Charge entry checking
All charges entered by the charge entry team are checked by the checking team for errors. Checking team collects data on common errors and fixes systemic problems that affect payment delays and bad debt. This long term perspective improves the collection rate and helps to protect future cash flows by fixing problems that affect the patient-provider relationship. Most of the claims error happens in the charge entry phase. ABC’s checking team service is unique because we strive to eliminate problems before they happen. All claims are reviewed for errors and risk of denial before claim submission.
Maintain a review log for billing claims
The most common rejection reasons are logged. The accumulated rejection reason logs help us to track rejection trends. ABC monitors and evaluates these trends in order to resolve the problems that are causing the medical claim denials and rejections. This way practices get increased revenue through reimbursements and reduce the risk of future claims rejections.
Eligibility, Referral and Pre-cert Verification
- Patient’s insurance coverage are verified for primary and secondary payers
- Verifications are done by call and online portal
- Referral required patients are identified before the appointment and alert is created in PMS to alarm the front office on the appointment day
- Weekly report and remainders on referral missing patients
- Precertification and Pre-Auth are obtained by calling, faxing and emailing hospital, facility and insurance portals
- Missing precertification claims are followed up every week
- Weekly Email reminders sent for prior authorization missing claims