Provider Credentialing/Enrollment
Enrollment of Physicians, Practice , Hospitals and Other Healthcare institutions specific to locations. Verification of Provider Professional Records are performed from our end before the enrollment with Health Insurance Plans
Eligibility and Benefit Validation
Verification of Patient’s Insurance accuracy and coverage determination are identified by our experts before the services are rendered. This enables provider to encourage clean claims, improve cash flow, minimize bad debts and timely follow up with patients if required
Authorization/Pre-certification
Our experts coordinate with payers to obtain approvals and pre-certification for certain procedures/inpatient admissions as per the Health Insurance guidelines. We ensure the approvals are obtained well in advance of the services scheduled for the patient
Demographic/Charge Entry
Proper Account Creation of Patients by capturing appropriate information and assignment of $ value as per the coding guidelines and appropriate fee schedule
Coding
We perform the proper assignment of codes based on illness, treatment, place of service as per the Coding guidelines before the claims are filed to the payers
Claim Submission
Timely claim submission electronically and manually via clearing houses or directly to payers, ensures the stabilization of Provider Revenue Cycle Operations
Accounts Receivable
Timely follow up on the claims submitted are practiced by our experts if there in no response from Payers; Standard Appeal process for the denials, to ensure the proper resolutions of claims
Reporting
We ensure regular reporting to our clients in the line of business undertaken with effective communication and strong support data to focus on relations, quality and plan of actions