Claims Submission/Payment Posting

• Claim Creation
• Quick Electronic Submission of Claims
• Immediate Claim Error Identification
• Line Item Payment Posting
• Identifying Underpaid Claims
• Secondary Insurance Billing
• Identify and Return Overpayments

 

Patient Collections

• Timely Patient Statements
• Incoming Patient Collection Calls
• Soft Collections

 

Denial & AR Management

• Timely Denial Management
• Appeals
• Average Days in AR <45

 

Monthly Custom Reporting

• KPI Dashboard Report
• Accounts Receivable
• Payment Analysis
• Referral Analysis

 

Workflow Processes & Procedures

• Evaluation of Charge Capture Process
• Evaluation of Charge Capture Tools
• ICD and CPT Code Analysis
• Fee Schedule Review and Analysis

 

Contracting & Credentialing 

• Credentialing with all Payors
• Contracting and Rate Negotiation

 

Compliance Plan & Policies

• Compliance Risk Analysis
• Compliance Plan
• Compliance Policies & Procedures
• Fraud & Abuse Education (Mandatory)
• OIG/GSA Sanction Screening
• Ongoing Auditing & Monitoring
• Corrective Action & Education

 

HIPAA Policies & Education

• HIPAA Privacy & Security Risk Analysis
• HIPAA Policies and Procedures
• HIPAA Education
• Monitoring Compliance with HIPAA

 

Meaningful Use & PQRS- Now MIPS

• Assistance with Understanding MIPS
• Assistance with Compliance to Avoid Penalties