plans for patients to facilitate payment and reduce bad debt.
• Financial Reporting:
Providing detailed financial reports and analysis to offer insights into financial performance.
• Performance Metrics:
Monitoring key performance indicators (KPIs) for practice management to track progress.
• Custom Reports:
Generating custom reports based on specific needs and requirements.
• EHR/EMR Integration:
Integrating billing services with Electronic Health Records (EHR) or Electronic Medical Record (EMR) systems to streamline workflows.
• Practice Management Software:
Offering or integrating with practice management software to enhance efficiency.
• Patient Portals
Providing portals for patients to view their bills and make payments online.
• Anesthesiology Billing:
Specialized billing for anesthesiology service, considering the complexities of time units and modifiers.
• Radiology Billing:
Managing billing for radiology services, including the technical and professional components.
• Pathology Billing:
Handling pathology billing requirements to ensure accurate coding and billing.
• Mental Health Billing:
Specializing in billing for mental health services, including psychotherapy and psychiaric services.
• Durable Medical Equipment (DME) Billing:
Managing billing for medical equipment to ensure proper documentation and coding.
