Eligibility VerificationInsurance verification is very important part of medical billing. Wrong information impacts on entire patient billing leads to delay in payment and sometime denial for for late submission. We have a team for Insurance verification who instantly verify insurance eligibility, benefits and obtains all pertinent information required “ not only coverage confirmation, but what kind of coverage the patient has, what their deductible is, and how much has been applied. Having all necessary information updated generates more revenue and reduces administrative costs.
Revenue Cycle Management (RCM)Account Receivable process involves research and recovery of claims which have denied due to missing information or additional follow up required with the insurance company. It is imperative that the reason for denials are researched thoroughly to make sure the claim is processed without any additional denials as it impacts the AR ageing which further delays revenue realization.
Therefore it is important to track the effectiveness of the AR process by measuring the First Time Resolution of claims processed at AR . We reduce AR aging with FTR policy.
We perform below mentioned all activities.
1- Patient Registration
2- Pre Authorization Request and verification
3- Charge Posting / Super bill review
4- Evaluation of valid HCPCS codes 9-10, ICD and Modifier
5- Work on Edits of rejected electronic claims
6- Check clearing house reports (Emedeon, Availity)
7- Provider PIN calling ( for verifying provider TAX id, NPI and billing address)
8- EOB and check search via websites and batches
10-AR Follow up on denied claims via call or websites(FTR).
12-Collection / Refund