Why it's the Best
Deep comprehensive resources. Exceptional customer service.
Our partner is an end-to-end global healthcare services company with an unwavering commitment
to deliver extraordinary value-added services to their clients. They are partnered with JP Morgan
Chase and operate internationally.
Our partner has developed interfaces with multiple hospital systems to ensure electronic charge
flow. Manual charges are entered directly into the system with a turnaround time of 24 hours. They
are set-up to transmit claims electronically to the large payers. They use the WebMD clearing
house for transmitting claims electronically to the smaller payers. In limited cases, paper claims are
Payments are posted electronically into the system. The company also manually posts certain
payments and denials. They analyze the under-payments and denials and appeal the same. The
accounts receivable team follows up on these under-payments, denials and delayed claims. Patient
statements are generated on the defined billing cycle and include all the information defined by the
client including the status of all charges, payments and claim filing information. They also pursue
patient balances to avoid high collection agency costs.
The services provided include:
- Billing Medicare, Medicaid and other governmental payers, commercial third party payers,
and self pay accounts as per their rules and applicable laws
- Providing accounts receivable management with respect to such bills, including accepting
and processing remittances from payers
- Undertaking follow-up activities to ensure that the bills are paid, including making inquiries
with, and providing additional information as requested or required by, such payers
- Developing protocols for delinquent accounts and for submitting these to a collection agency
- Generating and providing system reports and reasonably customized reports to the client
- Ensuring all such billing, when and as applicable, is in accordance with HIPAA
Out partner works with physician groups and hospitals in managing their accounts receivable
backlog wherein they prioritize and liquidate patient and insurance account balances as an adjunct
service to the provider’s business office operations. They also manage any accounts receivable
backlog created during the conversion to a new patient accounting system. They focus on unpaid
or under-paid insurance claims and pursue these from commercial insurers, managed care,
worker's compensation, no-fault and liability carriers. This typically involves full audit, processing
and rebilling of outstanding third party claims.
For these services, the company typically charges the client on a contingency basis. They
deploy advanced technology including comprehensive skip-tracing and automated letter generation
to deliver rapid account liquidation. Their staff adheres to high ethical standards and receives
training and regular updates on HIPAA and FDCPA guidelines. They follow-up on these claims to
the pre-legal stage.