Medical Billing services
We Focus On Your Collection, So You Can Remain Concentrated On Patients
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The Definitive Guide to Understanding Revenue Cycle Management
Finding it difficult to determine the eligibility of patients and their collections, and follow up on denied claims. Is it a cumbersome task to track and resolve tertiary tasks such as billing, collections, provider enrollment, revenue management, data analytics, etc. Revenue Cycle Management (RCM) is all you need. Revenue cycle management (RCM) is a term encompassing the financial side of healthcare. Healthcare is often thought of as a two-party arrangement, involving the patient and their insurance company. In this group of professionals who are involved with the patient from the start of their care to the very end when payment is made.RCM includes claim processing and denial management, patient payments, coding, billing, and revenue generation.
Our system can be set to automatically verify eligibility for all scheduled patients two-to-three days in advance in a batch mode and present you with a report. The VOB team checks the eligibility before claim creation to avoid rejection of claim denial from payer. We check eligibility online or by calling the payers. This provides assurance that the patient is still covered, the amount of their co-pay, co-insurance, deductibles, etc. Eligibility significantly reduces denials and thereby improves cash flow for the providers. In the absence of proper eligibility and benefit verification countless downstream problems are created as delayed payments, decreased patient satisfaction, increased errors, and delayed payment or non-payments.
At eClaim Solution, We have a team of billing specialist after reviewing the claims data provided by practitioners and generate a claim. While creating claim team ensures all procedures and diagnosis codes are captured from the medical records or superbills, and submit the claims as “Clean” before being submitted. Team also checks for the LCD / NCD guidelines for the diagnosis and procedures codes ensuring the faster reimbursement from payer and reduce the denials. Our specialist team validates all required information with coding specialists before submitting any claim Our Team completes the billing within the turnaround time, usually within 24 to 48 hours from the date of receipt superbills.
We focus on sending majorly claims through online submission for faster processing and scrubbing in the system as well as clearing house. Electronic claim submission results in faster payment processing and reducing the Insurance AR.
At eClaim Solution, our Payment posting team applies the payments, by reviewing the EOBs, ERAs, Virtual Credit Card payments in detail against the appropriate date of service for patient account. While applying payments we review, underpayments/overpayments which are immediately identified and necessary refund requests or credit payment accounts are shared with client for further course of action. Also the Denial analytics review the underpayments EOBs and work with payers. We also follow the payment reconciliation for understanding of payment credit and payment applied on provider’s account.
Secondary and Tertiary claims are automatically submitted when required. Patients are billed for any outstanding balances. We also send paper claims along with Primary EOB in-case of payer required primary payments information to adjudicate the claim.
Our Team performs all patient billing and follows up. Patient statements are sent one monthly, as indicated are as directed by client.
Our experienced customer service specialists will treat your patient with the upmost courtesy and respect. We will work with your patients to ensure unpaid balances are paid. Has a dedicated toll free number for customer service.
eClaim Solution ensures every patient has been billed correctly and timely, every procedure is accounted for and every dollar balanced, allowing you to get paid faster and maximizing the amount you are paid.
We at eClaim Solution, have a process of Denial and Appeal Management handled by a experienced analysts, they not only address denials but also study the denial patterns with analytics reports from practice management tools and EDI reports and educate the client in countering the denials and work with the payers aggressively to resolve these quickly. Our team identifies denials based on the payer, type of denial, reason for denial, the resolution and how to prevent the denial in future. Also tracking of denials that require appeals are done by the team and this helps our clients to avoid Timely filing for submitting medical necessity appeals within the standard timeline.
Every outstanding claim and/or denial gets immediate follow-up attention. Our specialists review, research, correct and reprocess denials also did you know that CMS rejects nearly 26% of all claims and up to 40% of those claims are never resubmitted? This can result in lost revenue of up to 10% per physician. However, with the proper revenue cycle processes and workflows in place, your office can increase payments while decreasing bad debt write-offs. AR Specialists do the follow-up on timely manner to avoid the situation of late filing.
eClaim Solution has various reports available with numerous sort modifications available to help you analyze your practice. Our customized summary reports with key performance indicators will help you make informed financial decisions for your practice. Dashboard reports provide you the live streaming data of your practice with increasing revenue for your practice.