This usually starts with us facilitating the creation of billable claims from your EHR encounter data. We’re not just pushing buttons but actually review your claims before submitting them to flag coding inconsistencies or other possible reasons a claim may deny such as making sure the necessary modifiers are in place. Once “scrubbed”, we submit your claims to the appropriate payer through a qualified clearinghouse and we monitor the acceptance and rejection reports to make sure your claims are accepted. We then track the claim status through the processing cycle. We proactively research unpaid claims to determine why the claim is unpaid and what needs to happen in order to get the claim paid. We then take the appropriate corrective action which varies depending on the payer and the denial reason. This can include submitting a corrected claim, generating and submitting appeals and redeterminations, etc. Naturally, we make sure secondary and tertiary claims are billed when applicable.

We also handle all patient balance billing. We send patient statements every month and we proactively make outbound reminder calls to patients who are late in paying their balance due. We also accept inbound calls from your patients and facilitate their billing inquiries. We’ll take their credit card payments over the phone and even run the transaction using your merchant services vendor. We even have a complimentary online patient payment portal and a 24/7/365 telephone IVR so your patients can literally make credit or debit card payments any time of day or night, every day of the year.

Most of our clients have their mail come directly to us. We process their in-the-mail credit card payments, we get any paper checks to their bank, and we preserve scanned copies of all documentation on a highly secure, HIPAA-compliant website to which you’ll have 24/7/365 access.