Revenue Cycle Management is the process of managing your offices’ claims, payments and collections. The entire Revenue Cycle Management process includes a multitude of steps;
- Verifying Eligibility
- Checking benefits
- Obtaining Pre-Authorizations and referrals
- Collecting Co-pays
- Appropriate chart documentation
- Coding claims correctly
- Sending claims
- Tracking Claims
- Collecting payments
- Denied claim follow up
With proper revenue cycle processes and workflows in place, your office can increase payments while decreasing denied claims and potential write-offs. Medical Billing & Consulting has the tools and knowledge to help your office optimize its revenue cycle. Our services are directly related to optimizing your revenue cycle management and can be tailored to your specific needs.
- Demographic entry
- Review of CPT and ICD-10 codes to assure a clean claim submission
- Claim Submission, both EDI and paper claims
- Claim follow up
- Posting of all insurance and patient payments
- Patient statements and follow up phone calls
These services can also be added onto our Full-Service Medical Billing or can be utilized on an as need basis.
- Insurance contract review and analysis
- Consulting & Auditing
- Fee schedule analysis
- Medical record or coding specific audits
Medical Billing & Consulting provides physicians with complete credentialing services and can credential you with the insurance carriers and networks of your choice. We can also assist with credentialing as part of the hospital privileging process, as well as for the credentialing required by all insurance providers, including Medicare and Medicaid, prior to formalizing payor contracts.
The overwhelming task of completing applications, gathering and submitting licenses, certificates, tax forms, degrees and other documentation required to complete Credentialing Applications can be time consuming. We can help ease this process while you concentrate on providing care to your patients.
Along with the Medical Billing Services we offer Medical Coding Services, including CPT and ICD-10 Coding. These coding services can be included with the billing services or offered individually.
We also provide education for both staff and providers to select the appropriate code in order to maximize reimbursement.
Consulting & Auditing Services
Medical Billing & Consulting provides a number of consulting services that are customized to match the needs of your practice.
Medical Record Audits/Coding Audits
Training – This can include in-house billing staff, reception area, physicians, and all facility staff on medical billing, medical coding issues as well as proper methodology.
Our expertise is in the identification and implementation of problem areas in operations. We offer the following:
- Practice Assessments
- Benchmark Practice Comparisons
- Physician Practice Compliance Audits