How It Works

1. Patient Registration and Eligibility Verification
   We start at the beginning of the patient journey by ensuring accurate patient registration and verifying insurance eligibility. This reduces the likelihood of claim denials and keeps the billing process smooth and efficient.
2. Medical Coding and Charge Capture
   Our certified coders capture all billable services accurately, using compliant coding practices to ensure that claims are processed correctly. This helps prevent denials and maximizes reimbursement for the services rendered.
3. Claim Submission and Tracking
   Once coding is complete, we submit claims electronically and track their progress with payers. Our team monitors each claim to ensure timely processing and minimizes delays.
4. Denial Management and Appeals
   In cases where claims are denied, our dedicated team investigates the reason for denial, addresses issues promptly, and files appeals to recover revenue. We work diligently to resolve denials and keep your cash flow consistent.
5. Payment Posting and Reconciliation
   We post payments to patient accounts accurately, ensuring all reimbursements are accounted for and matched with the appropriate claims. Reconciliation ensures that your accounts receivable remain accurate and up-to-date.
6. Patient Billing and Collections
   For balances due, we handle patient billing and follow-up, ensuring transparency and professionalism in all interactions. Our patient billing services help to improve collection rates and enhance patient satisfaction.
7. Performance Reporting and Analysis
   We provide customized reporting that highlights key metrics such as reimbursement rates, denial trends, and revenue performance. This data-driven insight allows you to make informed financial decisions and improve practice efficiency.

Key Components of Revenue Cycle Management

1. Pre-Authorization and Eligibility Checks
   Verifying coverage and obtaining pre-authorizations before services are rendered reduces claim denials and improves the likelihood of reimbursement.
2. Accurate Medical Coding
   Our certified coders use accurate, up-to-date codes to represent services provided, reducing errors and ensuring that claims meet payer requirements for reimbursement.
3. Claims Submission and Tracking
   Submitting and tracking claims electronically expedites the billing process, reduces paperwork, and minimizes the risk of claims being lost or delayed.
4. Denial Resolution and Appeals
   Addressing denials quickly and filing necessary appeals helps to recover revenue that would otherwise be lost. Our team is proactive in resolving denials and minimizing their impact on cash flow.
5. Payment Posting and Reconciliation
   Automated payment posting and reconciliation ensure that every payment is applied accurately to patient accounts, providing a clear financial picture for your practice.
6. Patient Statements and Collections
   Transparent patient billing and collection efforts improve patient satisfaction while maximizing collections on balances due, enhancing overall revenue stability.
7. Data Analytics and Financial Reporting
   Regular performance reports provide insight into your revenue cycle’s health. These reports allow you to identify areas for improvement, track revenue trends, and optimize practice performance.
8. Continuous Process Improvement
   We continuously assess your revenue cycle processes to identify opportunities for increased efficiency, reduced delays, and maximized revenue capture.