Revenue Cycle Services

Overview Eligibility and Benefits Verification, and Prior Authorization Patient Scheduling Patient Registration Medical Coding Claim Submission & Rejection Management Payment Posting Accounts Receivables Management Denial Management Credit Balance and Refunds Processing Revenue Cycle Analytics Provider Credentialing and Enrollment

The process of claims submission involves parsing of claims information from the revenue cycle system to the clearinghouse and addressing any throwbacks. The scrubbing process enables in the identification of claims that are not correct and enables the medical billers to address the claims.

Components of Our Claims Submission and Rejection Management Processes

  • Batch run from the RCM system to the clearinghouse system

  • Updates as appropriate to the exceptions

  • Parsing to the Payer Systems and corrections as appropriate

Benefits of our Claims Submission and Rejection Management Process

Our work edits team members address the issues with the claims proactively and eliminate denials. We offer our clients the following benefits:

  • Improved turnaround time (24-48 hours), productivity, and accuracy

  • Avoid claim denials and get higher and quicker reimbursement

  • Documentation of all business rules

  • Daily account support calls to address any issues

  • Reduce costs by as much as 50% through offshore delivery

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