Our Revenue Cycle Management Services
Higher of $2,000/month or 6% of all Net Receipts
Our comprehensive Revenue Cycle Management (RCM) service is the backbone of your practice's financial health, ensuring an efficient and uninterrupted financial workflow. From the moment a patient encounter is recorded, we meticulously manage every step of the billing cycle.
By entrusting us with your RCM needs, you can focus on providing top-notch care to your patients, confident in the knowledge that the financial aspects of your practice are in expert hands. We aim to minimize financial disruptions and optimize revenue, allowing you to maintain and grow a thriving healthcare practice.
Daily Services
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Office Charges: Accurate coding and entry of CPT/Modifiers and Diagnosis through EHR or paper fee tickets.
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Payment Processing: Prompt entry of over-the-counter payments and meticulous claims edit to address rejections.
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Claims Submission: Efficient electronic claim submissions to clearinghouses and diligent management of any rejections.
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Payment Posting: Detailed processing and posting of payments from ERAs and EOBs, with appropriate adjustments and reason codes.
Regular Follow-Up Services
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Claims Management: Vigilant follow-up on all unpaid claims, including denials, zero-pays, and low payments, with an appeal and refiling system in place.
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Refunds and Credits: Weekly reviews of credit balances and prompt refund processing.
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Debt Management: Coordination with collection agencies and handling of COB denials.
Patient Financial Services
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Statements and Collections: Monthly patient statements and collection letters, with proactive communication for outstanding balances.
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Support Calls: Responsive handling of inbound and outbound patient calls regarding A/R and balance inquiries.
Meetings and Reporting
Monthly Financial Review
In-depth monthly financial and operations reports with scheduled reviews to discuss financial health and operational efficiency.
Weekly Operational Analysis
Regular meetings to evaluate operational processes and implement improvements.
Add-On Services and Prices
Credentialing Services
Maximize your practice's reach and revenue with our Credentialing Services.
Initiating with the Credentialing Panel, we offer a one-time service at a fee of $200 per provider per payer, handling all aspects of initial credentialing. This includes verification of qualifications, certifications, and ensuring compliance with payer requirements. To keep your credentials current and prevent any disruptions in payer relations, we provide Credentialing Maintenance for a monthly fee of $1,000. This ongoing service manages all aspects of credentialing, from renewals to updating provider information, safeguarding your practice's ability to serve a broad patient base and bill for your services without interruption.
Pricing:
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Initial Credentialing: $200/provider per payer
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Credentialing Maintenance: $1,000/month
Coding Services
Enhance your billing accuracy with our precision-driven Coding Services.
Our team of certified coders brings expertise to both electronic and paper-based systems, ensuring that your claims are accurately coded the first time. With a deep understanding of the latest coding updates and regulations, we provide services that reduce denials and improve revenue cycle efficiency. Our coding professionals stay abreast of changes in medical coding practices to ensure that your billing process is compliant and optimized for maximum reimbursement.
Pricing: 2% of all Net Receipts
Insurance Eligibility and Referral Authorizations
Streamline your billing process with our Insurance Eligibility and Referral Authorizations service.
Choose from our tiered Insurance Eligibility and Referral Authorization services tailored to meet the specific needs of your practice, ensuring all services are approved for payment by insurers and reducing administrative burdens for your patients.
Tier 1: Basic Eligibility Verification
Price: $2.00 per Check
Ideal for: Routine services in general medical practice.
Includes: Automated checks for standard coverage, co-pays, and deductibles for services like annual physicals, dental cleanings, and standard vision tests.
Tier 2: Standard Eligibility Verification
Price: $4.00 per Check
Ideal for: Specialist providers like dermatologists, obesity clinics, and other procedural based practices.
Includes: Manual verification for service-specific coverage and basic referral authorizations for procedures such as skin biopsies, chiropractic adjustments, and psychotherapy sessions.
Tier 3: Advanced Eligibility Verification
Price: $9.00 per Check
Ideal for: High-cost or complex care settings like surgery centers, oncology, or cardiology clinics.
Includes: Detailed analysis for out-of-network benefits and comprehensive referral authorizations needed for procedures like MRI scans, chemotherapy, cardiac tests, or surgeries.
Tier 4: Custom Eligibility Verification
Pricing: Custom Quote
Ideal for: Multi-specialty groups, international insurance, or experimental treatment providers.
Includes: Tailored eligibility verifications for complex situations, such as multi-payer coordination or non-standard treatments requiring specialized knowledge and extensive communication with payers.
Streamline your billing and enhance patient satisfaction with our structured eligibility verification services, designed to suit the unique demands of your practice and patient care services.