Credentialing and Profiling
Our team provides contracting and payer credentialing services allowing our providers to broaden their payer and patient network base
Authorizations
Our quality assurance specialist obtains and submits prior authorizations to determine covered services as well as verifying patient medical necessity
Patient Demographics Entry
Our team creates patient accounts in our clearinghouse system which allows us to update accounting records with new payments, balances, and customer information
Verification of Benefits
We verify patient benefits and eligibility which allows our providers to stay up to date with patients accurate and most current insurance policies as well as any non covered services that maybe needed
Claim Submission
Our billing team submits claims to payers, identifies and corrects billing errors, verifies that all services are billable with the required information needed along with resolving any clearinghouse rejections within the claims timely filing requirements.
Claim Audits and Denial Management
Our team stays up to date with payer’s common denials and trends, as well as providing solutions for error issues as it relates to pre payments of claims.
Account Receivables
Our claims specialist follows up and reviews all outstanding and unpaid accounts allowing us to keep track of revenue, any denied claims, and patients delinquent accounts.
Patient Balance Reports
Our A/R department verifies insurance payments and patient unpaid balances in our clearinghouse system which allows us to keep track of generated revenue as well as create monthly income reports to track progress.
A/R Aging Reports
Our AR department creates reports allowing our providers to keep track of all unpaid accounts.
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