OVERVIEW OF SERVICES FOR MANAGING THE REVENUES CYCLE
Afiablee Healthcare Solutions will help you improve your healthcare revenue cycle management. You'll observe a decline in claim denials, be able to identify the primary causes of revenue loss, boost sales, and spend less time in accounts receivable. To make our revenue cycles more agile, we want to create a coordinated approach between patients, payers, and healthcare providers.
VERIFICATION OF ELIGIBILITY
We place a strong emphasis on the calibre of our work, which is why we are adamant about reviewing procedure specifics. The validity of important criteria including the eligibility of insurance, verification of benefits and co-ordination of benefits are considered to be a top concern at Afiablee Healthcare Solutions. And to top it all off, we immediately revise any claims that are denied so that Afiablee Healthcare Solutions has an edge over rivals in the market today.
PATIENT REGISTRATION & CHARGE CAPTURE FOR MEDICAL BILLING
In Afiablee Healthcare Solutions, claims of cleanliness are a fact. Our billing team has the expertise to process payer claims more quickly. Reimbursement may be lower if patient demographics and billing data are not precisely recorded. Our team is committed to offering excellent patient registration and charge capture services.
MEDICATION CODING
Our skilled team of AAPC-certified coders adheres to CCI editing standards to ensure that diagnostic and procedure codes are applied correctly to patients' medical records. In order to prevent codes from being denied and show an actual medical justification to the patient's insurance provider, we adhere to the regulations that are part of Local Coverage Determination (LCD) and match the appropriate Current Procedure Terminology (CPT-4) and ICD-9 CM codes. This way, we can ensure that patients don't lose out on money.
We are committed to constantly improving to stay ahead of the highly competitive RCM service market. We're currently ICD-10-compliant. This will let our clients enjoy better quality processes and improve productivity. As a Six Sigma level company, Afiablee Healthcare Solutions employs high-end tools of the highest quality and stops unprofessional practice of "upcoding". Additionally professional certified auditors of coding oversee and ensure the quality control of the process of coding, ensuring to ensure that the results are flawless.
While we check the revenue stream.
Medical billing companies and medical specialties can use the full- or partial-scope Revenue Cycle Management services that Afiablee Healthcare Solutions provides.
EXPLORE MORE ABOUT RCM SERVICES :
Submission of Claims and Clearinghouse Rejections
As the paper-based process is risky and somewhat antiquated, we rely entirely on electronic delivery of all claims. We track claims up until the payer receives them, which sets Afiablee Healthcare Solutions apart from other companies. We keep checking in until the payor acknowledges receiving the claim. We keep tabs on clearing-house rejections everyday and make an effort to transmit them right away.
ASSIGNING PAYMENTS
the ideal combination of cutting-edge technology, affordable solutions, and a group of trained billing specialists We are able to accurately process each payment in the billing system. By completing the steps and accounting for rejected claims, Afiablee Healthcare Solutions can get payment posting one step closer to completion. Our staff has experience posting Electronic Remittance Advice (ERA).
ANALYSIS AND MANAGEMENT OF ACCOUNTS RECEIVABLE
A/R calls are not even conceivable thanks to our perfect invoicing and coding procedure. We adhere to the philosophy of being prepared for any situation and provide assistance with A/R to make sure that our customers are quickly and affordably reimbursed.
All customers with more than 30 days of pending payments will be contacted within 30 working days and advanced to the next round thanks to the efforts of our AR team. Depending on the insurance carrier, contacts are made with the ageing buckets ranging from 0 to 30 between 20 to 30 working days.
COMMUNICATION AND APPEALS
The knowledge to manage issues involving medical expenses is available at Afiablee Healthcare Solutions. In the case of an incident, we will carefully mail any claim that the payer did not authorise or that has to be corrected and filed back. The insurance provider examines each submission to avoid denials due to late filing.
Taking into account the data gathered from the call support team The relevant steps will then be taken by our staff in relation to the underpaid claim in order to correct and resubmit the claim. This might entail billing, recoding, and letter-writing appeals.
CREDENTIALING AND ENROLLMENT OF PROVIDERS
Our team of credentialing experts makes sure that the healthcare practitioner provides all the pertinent information required for credentialing. We change the data to comply with each insurance provider's individual format requirements because each has its own set of rules that must be followed. Upon submission, Afiablee Healthcare Solutions stores the data in a database for later use and then follows up with insurance companies to complete the enrollment process. To make sure they are enrolled, Afiablee Healthcare Solutions makes sure to get in touch with the insurance provider.
If you're looking for an End to End RCM firm with experience, you've come to the correct place. Call us right away!