Eligibility Verification & Prior Authorization

Verifying patient insurance eligibility and obtaining prior authorization from insurance companies. 

Patient Demographics Entry

Accurately entering patient demographic information, including personal details, insurance information, and contact information. 

Medical Coding & Audit

Ensuring proper medical coding of diagnoses, procedures, and services for accurate billing and compliance. Conducting audits to improve coding accuracy. 

Charge Entry

Recording charges for medical services rendered to ensure accurate billing. 

Claim Submission

Submitting error-free insurance claims, managing work edits, and resubmitting rejected claims after corrections. 

Payment Posting Services

Posting payments received from insurance companies, patients, and other sources. Reconciling payments and updating financial records. 

Account Receivables Follow-up

Following up on unpaid or partially paid claims, identifying reasons for non-payment, and taking actions to resolve outstanding balances. 

Denial Management

Managing denied claims, identifying reasons for denials, appealing when necessary, and working to secure reimbursement. 

Coding Denial Management

Managing coding-related denials, reviewing coding guidelines, addressing errors, and appealing denials for proper reimbursement. 

Credit Balance Services

Managing credit balances on patient accounts, adjusting or refunding overpayments or excess payments. 

Patient Statement Generation

Generating patient statements with details of services rendered, insurance payments, and patient responsibilities for payment collection. 

Revenue Cycle Analytics

Providing analytical insights into the revenue cycle, identifying areas for improvement, monitoring key performance indicators, and optimizing revenue generation. 

Provider Enrollment & Credentialing

Assisting healthcare providers in enrolling with insurance networks and completing the credentialing process for eligibility to bill and receive insurance payments