Fertility Clinic Billing

Master The Complexities Of Fertility Clinic Billing
& Improve Your Revenue

Elevate your Fertility Clinic’s billing With Expert Solutions

Fertility clinic billing involves a complex system of diagnoses and procedure codes for the services provided by fertility specialists and gynecologists. These specialists need to accurately report their services that justifies the reproductive and medical billing and coding. Treatments in these services can range from simple interventions such as fertility drugs to induce ovulation to more complicated functions such as artificial insemination or IUI sperm injections and in vitro fertilizations (IVF). Billing for these procedures requires a deep understanding of coding which is aligned with specific procedures. It also requires a comprehensive understanding of the payer-specific regulations and adequate clinical documentation.

We, at RCM Workshop, understand the importance of revenue cycle management and how it can impact the financial health of your practice. With years of experience in this field, we bring knowledge and expertise in coding that can help you navigate the nuances of fertility clinic billing. Our dedicated team is adept at verifying eligibility swiftly, identifying coding discrepancies, improving coding turnaround times, minimizing denials, and addressing underpayments. We give equal importance to every claim and track them till closure so that you get correct and timely reimbursement for your services.

Unbeatable Service, Quality & Price

ACCURACY
0 %
TURNAROUND TIME
< 0 Hours
COLLECTION
0 %
PRICE
Starting from $ 1100 /Month

Challenges

Challenges in Fertility Clinic Billing

Regulatory compliance: Fertility clinics must comply with several federal and state requirements including HIPAA, laboratory and diagnostic standards and ethical norms. The SART also maintains strict data reporting requirements like assisted reproductive cycles and IVF success rates. It can be challenging for the in-house team to adhere to compliance while overseeing the revenue cycle, resulting in delayed payments.

High overhead costs: Fertility clinics have quite large overhead expenditures including specialized equipment purchases or providing extensive training to new employees. When faced with large expenses and the prospect of delayed or denied payments, proper revenue cycle management can be difficult.

Insurance reimbursement variability: Fertility treatments are not usually covered by insurance and the extent of coverage can differ greatly based on one’s insurance plan. Navigating the complexities of reimbursements, acquiring prior authorization, and managing denials as well as appeals might be time-consuming and cumbersome for the providers, detracting them from delivering excellent patient care.

OUR PROCESS

Our Fertility Clinic Billing Workflow

At RCM Workshop, we are working with experienced and professional billers who are equipped to handle all your billing needs, ensuring timely and accurate payments for the services rendered. Our expert billers have extensive experience in fertility clinic billing intricacies to manage the entire revenue cycle of your practice. We ensure accuracy in all facets of fertility clinic billing, starting from insurance verification, obtaining prior authorization, managing denials and appeals, and AR follow-up to patient collection. Our impeccable quality services ensure minimized denial rates and enhanced revenue.

Our Fertility Clinic billing workflow is built on industry-standard RCM best practices and adheres to a defined process management framework, providing our clients with frequent updates on the results at each billing stage. Our analytics driven platform allows us for real-time monitoring, giving insights into key revenue cycle metrics such as days in AR, denial rate, and payment velocity. Our metrics driven reporting tool helps us to monitor our performance closely and identify bottlenecks that create hindrance in getting timely payments.

Scheduling & Registration

Carry out well-coordinated appointment scheduling, update insurance details and handle inbound and outbound calls from/to patients.

Eligibility & Benefits Verification

Confirm patients’ primary and secondary insurance and verify their benefits coverage, co-pays, co-insurance, and deductibles.

Prior Authorization

Initiate request for prior authorization with the payer, follow-up to check Auth status till closure and finally update the system with Auth approval reference number.

Medical Coding

Check accuracy of codes and modifier according to specialty and assign corresponding and appropriate charges to the codes.

Charge Posting

Document and enter the charges for the services provided to the patients into the billing system.

Claims Edits & Submission

Audit the claims thoroughly to check for accuracy and edit if necessary and submit claims – both EDI and paper format.

Payment Posting

Carry out both auto as well as manual posting for payments received and conduct reconciliation against claims.

Denial Management

Analyse and categorize denial claim according to denial codes, $ amount and payers, and resubmit claims after correction.

AR Management

Follow-up with payers to gather status for unpaid claims, and their resolution.

Patient Collection

Sending patient statements and follow-up with patients for final and outstanding payment.
You can confidently rely on us to manage your entire billing process, or you have the flexibility to select specific DME billing services that suit your needs, ensuring a seamless operation without any interruptions.

BENEFITS

Outcomes guaranteed

Outsourcing fertility clinic billing to us will ensure that your practice is at the forefront of regulatory and federal guidelines for ART procedures and infertility coverages, resulting in a much improved financial outcome for you. We use industry best practices that not only maximize revenue but also ensure steady cash flow and reduced overhead costs.

Efficient Benefits Verification

>99% clean claim submission

Efficient authorization management

<24 hours turn-around time

Efficient Coding and Code Review

Efficient processing for flawless financial records.

Efficient denial management

<5% claims denials

Proactive accounts receivable follow-up

<40 days AR & reduced aging

Better coordination & process optimization

improved patient satisfaction

WHY US?

Why partner with us

Partnering with RCM Workshop means entrusting your fertility clinic’s financial well-being to us. We focus on meticulous attention to detail, proactive management of the revenue cycle and utilization of technology to deliver unparalleled results for fertility clinics of all sizes. With our support, you can minimize administrative burdens, reduce claim denials, improve overall revenue capture, and stay compliant with the ever-changing regulatory landscape. Together, we can provide outstanding results that will stabilize your income streams and significantly enhance your billing process as a whole.

Guaranteed Improvement in Reimbursement and
Cash Flow

Reduction in Denials
and AR

Transparent reporting
– NO BLACK BOX

100% data security
& HIPAA compliance

On demand scale up
of operation

Significant Reduction
in Cost > 75% Savings

Simple & No
Cost transition

Flexible & Unbeatable
Pricing Plan