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We specialize in personalized billing and revenue cycle management solutions, ensuring error-free claims and boosting revenue by up to 20%. Our expert team delivers transparency, efficiency, and consistent improvement for your practice's success.
Precede to service being performed by the Healcare provider, This step is crucial for ensuring that healthcare providers receive.
We verify Patient’s detailed benfits such as deductable, co-pay & any limitations in benefits. Also determine weather the patient has multiple plans for any differnt purpose.
We initatie the prior-authorization request & continuosly get follow-up with payers before the treatment is received by the patient. We do also take care of that, the provider can deliever service to the patient without any fear of non-payment.
At the time of billing we do review the patient record to determine the medical tests, diagnosis & treatment which is received. Additionally, we take care of CPT codes, HCPCS Codes & ICD-10 CM Standardized codes of the treatment which is received by the patient. Furthermore, we also include LCD Guidelines, Place Of Service (POS), & Facility where services are rendered during the billing process. Over & above that, we also identify & correct the errors prior to submitting the claims to payer which helps to reduce claims, denials & lower turnaround time on accounts receivables.
It helps to provide financial overview and visblility into aa revenue process. Our team helps to provide overview of payments from insurance and patient according to the EOB. All paymets received will be posted within 24 hrs. For the payers who do not have electronic remitance (ERAs), our team manually post the insurane payments onto the patients account with the matching of respective allowed amount for each charge to ensure that all payments receievd are posteed we compare bank depostis with the total payment posted in the PMS. Any patient responsiblity such as deductables, copay, coinsurance & other patient responsiblity remaining unpaid charges will be file to the secondary insurance as per the coordination of benefits. We also notify to the patient of their dues via patient’s statement which are generated on monthly basis. Before generating statements, we thoroughly review the patient’s account balance is correct and are billable for the liable patient’s responsibility.
We supply complete denial management services that focus on reducing denials, identifying trands, and taking proactive measures to reduce future denials. We provide an end to end denial management process aimed at reducing denials by upto 35 to 50%. We identify the denied claims and investigate the root cause of it and take corrective and effective actions to correct deficiencies. We have expetize in appeals and refiling claims.
Firstly, our account receivable and denial management works to collect payments from the patient or insurance. Getting 100% reimbursement from any of the payers is tough as they give several reasons to deny the payments. This denials drastically affects cashflow, and the aeging of claims keeps growing. Our AR team tracks all the unpaid claims and takes appropriate actions to get a reimbursement for the billed procedures by sending appeal or submitting medical records. Our main goal is to resolve denail or unpaid claim to convert into as payment. We also compares expected and actual collections, understand the cause of loss and according to reason we takes corrective measures to recover the difference. In first stage we analyse of all outstanding receivables will be performed whenever a new client joins us and we tack corrective action to recover revenue from claims filed prior to the client joins Harmony Healthcare MBS. Furthermore our account receivable team check the unpaid claim are processed using a priority session based method with high value claims and claims approaching the insurance timely filing limits are given top priority. Our main goal is to resolve denail soon and convert that denial into a payemt.
All claims will be created and submitted electronically or on paper in accordance with payer standards. To avoid any claim losses, the insurer's acknowledgment of claim receipt will be confirmed. Any potential Errors arising from the transmission, whether at the gateway or the insurance clearinghouse, will be addressed and resent within 24 hours, except in cases of clinical discrepancies.
Are you seeking a method to track and enhance the effectiveness of your medical billing provider? Our performance reports for practices provide a simple and affordable method to monitor and assess your provider's performance. Our reports are customized to suit your clinic's particular requirements and feature analytics on claim submissions, denial percentages, payment statuses, and additional details. You can also establish personalized objectives and performance targets to guarantee responsibility from your provider. Our reports offer thorough insights into potential areas for improvement, emphasizing any points of concern. With our practice performance reports, you can trust that your provider is not only meeting but also surpassing your expectations.
1: Insurance / Clearinghouse Credentialing We have a dedicated team that focuses on healthcare insurance enrollment and credentialing. Our primary goal is to eradicate mistakes, anticipate possible challenges, and prevent setbacks in getting you on the insurance roster of a participating provider while making sure you remain up to date. *** ensures the protection and confidentiality of provider data. 2: NPI Registry We assist doctors in acquiring NPIs. Any holdup in acquiring an NPI threatens practice cash flow, and **** is dedicated to ensuring that NPI-related delays do not adversely affect your practice.
1: Auditing / Compliance * Assess medical records for completeness and accuracy * Assess documentation accuracy * Assess compliance with respect to coding and billing * Enhance revenue * Discover lost revenue * Look for coding irregularities 2: Medical Billing Analysis * Review of entire billing process, including software * Coding practices and billing methodology * Unbilled charges and services * AR characteristics and type of denials * Revenue flow and A/R recovery * Dead AR recovery * Ageing review 3: Coding Analysis * ICD-10, CPT-4 and HCPCS coding * Modifiers usage * Under-coding E/M visits or vice versa * CCI and NCCI Edits * Accurate, ethical and compliant coding 4: Collection Analysis * Contracted amount vs. payment collected * Drugs P&L Analysis * Underpaid and undervalued charges * Contract negotiation * Out of Network payment analysis and negotiation