Claims are scrutinized ensuring maximized reimbursements without over-coding which is one of the ways we typically increase clients’ revenue by 10% – 20%. We maintain a nearly 100% success rate on first attempt HCFA and UB clearinghouse claims with WC (workers compensation) and NF (No Fault) available as well. We stay on top of all latest coding updates.
We make sure your AR experiences minimal denials. Our experts have extensive experience in overturning all types of denials, right from medical necessity denials, maximum benefits exhausted, additional documents required, coding related denials, patient benefit related denials, prior authorization issues, EDI issues, our team is adept at resolving and getting.
We have a separate appeals and reconsiderations team that works closely with the AR team. The team has both pre-set and customizable appeal formats for each and every type of denial. Extensive appeals including the right information, submitted timely can have a huge impact on overturning the most complicated denials effectively.
We make sure all your EOB’s ( Explanation of benefits ) and ERA’s ( Electronic remittance advice ) are posted and reconciled daily to ensure an accurate end of day statement for your staff to review and access average growth in revenue. We have a two tier quality system in place, ensuring all postings go through a level 1 and level 2 check before.
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15 years of RCM expertise, over 500 practices across the nation, a team of over 150 expert billers, pretty much taught us everything we needed to know about the most important facet of RCM – Denial Management.
Every time we took on a practice’s Billing, we made sure we set a target to reduce the denial percentage by a good 15-18% in the first quarter, and proud to say, we didn’t fail to achieve it even once. That is actually what gave birth to our credentialing & enrollment arm, because you cannot reduce a practice’s denials unless you handle their credentialing.
