The submission of claims and the subsequent collection of payments represent the core functions of RCM and are likely the root of most gaps and inefficiencies in the entire billing process. We take an intuitive approach to determine those gaps and provide sustainable solutions that work for you.
Claim Generation
- Coding for both professional and institutional providers i.e. HCFA-1500 and UB04 Forms
- Superior internal controls and processes to eliminate errors in data entry
- Customized Claim scrubbing software that ensures the industry’s fastest turn-around time for generating clean claims
- Front end auditing to ensure only reimbursable claims are generated
- Generation of claims for secondary and tertiary insurance carriers
Electronic Claim Submission
- Clean claims submitted electronically to ensure the fastest possible payment turnaround time
- Real Time claim submission payer acceptance confirmations
- Immediate correction of all electronic claims rejected by clearinghouse and payers
Claims Management
- All billed claims are called on a consistent set call cycle
- Effective and Aggressive denial management system to get denied claims resolved
- Fee negotiations for the highest possible rate with 3rd party pricers utilized by commercial payers
- Assistance and execution of Single Case rate negotiations for the highest possible reimbursement on services rendered
- Our staff strives to get claims processed for payment within a 30 day period
We Changed the Playing Field
so YOU can WIN