Verification of documents and validation of insurance coverage
Submission of claims and electronic billing
Posting of all Payments and Adjustments (Insurance & Personal receipts)
Old Accounts Receivable Clean-up
Compilation of patients records and statements
At PHYSICIANS CHOICE, we also recognize the responsibility to ensure accuracy for the submission of all our clients'' charges. We are committed to providing our services within compliance standards, in accordance with all existing Federal, State and Payer regulations.
» Verification of documents and validation of insurance coverage
» Data Entry
» Demographic Information
» Medical Coding
» Charge Entry & data validation
» Submission of claims and electronic billing
» Posting of all Payments and Adjustments (Insurance and Personal receipts)
» Accounts Receivable Analysis and Management
» Insurance and Patient Follow-up
» Old Accounts Receivable Clean-up
» Compilation of patients records and statements
Verification of documents and validation of insurance eligibility
Eligibility Verification and Validation ensures that the Billing follows the correct path. Our experience and industry surveys show that incorrect insurance information is a source for Claims denial resulting in delayed and incorrect revenue realization. At PHYSICIANS CHOICE we understand the importance of understanding the coverage and benefits of different carriers and processing these accurately in the billing. This ensures reduced denials due to incorrect insurance information and data mismatches.
Patient Demographic Entry and Validation
The Medical billing professionals capture the patient demographic details such as name, date of birth, address, medical history, insurance etc. for the new patients. For the existing patients, validation of the details with necessary changes are done.
Our experienced teams are well versed with the AAPC guidelines. Coders are provided with appropriate tools to assist them in keeping up with the changes and updates to CPT, ICD-9/10, HCPCS, C++ edit.
The coder determines the code to be used following each patient encounter. A Coder is extremely careful while coding for patient records.
The benefits we offer are:
» You get clean claims and fewer denials.
» Transparency in the coding methodology gives you access, produces consistency, and eliminates the risk of errors.
» You eliminate recruiting and training, reduce labor costs, and improve accuracy through our high-quality operations.
» At PHYSICIANS CHOICE, we offer quality medical coding services to healthcare providers. We have an extensive network of experienced medical coders who can
provide you with the highest level of quality medical coding services. We are committed to providing accurate and aggressive coding, that is compliant under
government regulation. Our coding teams, many of whom are CPC and CPC-H certified, have their efforts supported by your appropriate documentation to provide
maximum and accurate reimbursement. To ensure a high level of accuracy, we continually monitor the coding activities performed by our staff and for our clients.
Charge Entry and Validation
The CPT and ICD 9 codes are entered into the system, and then the details are checked for the validity and accuracy before the filing of the claim. The various schedules of the fee structure are pre-loaded in the system.
Claims Submission and Electronic Billing
By following the client''s billing and electronic submission through the clearing house of choice, any edits which occur through the submission process are monitored and resolved to ensure prompt electronic filing of the claims. While performing a batch submission, reconciliation is performed through claim counts and hash totals to ensure all the claims billed have been successfully submitted to the appropriate carrier for payment.
Payment Posting and Adjustments
All the payments are entered into the system. The scanned copies of EOBs (Explanation of Benefits) forms and checks which are posted in the system are reconciled on a daily/weekly/monthly basis.
The PHYSICIANS CHOICE Healthcare medical billing team categorizes Accounts Receivable Management into three distinct functions for its physician billing company and hospital A/R management company clients.
Correspondence and denied claims are processed in daily batches by our team of experienced billing personnel. The categorization of the claims and subsequent actions are determined on a client-by-client basis.
Unpaid claims are typically sorted by financial class. Employees call the appropriate insurance companies, or self-pay patients if requested, and aggressively resolve any non-payment issues.
Call Groups are assigned to handle incoming patient phone calls for designated clients.
Cash flow and revenue management are among the most critical factors in any professionally run practice. At PHYSICIANS CHOICE, we can assist you in driving your business growth by effectively managing your cash and revenue flow by reducing the accounts receivable days and improving profitability by increasing the collection ratio.
PHYSICIANS CHOICE has a large team of AR follow up professionals who can identify patient accounts that needs to be followed up and take necessary action to collect unpaid claims and underpaid claims.
Our Services in Account Receivable include:
» AR analysis
» Insurance follow-up
» Self-pay follow-up
Compilation of Patient Record and Statements
Patient Statements bills or invoice needs to be sent out periodically as part of the communication process to the patients, this will ensure that patient responsibility amounts are communicated to the patients prior to follow-up of patient collections. PHYSICIANS CHOICE handles all special reporting requirements, and ensures that reports are compiled and available for remote printing and electronic transmission. PHYSICIANS CHOICE understands that quality in reporting leads to improved customer satisfaction.
Reporting & Auditing
» Payer punctuality
» Payer Mix
» Aging analysis, procedure code analysis, insurance analysis, cash collection analysis, expected collection report
» Charges, payments and adjustments
» Daily reconciliation of the payments and receipts entered into the system with the documents received from the client
» Daily reconciliation of the charges posted
» Coding checks and validations done on routine basis.
» Regular checks on the updating of coding policies
Software and Scanning
PHYSICIANS CHOICE Healthcare employees are well versed in numerous US medical billing software packages and practice management systems. We also help implement the latest scanning technology at each of our client facilities in order to reduce paper transactions, which virtually eliminates transmitting errors and improves the workflow process over to India.