Healthcare Services
TOP TIER MEDICAL BILLING SERVICES
Outstanding understanding of the common concerns of medical providers and physicians.
Patient Registration
Basic information about the patient is collected and verified, establishing a profile within the billing system to streamline future interactions and claims processing.
Insurance Verification
This step confirms a patient's insurance coverage, ensuring services will be reimbursed by verifying the plan’s benefits, copayments, and deductibles before treatment.
Coding
Medical coders translate diagnoses, treatments, and procedures into standardized codes required by insurance providers, facilitating accurate claim submissions.
Charge Entry
This involves entering the correct medical billing codes and associated charges into the system, forming the basis of the claim.
Payment Posting
Payments received from insurance providers or patients are posted to each account, ensuring the account reflects accurate financials for services rendered.
Clearing House Rejections
Claims may be rejected by the clearinghouse due to errors or inconsistencies; this service identifies and corrects such issues to allow for successful resubmission.
Claim Transmission
The process of submitting claims to the insurance company or clearinghouse in the proper format to initiate payment processing.
Audit Quality Check
Claims undergo a detailed review to confirm accuracy and compliance, reducing the risk of denials or rejections by insurance providers.
Denials Management
When claims are denied by insurers, this service analyzes the reasons and takes corrective actions to appeal and resolve the denial, securing the payments due.
AR Recovery
Focusing on overdue or unpaid claims, this involves tracking and following up with insurers and patients to recover outstanding balances.
Patient Statement
Billing statements are generated and sent to patients, detailing their account charges, payments, and any remaining balance due.
Collections
When payments remain outstanding, collection processes are initiated to obtain the owed amount, following up with patients in a structured manner.
Referral Management
When claims are denied by insurers, this service analyzes the reasons and takes corrective actions to appeal and resolve the denial, securing the payments due.
Mission and Core Principles
Mission:
To serve as a comprehensive value services partner for medical providers, delivering top-quality services at the most competitive prices.
Core Principles:
We have collaborated with physicians, hospitals, laboratories, radiology centers, and facilities, prioritizing high quality, swift responses, and a customer-centric approach.
25+
Years Medical Experience
24/7
Services
Services Offered
A RCM company provides extensive support to U.S. healthcare organizations by supplying the personnel needed to process medical claims and submit them to insurance carriers for review and payment. We lead the industry in accomplishments, stability, and business excellence in key RCM services, including coding, charge posting, EOB/ERA posting, and accounts receivable management. Our experienced and seasoned team is capable of handling all specialties, offering 24/7 services to meet client service level agreements and quality standards.
- Scheduling and reminding appointments
- Verifying eligibility and benefits
- Phone assistance services
- Inbound and outbound referral coordination
- Authorization services for insurance, including medication, radiology, procedures, etc.
- Managing fax communications
- Providing support through email and chat Staff training tailored to client requirements and adaptable to any software platform.
Virtual Staffing Services
Revenue
Streamline your rounds with on-the-go patient documentation to see more people efficiently.
Compliance
We simplify the process for you to achieve Meaningful Use effortlessly. Quality - Employ trained virtual scribes to capture comprehensive patient narratives and reduce errors in the medical record
Time
Liberate yourself from the tedious reporting of patient encounters, enhancing your work-life balance.
Savings
Eliminate concerns about high salaries, employee benefits, sick days, and office space.
Distinctive Qualities
While many organizations provide similar services, our key distinction lies in the unmatched expertise and knowledge we offer. Our Senior Management Team brings over 15 years of experience managing medical practices and RCM organizations in both India and the U.S. The extensive knowledge we’ve gathered over the years is continuously passed on to our teams through constant engagement. Instead of being confined to offices, we actively interact with our teams on the floor, addressing their concerns.
We’re always ready to jump on calls to demonstrate how to handle complex situations with insurance representatives. Our approach goes beyond merely
processing claims and marking them as complete. We focus on teaching our teams to think critically and solve problems effectively. Our supervisors and managers have real-world, hands-on experience, which helps them understand and address the challenges their teams face. Through this practical guidance, they equip their teams to overcome obstacles and successfully complete their tasks. In most organizations, senior management is often hired from outside the industry. Their expertise lies in people management rather than process management within an RCM company. The focus tends to be on increasing productivity rather than improving resolution rates, frequently asking, ‘Why aren’t more claims being processed?’ Their goal is to boost margins, not collections. They might prefer handling 80 claims a day to show increased production in reports, even if only 10 claims are actually resolved. However,
it’s far more impactful when a team member resolves 40 claims a day.
In a broader sense, our success is closely tied to our ability to boost our clients' revenue. If they don't experience a revenue increase, dissatisfaction may follow. What distinguishes us is having a senior leader with extensive experience in Practice Management within large medical organizations. This deep expertise in healthcare law, contract negotiations, and compliance is a valuable asset that our clients greatly appreciate.
Virtual Staffing Services
- Assured Quality Assurance
- Thorough Application of Outsourcing Methodologies (Six Sigma Tools)
-
Profound Domain Expertise in
a. Healthcare IT Services b. Process re-engineering, migration, and delivery c. Regulation Compliance (HIPAA Compliance) - Strong and Expandable Infrastructure with an integrated security framework operating 24x7
Our Expertise
In-House Challenges
Offering in-house patient registration services can be financially taxing. Our team efficiently manages work queues and carefully processes each patient record.
Enhanced Accuracy
Increase productivity and precision, supported by guaranteed service standards for accuracy and turnaround time.
Process Optimization
Reduce claim denials and improve clean claim submission rates.
Quality Improvement
Enhancing the patient registration process improves first-pass rates and decreases claim denials.
Optimized Cash Flow
Accelerated cash flow naturally follows from streamlined patient registration processes.
Collaborative Teamwork
Our account management team works closely with you to improve the efficiency and effectiveness of the patient registration process, utilizing real- time portals, daily quality reports, and coordinated turnaround time updates.
