Revenue Cycle Management- What is covered?
Eligibility and demographic verification
Eligibility and demographic verification
Eligibility and demographic verification
Patient's insurance is checked to confirm validity.
New patients are added to the system.
Charge Entry
Eligibility and demographic verification
Eligibility and demographic verification
Generating claims within the system based on the superbill created by the medical coder. Correct claim creation directly impacts revenue.
Claim submission and Rejections
Eligibility and demographic verification
Claim submission and Rejections
Claims are sent out electronically to payers and any claim that is rejected is worked upon. This impacts the clean claim ratio.
Payment Posting
Account receivable and Denial Management
Claim submission and Rejections
Details of payment from payers are entered within the system. any denials are captured and tagged appropriately.
Account receivable and Denial Management
Account receivable and Denial Management
Account receivable and Denial Management
Unpaid claims are followed up and the exact status is documented. Anything that causes delay in claim payment is addressed thereby directly impacting revenue. Claims that are denied are worked upon and all the necessary steps are taken that enables us to overturn the denial.
Patient Billing Queries
Account receivable and Denial Management
Account receivable and Denial Management
Patients reach out to the clinic via phones to get clarity on the statements that they have received.