| Sl.No. | SERVICES OFFERED | -- OPTIONS -- | |||
|---|---|---|---|---|---|
| 1 | 2 | 3 | 4 | ||
| 1 | Real time patient insurance eligibility | ✔ | ✔ | ✔ | ✖ |
| 2 | Charges for all patient encounters (Office, Hospital, Nursing Home, etc…) | ✔ | ✔ | ✔ | ✔ |
| 3 | Processing of primary, secondary, and tertiary claims both electronic and paper as required | ✔ | ✔ | ✔ | ✔ |
| 4 | Review and scrub all claims for accuracy of data received | ✔ | ✔ | ✔ | ✔ |
| 5 | Ensure claims are accepted at the clearing house and at the payor in a timely manner | ✔ | ✔ | ✔ | ✔ |
| 6 | Manage all denials and accuracy of allowed amount payments where contract information is available | ✔ | ✔ | ✔ | ✖ |
| 7 | Manage all claim appeals with payors | ✔ | ✔ | ✔ | ✖ |
| 8 | All electronic and paper insurance payments and adjustments | ✔ | ✔ | ✔ | ✔ |
| 9 | Manage Insurance Accounts Receivable to ensure timely payment from payors. All claims over 60 days from initial submission and worked weekly | ✔ | ✔ | ✔ | ✖ |
| 10 | Generation of patient statements for mailing | ✔ | ✔ | ✖ | ✖ |
| 11 | Apply patient payments to accounts | ✔ | ✔ | ✖ | ✖ |
| 12 | Process patient accounts for collection agency follow up | ✔ | ✔ | ✖ | ✖ |
| 13 | Reporting: Daily, Weekly, and Monthly | ✔ | ✖ | ✔ | ✔ |
| 14 | Manage all patient phone calls regarding questions about balances and insurance policy | ✔ | ✖ | ✖ | ✖ |
| 15 | Preparation of data for patient refunds. Data will be supplied to the customer to issue checks to the patients | ✔ | ✔ | ✖ | ✖ |
| 16 | Database updates for all changes to billing codes | ✔ | ✔ | ✔ | ✖ |
| 17 | Assistance in obtaining prior authorizations where required by insurance | ✔ | ✖ | ✖ | ✖ |
| 18 | Prepare, submit and follow up on all necessary credentialing activities | ✔ | ✖ | ✖ | ✖ |
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