Virtual Assistant
Our virtual assistant service maximizes efficiency, reduces operational costs, and improves patient experience and our team works as an extension of your practice remotely and assist your administrative non-core tasks. With exceptional communication skills and knowledge of healthcare domain, our team adds true value to your practice.
- Handle inbound and outbound calls
- Patient coordination & support
- Front desk assistance
- Concierge service
- Data entry and management
Appointment Scheduling & Registration
An efficient appointment scheduling & registration process not only improves patient satisfaction but also ensures success of revenue cycle outcome. Through proper coordination, effective communication, and gathering relevant information, our team seamlessly schedules appointments to grow your practice.
- Proactive patient engagement
- Proper follow up with patients
- Quick response to reduce wait time
- Accuracy of patient data collection
- Entry of demographic and insurance details
Eligibility & Benefits Verification
Our eligibility & benefits verification process is optimized to ensure accuracy and correctness in eligibility data to ensure clean claims submission. Our verification process outcome ensures that the subsequent processes are performed seamlessly with accurate eligibility and benefits information.
- Confirm the patient’s eligibility for insurance benefits
- Determination of prior authorization and referral requirements
- Identify the primary and secondary payers
- Verify the patients' coverage, co-pays, co-insurance and deductibles
- Patient follow-up to seek any missing or incorrect information
Prior Authorization
Our prior authorization workflow covers payer specific authorization requirements and industry standard best practices to obtain prior auth approval on time. Our PA experts work meticulously to submit auth request, track status and follow-up with payers till closure and ensure in high level of efficiency in revenue cycle.
- Evaluate authorization requirement
- Collect all necessary medical documents and records
- Initiate authorization request
- Track status of auth request and follow up
- Submit additional information to the payer as required
Medical Coding
Our team of certified medical coders possesses knowledge and expertise in ICD-10 and CPT coding standards across multiple specialties. Our coding workflow ensures coding standardization and reduces coding errors to ensure appropriate reimbursements. Our code audit and review practice ensures compliance in coding.
- Collect all relevant medical records and encounter notes
- Assign correct ICD-10, CPT codes and Modifiers
- Code review & audit
- Documentation support
Charge Posting
Our charge posting service ensures that all services rendered to the patient are appropriately documented and billed. Our expert billers are detail oriented and have adequate knowledge of medical coding, reimbursement guidelines and compliance requirements to ensure appropriate reimbursements.
- Collect Superbills, charge tickets
- Enter patient demographics and claim service details
- Review of charges entered for accuracy
- Daily audit to identify missing charges, overbilling, etc
Claims Edit & Submission
We aim to submit clean claims first time to reduce rejections and denial rate. Our expert billers meticulously review the claims according to our best practices for claims scrubbing. After completion of data integrity audit, the claims are submitted to the payer through EDI gateway. Our team also handles clearing house rejections, if any at this stage.
- Claims Review & Edit
- Rejection Management
- Claims submission through EDI gateway
- Paper claims submission
Payment Posting
Our goal is to post payments accurately and give you a clear picture about payments and outstanding. Our expert billers work diligently to make correct payment adjustments and reconciliation and provide you a comprehensive report to reflect trends in reimbursement and cash flow, that gives you clarity on the state of your revenue cycle.
- Payment posting through ERA/EOB
- Posting of patient’s payments
- Posting of denials
- Write-off and adjustment
- Payment analysis and reporting
Denial & Appeals Management
Our denial and appeals management practice is built in deep understanding of revenue cycle management, reimbursement guidelines and payer specific requirements. Fully driven by data analytics and trend analysis, our denial management process aims to prevent and reduce denials to provide exceptional outcome to your revenue cycle.
- Identify and categorize denials
- Contact payers and patients for additional information
- Correct claims and submit appeals on time
- Tracking and follow-up with the payer for the appeal
- Denial trend analysis to prevent recurring denials
Accounts Receivable Management
Our accounts receivable management aims to reduce AR days and improve cash flow through structured workflow, AR queue management and analytics driven approach. Our expert AR associates have impeccable communication skills and thorough understanding of reimbursement guidelines to gather pertinent information from payers about claims and help in taking early measures for claims resolution.
- AR analysis and categorization
- Proactive follow-up with payers
- Tracking and monitoring of unpaid claims
- Clean up of old AR
- Reporting of AR based on performance metrics
Patient Collections
We understand that collection of patient’s outstanding is a sensitive task and we do not act as collection agents. Our courteous patient collection experts are properly trained to deal with the nuances of patient calls and maintain a healthy relationship with patients to pursue outstanding payments. We follow client’s guidelines and protocol while communicating with patients..
- Generate structured patient statement
- Offer flexible payment plans and mechanism
- Offer various payment options
- Track and follow up with patients methodically
- Communicate clearly and respectfully
Full Service RCM
Our full service RCM assures each and every task of your revenue cycle are carried out according to industry standard best practices, with deep understanding of healthcare landscape, regulatory requirements and payer specific reimbursement guidelines. Our analytics driven and quality first approach ensures appropriate and timely reimbursement to serve your practice grow.
- Eligibility & Benefits verification
- Prior Authorization
- Denial & Appeals management
- AR Follow-up
- Other RCM services