The medical billing specialists enter patient demographic details such as name, date of birth,
address, insurance details, medical history, guarantor etc. as provided by the patients at the time of the visit. For established patients, we validate these details. Necessary changes, if any, are done to the patient records on the practice management system.
The fee schedules are pre-loaded into the practice management system. CPT and ICD-10 codes are
entered into the system. The billing specialists ensure that all details have been provided in the claim and are ready to be filed.
Claims are submitted electronically via the practice management system. However, we can process paper
claims as well. A thorough quality check is done by a senior billing specialist before submission.
Scanned EOBs and checks are sent to our team for Payment Posting. All payments are entered into the
system. The amounts from EOBs/checks and amounts posted in the system are reconciled on a daily basis. A daily log is updated with these data.
All claims in the system are examined and prioritized. Claims are given priority based on the age of the claim. Periodic follow-ups over phone, email and/or online are done to update the status of each claim submitted to the insurance company.
Denial management, including analysis of denials and partial payments, is done by our senior medical billing specialists. Payors, patients, providers, facilities and any other participants are called to follow-up on denied, underpaid, pending and any other improperly processed claims and the action is documented in the system.
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