Using our secured server, provider documentation is forwarded to the billing representatives handling your account via superbills, transcripts, etc.
Patient responsibility, insurance coverage and demographic details of the patient are reviewed for accuracy.
Our Eligibility Specialist will confirm the following patient benefits on each date of service:
Demographic data –
if the information on the insurance identity card is up to date and correct for that date of service
whether the patient has valid coverage on the date of service
Benefit options –
patient responsibility for copays and coinsurance
Prior authorization requirements –
confirming authorization for treatment from appropriate sources, if applicable
If necessary, our certified coders will enter appropriate procedure and diagnosis codes with modifier placement based on your documentation
Entry of Charges
Each patient is entered under a separate account. Appropriate charges for each code are assigned
All claims are reviewed for accuracy of key components before they are submitted to the payor.
Following HIPAA Guidelines for transmitting claims, we will electronically transmit completed claims to the payor.
All claims are followed up on including contacting patients and coordinating with payors. If necessary a secondary claim will be submitted.