• Basic
  • Enhanced
  • Premium
Services BasicEnhancedPremium
Services
3%
of the total collection
/Monthly
4%
of the total collection
/Monthly
5%
of the total collection
/Monthly
Daily claim submission
Posting insurance remittances/payments
Handling claim denials
Tracking and following up on unpaid claims
Contacting insurance companies to resolve claim denial issues
Sending bulk patient statements every 30 days
Credentialing is a separate service with an invoice of $350.00 per application.
Monthly financial report
Year-end practice performance analysis report
Bi-weekly AR report
Uploading claim batch files to ACO
Mailing medical records to payers, attorneys, and workers' compensation.
Mailing HCFA paper claim forms
Transitioning from virtual credit cards to paper checks or EFTs
Reconciliation of billed amounts against payer contracted amounts every six months
Patient unapplied overpayment report generated every six months.
Posting patient remittances/payments
Posting inpatient hospital and other facility charges
Quarterly zoom client meetings
Monthly prior authorization and referral missing report.
Enroll in ERA/EFT for eligible payers
Monthly Zoom client meetings with a dedicated practice manager.
Download patient face sheets from hospital and other facility systems
Checking uninsured status across various portals.
Customized reports
Managing inbound and outbound patient calls
Submit and follow up on patient collections
Submitting medical records to attorneys/payers for post-paid claims
Retrieving records from the hospital portal
Contacting hospitals/facilities to obtain prior authorization numbers
Checking the facility portal for the preauthorization number
Prepare medical record invoice for post-paid claims
Appeal claims and hearing scheduling for payer denials.
Mailing appeal letters with tracking number Any postal mail
Setting up insurance portals for practice and billing
Sending itemized bills to attorneys for post-paid claims
Contacting dialysis centers for provider lock-in verification
Training for front office staff
Complimentary coding audit report for the first three months from the signing date
Complimentary practice consultation available anytime
Customized reports
Managing inbound and outbound patient calls.
Complete practice management system (PMS) implementation
Managing returned patient statements (RTS)
Managing patient accounts submitted for collections
Collections payment monitoring and posting
Collecting the patient balances directly in the PMS
Provider's CAQH profile up to date
Reattesting the provider's CAQH profile if needed as per the payer's requirement
Clearing house setup
Medicaid CMO revalidation
Medicare revalidation
Payer contract negotiation Attorney reference
PECOS enrollment
Checking allowed rate with the payer contract
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