We scrub your data, making sure your claims are correct the first time. We don’t just click buttons – we review every claim for accuracy BEFORE they are submitted.
If you don’t have software or in-house staff to enter your patient demographics and sales orders, we can do that for you.
We post accurate payments daily to ensure the collections process continues to the next payer as quickly as possible.
We are here to assist staff in determining the appropriate HCPCS and/or ICD 10 codes based on payer/product.
Quick Denial Turnaround
We work payer denials daily. This process includes solving the denial at hand, as well as identifying recurring problems to prevent future denials.
We work rejections daily, identifying and resolving any system issues to prevent future rejections.
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Our staff can assist you with payer contracts, software conversions, price table configuration, EFT and EDI enrollment and more.
Revenue Cycle Management
Our concept for successful RCM is simply to get you paid fairly, consistently and quickly. To make this happen, we place emphasis on 6 key measures:
- Claims that are being held in your system
- Ongoing issues with payer contracts
- Days orders go unconfirmed
- Collection Ratios
- Denial Rates
- Aged Accounts Receivables
We can help you bridge the gap between Documentation and Revenue.
- Pre-screen review of documentation prior to provision of services – We will review your documentation to ensure all requirements have been met before you dispense the equipment.
- Additional Documentation Requests -we will collect all necessary documentation and respond to your ADR letters.
- Appeals – we will prepare appeals and track the appeal process for you.
- Education and Training – our staff is available to come to your location to provide training on topics you deem appropriate. On-site training is charged on a per day basis plus travel expenses. Online training is also available on a per hour basi
We offer support for your in-house staff, working with them to establish effectiveness and efficiency. We use a proven method to improve your revenue cycle.
- Identify and establish opportunities for proficiency and productivity
- Accuracy at the order entry stage
- utilizing the established eligibility criteria based on payer and medical necessity
- knowledge of payer/product rules prior to dispensing
- Integrate best practices
- Create workflow and accountability
- Create an effective line of communication between staff