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Front End Work Pays Off
a. Your
provider profile(s) and detailed managed care fee schedules are
loaded into our system
b. Correct CPT and ICD-9 coding by certified coders using supporting
documentation
c. Demographic Verification
d. Timely Accurate Charge Entry
e. Electronic Submission where possible with front end scrubbing
software for things such as concurrency, modifiers, 5th digit
diagnosis coding, and more
f. Paper submissions where required with complete required
attachments
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The Collections Process
a. Charge capture audits
b. Electronic remittance where possible and reconciliation
c. Payment posting.
d. Rejections worked by payor specific collection specialists
e. Early patient involvement if payment delay by insurers is without merit
f. Credit card processing for self-pays, cosmetic and uncovered procedures
g. Pursue, Persevere, Penalize, get Paid |
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The Old Fashion Way
a. Solid knowledge of the market and the payors
b. Understanding of the rules
c. Application of skills sets
d. Continuing focus and perseverance |
What can go wrong with your
professional billing?
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