Revenue Cycle Management, Billing & Collections
- Claims processing
- Accounts receivable follow-up
- Underpayments* and denials
- Claims disputes and appeals
- Payor refund requests
- Patient statements
- Self-pay collections management
- Reporting package as directed by physicians
*With our proprietary systems we are able to identify payor underpayments, and work to immediately capture them.
- Negotiate single case agreements with out of network payors
- Analyze existing payor agreements and associated payor revenue cycle history
- Analyze payor mix
- Develop negotiation strategies
- Develop payor specific rate requests, including development of carve-outs and case rates
- Monitor and maintain fee schedule updates
- Develop and maintain ongoing payor relationships
Payor Contracts
Payor & Hospital Credentialing
- Complete initial payor and hospital applications
- Maintain payor and hospital affiliations
- Maintain CAQH profiles
- Obtain procedure and surgical authorizations
- Review patient insurance and perform eligibility checks
- Perform verification of benefits
Authorizations & Verification of Benefits
Patient Scheduling & Registration
- Receive requests for scheduling
- Place appointments on provider’s schedule
- Obtain appropriate co-pay or self-pay payments
- Obtain required registration documentation
- Enter all information into medical practice management system
