COMPLETE HEALTHCARE REVENUE CYCLE MANAGEMENT
We are a great billing partner for all types of medical practice. Our team has successfully assisted solo medical practice, and group medical practice of various sizes with variety of specialties.We begin our relationship by examining all past records of our new partners and try to clean that up. More often than not, we discover something interesting that brings unrealized benefit. Our efforts start showing results pretty soon.The common pattern we have observed after our intervention is
- Increased revenue up to 30%
- Cash flow stabilization and significant improvement
- Decreased gap in billed total and realized revenue
- Reduced Costs up to 50%
ALL THE SERVICES THAT WE ASSIST YOU WITH OUR REVENUE CYCLE MANAGEMENT
- Eligibility verification and Pre-Authorization
- Medical Coding
- Claim Management
- Payment posting
- Denials and Underpayment Recovery
- Patient Balance Collection
- RCM ANALYTICS
We provide complete eligibility verification and pre-authorization services co-pay / co-insurance estimation.
Our experienced coders are familiar with ICD 10 and CPT and validate procedure codes. Our team also scrub procedure and diagnosis codes against correct coding initiatives and payer-specific edits to maximize the number of clean claims. We also provide charge capture audits and charge data reviews to ensure that all procedures, services, supplies and drugs have been captured.
We ensure appropriate and timely submission of claims and track claim status. We submit scrubbed claims either through any industry standard state-of-the-art clearing houses.
Our team of specialists post payments to patient accounts and identify claims for denial and underpayment recovery. Any unpaid / denied claims are identified for further action. Any balances as per the primary payer are either billed to secondary payers or the patients.
We welcome your hard-to-collect or outstanding claims to attempt complete recovery. Our team pursues every claim to its logical conclusion and provides you with detailed reports on activities for each claim maximizing your revenue as well as visibility.
Using technology-assisted processes, along with patient advocacy to optimize collections we shorten lead times on collection of patient balances. We help you with daily visibility on patient balances as well as prepare standard bad-debt reports for your further actions.
We help you with infographic view of your practice’s claims, collections, receivables, and denials. We design reports to track finer details of claims. Our timely reporting system assists you to gain insights that can change into actionable plans to improve performance.
VIRTUAL FRONT OFFICE
We are in a service business. A great customer experience, patient experience in our position, helps to create a positive impact and a good name for our practice. With our Virtual front Office service you will have access to highly skilled and stable workforce. They will collaborate with your front office to assist in stabilizing your operations.
- Call center to make patients calls
- Transcription Service
- In-room live meetings
- We have highly skilled people taking calls. They collect all the necessary information from patients that are important and relevant.
- Other office administrative services provided by non-medical personnel
- Eligibility checking
- Processing of patient statements
- Patient Charting
- Claim follow-up to ensure payer acceptance
- Post updates on insurance payments, patient payments, and denials
- Denials management, appeals management
OUT-OF-NETWORK SOLUTIONS
Insurance providers try their best to limit reimbursements on out of network claims using variety of tricks. It takes years of experience and knowledge to deal with insurance and get paid reasonable amounts on claims. Our years of billing and collecting claims has allowed us to maximize the reimbursement on your out of network claims. Our goal is to achieve maximum amount on your out of network claims. And if we do your billing then the result will be even better.
AMBULATORY SURGERY CENTER
- Buy-sell brokering with investors and participating doctors
- Developing operating agreements
- Surgery centre validation
- Surgery centre management
- Surgery centre de novo construction and renovation
- ASC consultancy
OFFICE MANAGEMENT SERVICES
- Book keeping and Accounts: Provide all bookkeeping and accounting services
- Non-Medical Personnel: Assistance to Client in recruiting and evaluating prospective Non-Medical Personnel to be engaged as employees or independent contractors by Client
- Marketing and Advertising Programs: Provide advice and assistance to Client on overall marketing programs.
- Insurance: Obtain and maintain in full force and effect during the Term of this Agreement.
- Payment Services: Payments to Client’s invoices, bills and other amounts payable to vendors.
- Financial Statements and Budgets: Financial Statements and Budgets financial statements containing a balance sheet and statement of income for Client.
- Litigation Management: Manage and direct the defense of all claims, actions, proceedings or investigations against Client or any of its officers, directors or employees in their capacity
- Tax Returns, Reports: OSHUN prepare and file all tax returns and reports required
