1. Get Credentialing
Become a part of major commercial payors’ network through credentialing. This will authorize you to provide services to patients who are on their health insurance plans. Don’t just restrict yourself to Medicare or Medicaid or patient payment plans. You can opt for our professional credentialing or recredentialing services as it is a detailed process that requires utmost accuracy and timely filing.
2. Set up Effective Documentation & Collection
Improper or insufficient documentation is one of the prime causes of denials or underpaid claims. We are proactive in setting up a clear and organized documentation and collection process. It enhances patient experience and ensures a healthy revenue cycle.
- We request all patient information including name, date of birth, home address, contact information, photo ID etc. Verify it once received.
- We reverify their eligibility when they visit again. This is essential to prevent clearing-house rejections as well as insurance denials.
3. When it Comes to Claims, We Make No Mistakes!
It is difficult to avoid processing errors but we ace at claim filing. With our experience and regular training in healthcare billing, we are fluent with patient data entry, coding, accounts receivables and payment posting services. We keep a track of filed claims and even perform follow ups when necessary.
- We ensure the patient, provider and payor information is accurate
- We file the claims within 24hrs of treatment.
- We prevent duplicate billing and write offs.
- We refund the overpayments.
In the healthcare industry, 20% of all claims contain errors. So, despite the detailed and time-consuming claims submission process, we double check all the information and make sure it is error free.
4. Resubmit Denied/Underpaid Claims
What is more unfortunate than denied or underpaid claims? Failure to appeal.
We appeal the genuine claims for reconsideration as there is a possibility that those can be accepted or paid better. This prevents loss of revenue to your practice.
Now in cases of physical claims, the insurers may fail to attach EOBs making it difficult to spot errors or inconsistency in information on the claim form. Our team handles such tasks diligently and submits the appeal.
In case of online claims submission, the payor may return the claims with claim numbers, but missing or unclear denial codes. We follow up, correct the error and submit the appeal.
5. Pro Tip – Realize When it is time to Outsource
The healthcare industry is constantly evolving. It has given rise to complicated billing processes and regulations. To follow their pursuit of maximizing revenue, we advise providers to outsource their accounts receivables management services to a medical billing company.
Relying on professional and expert medical and dental billing company like Astron EHS has a dual advantage. It takes a lot of hassle and responsibility off your plate and maximizes your revenue too!