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Appointment Scheduling
– Patient takes an appointment with the provider Putting notes for reminder call to be placed to the patient one day prior to appointment
Eligibilty and Benefit Verification
– to check insurance coverage and what all benefits covered in the patients insurance policy
Registration
– Patient fills his demographics & payer detail at the time of visit. Demographic form & Card copies are scanned and will be sent to the billing company after encounter
Encounter
– The meeting between patient and provider. Based on the diagnosis, provider shares the treatment plan
Medical Trancription
– Medical transcription, also known as MT, is an allied health profession, which deals in the process of transcription, or converting voice-recorded reports as dictated by physicians or other healthcare professionals, into text format. These text documents later turn out to be medical records or EHR (Electronic Health Records)
Medical Coding
– Transcribed files forwarded to the Coder to assign diagnosis & procedure codes. A certified coder (CPC) does the coding. Coding is classified as Procedure Codes, Diagnisis Codes and Modifiers
Charge Entry
– Coders code the text files into Diagnosis and Procedures codes. The data is cross checked with medical records and sent for charge capture before the claim is forwarded to the insurance company
Claims Generation
EDI:
The process of sharing the data at a secure path/Network is Known as Electonic data Interchange.
Clearing House
– is an organization which does exchange of information between payers and provider offices / medical billing companies. There are multiple clearing house that the profiver can select from to bill the claims
Insurance
– Insurance companies to process/deny claims. If processed, payment is received else follow is done to get claim paid
Payment Posting
– when the claim is paid and we receive details from provider to post the payment in the PMS (Practice Management software). There are two mode of payments. ERA (Electronic Remittance Advice) and EOB (Explanation of benefits) for manual posting.
Acount Receivable and Denial Management
Collection
– Collecting outstanding money from the Patients. This can include deductibles, Coinsurance amount or any amount the Patient is liable to pay to the provider.
Provider Credentialing Cycle
– We ensure all of our providers are credentialed which increase their efficiency.
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