Medical Billing Services
Complete claim management from patient registration to final payment:
- Charge Entry & Claims Processing: Real-time eligibility verification, automated charge capture, intelligent claims scrubbing, electronic submission
- Payment Posting & Reconciliation: ERA/EFT processing automation, remittance advice matching, patient payment application
- Accounts Receivable Management: AR aging analysis, worklist prioritization, collections workflow optimization
- Technology Integration: API connectivity with major EHR vendors, real-time dashboard access, custom reporting capabilities
Benefits: 15-25% reduction in days in AR, 95%+ clean claims rate, 20-40% decrease in administrative costs
Denial Management
Our proven denial management framework turns denials into recoveries:
- Denial Analysis Framework: Categorization system (technical vs clinical, preventable vs non-preventable)
- Recovery Process: Automated denial identification, root cause determination, corrective action implementation
- Prevention Strategies: Pre-submission validation rules, real-time eligibility checks, documentation improvement recommendations
- Advanced Tools: Denial trend dashboards, recovery tracking reports, prevention recommendation engine
Results: 60-80% average recovery rate, 25-40% reduction in future denials, typical recovery timeframe: 30-60 days
Provider Credentialing
Fast, accurate provider credentialing services to accelerate revenue generation:
- Initial Setup: CAQH profile completion, primary source verification, license and DEA verification
- Enrollment Management: Insurance panel applications, PECOS/NPPES registrations, contract negotiation support
- Ongoing Maintenance: Re-credentialing reminders, license expiration monitoring, provider status change notifications
- Specialty Coverage: Primary Care, Cardiology, Orthopedics, Behavioral Health, Radiology, Surgery, Urgent Care, Telemedicine
Timelines: Initial credentialing: 60-90 days average, Re-credentialing: 30-45 days average, Emergency credentialing: 24-48 hours available
RCM Optimization
Maximize financial performance with our data-driven RCM improvement strategies:
- Workflow Analysis: Current state assessment, bottleneck identification, process improvement recommendations
- Performance Benchmarking: Industry comparison reports, key metric tracking, trend analysis and forecasting
- Technology Implementation: EHR integration optimization, automation tool selection, reporting dashboard setup
- Continuous Improvement: Regular performance monitoring, staff training programs, technology enhancements
Measurable Improvements: Reduced claim processing time by 40%, increased first-pass resolution rate to 90%+, decreased administrative costs by 25-35%, improved provider satisfaction scores
Specialty-Specific Solutions
Tailored billing solutions for different medical specialties:
Primary Care
Chronic care management billing, annual wellness visit optimization, panel management reporting, value-based care program support
Cardiology
Stress test and echocardiogram coding, cath lab procedure optimization, device implant tracking, cardiac rehab billing support
Orthopedics
Surgical procedure coding expertise, DME and brace billing integration, workers' compensation coordination, implant tracking
Behavioral Health
Mental health parity compliance, telehealth session billing, group therapy coding optimization, crisis intervention billing support
Hospitalist
Inpatient billing coordination, discharge summary optimization, concurrent review support, DRG coding expertise
Dental
Insurance verification specialization, treatment plan breakdown services, predetermination processing, collections strategy development