Claims Submission/Payment Posting

  • Claim Creation
  • Quick Electronic Submission of Claims
  • Immediate Claim Error Identification
  • Line Item Payment Posting
  • Identifying Underpaid Claims
  • Secondary Insurance Billing
  • Identify and Return Overpayments

 

Patient Collections

  • Timely Patient Statements
  • Incoming Patient Collection Calls
  • Soft Collections

 

Denial & AR Management

  • Timely Denial Management
  • Appeals
  • Average Days in AR <45

 

Monthly Custom Reporting

  • KPI Dashboard Report
  • Accounts Receivable
  • Payment Analysis
  • Referral Analysis

 

Workflow Processes & Procedures

  • Evaluation of Charge Capture Process
  • Evaluation of Charge Capture Tools
  • ICD and CPT Code Analysis
  • Fee Schedule Review and Analysis

 

Contracting & Credentialing 

  • Credentialing with all Payors
  • Contracting and Rate Negotiation

 

Compliance Plan & Policies

  • Compliance Risk Analysis
  • Compliance Plan
  • Compliance Policies & Procedures
  • Fraud & Abuse Education (Mandatory)
  • OIG/GSA Sanction Screening
  • Ongoing Auditing & Monitoring
  • Corrective Action & Education

 

HIPAA Policies & Education

  • HIPAA Privacy & Security Risk Analysis
  • HIPAA Policies and Procedures
  • HIPAA Education
  • Monitoring Compliance with HIPAA

 

Meaningful Use & PQRS- Now MIPS

  • Assistance with Understanding MIPS
  • Assistance with Compliance to Avoid Penalties
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