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Our Credentialing and Enrollment Services streamline this process, ensuring that your providers are enrolled with payers quickly and efficiently. We handle all aspects of credentialing, including application preparation, submission, and follow-up, so you can focus on patient care.
The RCM process begins with patient pre-registration, where we collect essential patient information, including personal details, insurance coverage, and medical history. This step ensures that all necessary data is available before the patient arrives, streamlining the check-in process and reducing wait times.
Accurate insurance verification is crucial to avoid claim denials. We verify the patient's insurance coverage and benefits before the appointment, ensuring that the services provided are covered and identifying any out-of-pocket costs the patient may incur.
During patient registration, we confirm and update the information collected during pre-registration. This step includes verifying patient identity, collecting co-pays, and ensuring all necessary consent forms are signed. Accurate registration is vital for smooth billing and claims processing.
Charge capture involves recording the services provided to the patient. Our team ensures that all billable services are accurately documented using the appropriate codes. This step is critical for generating accurate claims and maximizing revenue.
Once charges are captured, we prepare and submit claims to the appropriate insurance payers. Our team ensures that claims are complete, accurate, and compliant with payer requirements, reducing the likelihood of denials and delays.
Claim adjudication is the process by which insurance payers review and process submitted claims. We monitor the adjudication process closely, addressing any issues or discrepancies that may arise to ensure timely and accurate reimbursement.
After claims are adjudicated, payments from insurance payers and patients are posted to the appropriate accounts. Our team ensures that payments are accurately recorded, and any discrepancies are promptly addressed to maintain accurate financial records.
Denial management focuses on identifying, analyzing, and resolving denied claims. We investigate the reasons for denials, correct any errors, and resubmit claims as necessary. Our proactive approach helps minimize revenue loss and improve overall claim acceptance rates.
We provide comprehensive patient billing services, including generating and sending billing statements, offering multiple payment options, and addressing patient inquiries. Our goal is to ensure a clear and efficient billing process that enhances patient satisfaction and facilitates timely payments.
Our AR Recovery Services are designed to recover outstanding payments efficiently. We use advanced analytics and proven strategies to identify and resolve unpaid claims, improving your revenue cycle and reducing write-offs.
We provide detailed reports and analytics to give you insights into your practice's financial health. Our customized reports analyze key performance indicators, reimbursement trends, and claim denials, helping you make informed decisions and optimize your revenue cycle management.