BILLING
Our specialists review the charts, notes and dental claims for accuracy. This process ensures that claims are clean and will significantly increase first-pass payments and reduce claim denials. Our high-level accuracy results in a 97.5% first pass clean claim ratio. We also scrub the patient ledger for any previous balances.
The Vital Component
Medical billing is the cornerstone of the healthcare revenue cycle. This process involves generating healthcare claims to submit to insurance companies for payment. A medical biller plays an important role in optimizing revenue performance for physician practices or healthcare organizations by navigating between patients, healthcare providers, and insurance companies.
Collecting Necessary Information
Medical billers first collect the necessary information required to generate a claim. This includes patient demographics, medical history, insurance coverage, and the services or procedures received by the patient. With this information in hand, billers then review the patient’s medical chart and insurance plan to verify the coverage of services.
Generating Claims
The next step in the medical billing cycle is to generate a claim, check for accuracy, and submit it to the payers. The medical billing cycle comprises several steps that can take anywhere from a few days to several months. Accurate billing and timely follow-up are critical to the success of the process.
The Cost of Errors
Errors occurring at any stage in the billing cycle can prove costly in terms of revenue and administrative workload. To prevent these errors, it is important for billers to be diligent and attentive to detail, as the financial health of physician practices and healthcare organizations, such as hospitals, health systems, and surgery centers, depends on the effectiveness of front-end and back-end billing staff.
Medical billing and coding are essential components of the healthcare revenue cycle. They play a crucial role in optimizing revenue performance and ensuring the financial health of physician practices and healthcare organizations. The importance of accurate and timely billing cannot be overstated, as errors at any stage in the process can have significant consequences.
ACTIVITY DESCRIPTION
- • Set complete / not complete daily chart audit
- • Claim Generation
- • Claim Batching
- • Claim Submission
- • Providing Office Manager with daily Claim Submission Report
KEY DELIVERABLE
- • Review of charts
- • Claim level review and submission
- • Quality Check and Approval
- • Creation and submission of ‘Claim Submission Report’