Our Process

Our top-quality services are designed to enrich your business by taking away the hassles and facilitating a smooth and efficient medical billing process. We meticulously manage every phase of the claims processing, to support an error-free and accurate outcome.

Pre-certification & Insurance Verification: 
We check the data from the doctor’s appointment diary, match it with the patient’s demographic profile and ascertain the eligibility through an online process - thereby reducing the chances of rejections.

Patient Demographic Entry: 
At this stage, our medical billing specialists scrutinize and enter the patient’s details, as provided at the time of the visit. This includes details like, patient’s name, date of birth, address for correspondence, insurance details, medical history, guarantor details, etc. In case of existing patients, records are validated on the practice management system; changes, if any, are updated.

CPT and ICD-9 Coding:
Our AAPC certified and highly qualified coding team has over two years of experience in multi-specialty coding, allowing us to accept superbills with diagnostic notes with or without ICD and CPT codes.
In case, the superbill is accompanied by the codes, our expert coding team, verifies and validates these codes to confirm that there are no glitches while ‘up-coding’ or ‘down-coding’, which may lead to unnecessary denials.

Charge Entry:
Our billing specialists make certain that once the fee schedules are pre- loaded into the practice management system, CPT and ICD-9 codes are entered into the system. Post this, they methodically confirm that the claim contains all the necessary details and is ready to be filed.

Claims Submission: 
We accept claims in both electronic as well as paper format. A senior billing expert scans your claim and scrutinizes it thoroughly. After the quality assurance process is complete, the claim is submitted. In case the claim is rejected, we obtain the report from the clearinghouse, incorporate the suggested changes and resubmit your claim.

Payment Posting: 
We maintain the integrity of your data by collating the electronic data and scanned EOBs with the bank data on a daily basis.

Account Receivables Follow-up:
The filing limits and the age of the claims are reviewed and prioritized as soon as they are entered into the system. A periodic follow-up with the insurance company, online and/or via phone/email, is carried out to get an updated status of the submitted claim.

Denial Management:
Our senior medical billing specialists carefully analyze the denials and partial payments. We contact the relevant individuals (payers, patients, providers, facilities and others) in case of denied/underpaid/pending/improperly processed claims. If the provider authorizes us to directly elicit data like the ID# from the patient, we directly contact them and update the COB (Coordination of benefits) with their insurance companies. In case of secondary paper claims, we process the necessary documents and send them to the client’s office for submission.

Reporting:
We customize your reports to suit your requirements.