We start by ensuring all patient demographics are captured accurately. Our team conducts real-time insurance eligibility checks prior to the visit, confirming coverage limits, copays, and deductibles to prevent front-end denials.
Once the patient encounter is complete, our AAPC/AHIMA certified coders translate medical reports into accurate ICD-10, CPT, and HCPCS codes. Charges are then meticulously entered into the system following specific payer guidelines.
Before any claim is submitted, it passes through our advanced scrubbing software. This identifies missing information, NCCI edits, and formatting errors. Clean claims are then electronically transmitted to the clearinghouse.
As payments come in via ERAs or paper EOBs, our team posts them accurately to the patient accounts. We reconcile actual payments against contracted fee schedules to ensure you are being paid what you deserve.
If a claim is denied, our denial management team immediately investigates the root cause, corrects the issue, and files an appeal. Simultaneously, our A/R analysts aggressively follow up on aging claims (30/60/90+ days) to recover outstanding revenue.
We provide comprehensive, transparent reporting on your practice's financial health. You receive custom dashboards detailing collections, denial trends, A/R aging, and provider productivity, empowering you to make data-driven decisions.