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Professional Medical Billing

Forming accurate medical billing for perfect revenue cycle management, along with providing cost-effective healthcare solutions

Health Care Industry has Transformed!

The Healthcare industry is booming at a very rapid pace. The population has grown rapidly, and nearly 68% of the general population has issues like chronic ailments and underlying health diseases. 

At first glance, it is natural to assume that doctors and nurses are the most important professionals running the show. It is quite an authentic assumption considering they provide treatment to the patients.

 However, as time has progressed, the functions of healthcare have advanced. Doctors and nurses are no longer running the only show. Many operations are running behind the main scenes. 

Medical Billing is Vital for Hospitals and Clinics

Medical billing professionals prepare billing claims and submit them to the insurance providers. Hospitals are no longer just treatment facilities. They also deal with many financial protocols for correctly providing patient care. Medical billing ensures that the hospitals, clinics, and healthcare facilities are reimbursed for the correct amount of services they provide. 

A proper professional in the field of medical billing ensures that the revenue cycle management is secured to ensure the smooth functioning of the medical offices. Suppose hospitals or clinics are not reimbursed for the services they offer. In that case, it is difficult for them to remain open, which is why professionals in medical billing who have an intelligent understanding of the insurance industries are needed for the hospitals. 

Cost-Effective and Reliable Solutions

Our healthcare solutions are quite cost-effective and reliable for the healthcare industry. Our professionals have spent over a decade working in this industry. By availing of our services, you can be ensured that you are dealing with healthcare professionals who have command over this field. We provide streamlined medical billing services, which greatly improve your cycle revenue management. That’s not all! We help you in sensitive matters like contractual compliance and regulations. 

Ensuring Smooth Payment Flow

Our professionals have the specialized knowledge of follow-up claims, claim denial resolutions, appeal submissions, posting payments, and collections management. We work to ensure that your payment flow is smooth and the revenue cycle remains unhindered. Our medical billers have sound knowledge of medical regulations, along with private and public insurance policies. 

Medical Coding

Experienced Medical Coders at Your Service for Transforming Your Operations and Helping to Improve Your Billing Accuracy 

Medical Coding

In the face of the blooming healthcare industry, the medical facilities are switching to more advanced systems that ensure high output and reduce all the orthodox systems. Amidst the transforming systems, the importance of medical coding cannot be overemphasized. 

Medical coding is utilized in a variety of Health Care centers. Their job requires them to work in physicians’ offices, hospitals, and clinics. Our professional medical coders are making a difference in the world of patient care by improving conventional procedures and maintaining a smooth flow of operations through their skills. The people working for us have robust command in their field.

Providing Effective Patient Care

Scouring patients’ data and leveraging it to find something useful is a skill. Medical coding is critical for efficient patient care because of its value. It delves deeper into the patient data from electronic records, lab results, medical notes, transcriptions, and medical assessments. 

The result is providing effective patient care in the form of demographic assessments, treatment outcomes, and the study of diseases.  Our medical coders know how to effectively extract information from data and use it for proper treatments. 

Accurate Billing Solutions

Medical coding often works in tandem with medical billing. The purpose is to use the medical data to devise correct billing reports for revenue cycle management. 

Our medical coders are adept at transcribing medical and clinical data for useful purposes. The clinical and diagnostic data is transformed into billing cycles and completion codes. The medical coders know which data is relevant and which is not. 

CPT and ICD Coding Experts

The world of medical coding is very vast. Across different healthcare processes, there are over 70,000 codes in the ICD- 1O standard alone. These codes are not the only ones of the healthcare standards. There are also many difficult codes Healthcare Common Procedure Coding System (HCPCS) level 2 and Current Procedural Terminology (CPT) codes. 

Skilled medical coders have perfect command over these codes used for various purposes. ICD describes illness, injury, or death. The CPT codes deal with radiology measurements, surgery procedures, and anesthesia. Skilled coders know the functionality of these codes and what functions they can be used for. 

 

Our medical coders excel in accurate transcribing CPT Codes, which are essential. They tell the payers what clinical procedures were performed, and ICD codes testify to it with a transcription of the diagnosis. These codes work together to make a robust payment claim. Our medical coders form the perfect alliance between the CPT and ICD coding experts and make it all work. 

Resolving Issues on Time

Removing errors and performing optimizations on time is an essential task. One of the most important tasks for medical coders is clearing the backlogs. Due to pending issues, these backlogs can remain pending. Clearing them is of utmost importance. Other than that, our medical coders clear all data logs and register everything right on time. The aim is to optimize everything to the best of your ability and ensure the peak performance of your systems.  

Medical Credentialing Services

Whether it is ensuring the quality of patient care, preventing loss of revenues from denied or delayed reimbursements, increasing the patient base, or simply delivering competitive patient care in the industry, our experienced team helps you with the necessary credentialing process.

Ensuring Quality Patient Care

Assurance of quality medical care remains an issue for the healthcare industry. It is very important to verify the practitioner’s claims of providing the required care to meet the patients’ demands and meet certain standards. 

Our team is always there for the process of credentialing and re-credentialing to ensure quality healthcare services. We offer services to ensure that the credentials of the acclaimed practitioner are accurate, which provides quality assurance in the healthcare field. The top physicians and medical professionals who have constantly shown competent skills are privileged to avail the quality service of the insurance companies. 

Maintaining Higher Patient Safety

Medical credentialing services ensure that the practitioners providing necessary healthcare services are qualified enough to do so. The process significantly reduces medical errors, which may sabotage a medical facility’s reputation. 

As a result, only qualified medical practitioners are deemed suitable for treating the patients. It often leads to the patients trusting their physicians or doctors more and allows them to become their providers. 

Increasing Patient Base

Increasing the patient base is one of the most important aspects of the service. By leveraging our medical credentialing services, you will ensure that only the most qualified and cream of the top medical professionals make it to your facility.

When only the top medical professionals inspect the patients and repeatedly show themselves to be competent healthcare practitioners, your patient base will increase. Patients will start placing more trust in the professionals who work at your healthcare facility. It will directly lead to an increase in revenues. 

The revenue stream will be boosted, and the profits will grow manifolds. When the patient base grows, the income will thrive and help build a proper reputation. 

Building a Proper Reputation

When your patients increase, and your healthcare center hires only professionals whose credentials have been verified, your facility will build a decent reputation. 

Increased patient satisfaction rates are directly linked to the boosted reputation of a healthcare center, along with an exponential upscaling of revenues. 

Prevention of Loss of Revenues

When the medical practitioners’ credentials are verified, insurance companies are more likely to offer them privileges. It promises a revenue stream. 

However, the opposite is, unfortunately, true as well. If a medical practitioner cannot provide proper credentials, the insurance companies don’t reimburse them. Nearly thousands or more dollars can be lost in unattainable revenues from the delayed or denied reimbursements. 

When a medical professional is verified during the credentialing process, the insurance payer can reimburse the healthcare practitioner to cover the treatments. It prevents loss of potential revenues. 

Denial Management Services

Flawless denial management for a healthy cash flow and efficient revenue cycle! Our denial claims follow-up services save your time and revenue.  

Ensuring a Healthy Cash flow

Denial management is very crucial for ensuring a healthy cash flow. It is one of the most important things to ensure that your revenue cycle doesn’t break. 

We work efficiently to stop such incidents in the future or to resolve the current issue as soon as possible. We are professionals who work to determine the causes of denial claims, foresee future risks, and facilitate quick turn-around payments as soon as possible. 

Proper Investigation of Underlying Causes

Denial claims are quite troublesome. Not only do they interrupt the flowing cycle of revenues, but they also hurt a facility’s reputation. They are some of the biggest hurdles in the way of healthcare reimbursement. Therefore, it is crucial that they are properly investigated and their underlying causes are identified. 

Generally, there are many causes for denial claims. Some of them are given below. 

  • Inaccurate billing 
  • Delayed claim submissions 
  • Duplicate claim submission 
  • Late submission 
  • Incorrect patient data 
  • Missing patient information 
  • Documentation error 
  • Pre-authorization error 
  • Services not covered under the insurance 
  • Poorly managed care contracts 

We investigate the unpaid claims, appeal the rejection appropriately, and identify any trends by the insurance carriers. 

Recovering Overdue Payments

We help all the healthcare facilities recover all the overdue payments that have gotten past their original time due to any complexities. 

Our team is always ready to help you receive overdue payments. You will get an entire team of professionals to address the claim follow-ups. Most of our operations result in a smooth recovery of all the overdue payments. With our services, your job as a healthcare provider becomes very easy. You will receive all your payments on time. 

Following All Claims

Our knowledgeable staff is always ready for all situations. We will extend our experience and help to help you follow up on a denial claim. However, on your end, you can take several steps to ensure you never lose any claim. While it is the conventional practice to follow the claims in paper form, it is far wiser to convert all those claims into electronic form so that it never gets lost. 

 

We help you follow up on a denial claim with proper corrections. You can send a new claim request with a few changes based on the proper denial reasons. Our team integrates proper practices for you to follow the claim and contact the insurance companies instead of waiting for the mail. 

You must take action first and follow the proper procedures instead of waiting on a chance. 

Recovery of Pending Claims

Your healthcare facilities may have a few pending claims that need more processing for information. Sometimes, the process is met with uncertain hindrances and delays, which result in difficulty in recovery. 

We make the process quicker and more efficient so that the claims are recovered for all information, and no pending claims remain on the list.