Full chart accountability, reconciliation, and reporting transparency allow billing every chart for every patient. Exceptional ICD10 and CPT coding accuracy with timely automated workflow, clean claim submission, and electronic payment interfaces with all major commercial and governmental payers assure appropriate compensation for your services. When payers choose not to pay, our effective A/R management demands timely responses to payment denials, delays, and downcodes with precise reasons for appeals. The payer then knows precisely why their failure to pay is wrong. We demonstrate that you won't settle for less than the right reimbursement.
You can only get paid timely and accurately if you have the correct insurance coverage information. Our discovery process uses multiple commercial databases to verify the patient's identity and sources of coverage that the hospital did not know. We even find commercial coverage and get payments on patients who display only Medicaid.
Most billing companies do not know how to do the work to find secondary coverages when two payers might be involved with the patient. So we use advanced technology and specialized services to discover these payers to achieve full payment after the first payer exhausts coverage.
The No Surprise Act requires particular actions from emergency providers and billers to preserve your rights to proper payment. If you do not meet those requirements precisely, you may lose your right to fair payment. For example, payers require that the biller exhaust all of their administrative appeals before you can make further collection demands when OON payers behave badly. In addition, we know payer out-of-network practices, and we make that extra effort using data to prove inadequate reimbursement. Knowing the details in the law and regulations keeps you compliant. It allows us to find the rules that support optimal payment, in some cases even obtaining more than you were getting on similar claims before the law went into effect.
High deductible plans, large co-pays, and lack of insurance coverage make the patient the predominant payer of physician services. But collecting from patients is not improved simply by billing, calling, or sending them to a web portal. Instead, we bring compliant SMS texting technology that makes patient payments much easier and faster than ever. Often 20 percent of all self-pay payments are completed within ten days of the text notification, even before a patient statement is sent. No other patient billing process can produce such a timely response. Overall, self-pay payments will not only be faster but typically 15% more than any different billing process.
Most billing companies stop paying attention to your money when you send accounts to collection agencies. We manage the agencies just like any of your payers, demanding clear and meaningful remittances, timely payments, and complete accountability. Agencies are aware when no one is looking at their work. We don't let that happen, monitoring performance and recommending new agencies when their performance has fallen off. We then assist you in finding the right secondary companies and making timely placements there if you choose to liquidate receivables after initial agency activity.