We help you collect more. We solve your Account Receivables problems.

We Provide All Aspects Of Medical Billing Services for Doctors and HealthCare Providers

Afiablee Solution has been present in USA since 2020, offering innovative solutions, specializing in medical services for treatment of medical infrastructure.

At Afiablee Solution, we can help you achieve greater profitability while at the same time freeing up your time to focus on patients.​

Account
Receivable

We provide customized solutions to increase salvaged revenues and minimize operating costs and delinquencies, with a single centralized repository of documentation. We set up follow up services on outstanding claims, collections, track claim denial causes, and pending receivable balances. We have an extensive range of service models that allow our clients to choose the one that befits their budget and requirements.

CHARGE
ENTRY

The charges from the coded documents are entered into the particular patient account. If the patient is new and an account number does not exist as yet, then the patient account is created by entering all the demographic details from the patient registration form. Before transmitting the claims to the insurance payer through the clearing house, the entered charges are audited by the Quality Assurance (QA) team to ensure a ‘clean claim’ is submitted.

Medical
Records Indexing

We review and analyze all types of records such as hospital & emergency discharge note, admission notification, transition care summary, lab results, hi-tech radiology results, consultation notes, insurance procedure authorization request, medication prior authorization, medical records from outside doctor, referral request from the patient to see a specialist which are fed into software and index with respective label and attach it to patient’s medical chart.

CLAIMS
TRANSMISSION

Once the charges are entered and audited, the claims are then filed with the payer electronically. We also have the capability to process paper claims. Usually at clearing houses, the claims go through some type of cursory filtering software to ensure that they are accurate and all information is contained within the document. Within 24 hours, a paper report is sent back with errors that have been caught. Once we have the report, the incorrect claims are rectified with the necessary information within 24 hours and the claims are resubmitted to the insurance company.

Medical
Coding

Our highly trained AAPC certified coders help to improve cash flow management and deliver up to 98% accuracy with their processes, while ensuring HIPAA and AHIMA compliance. We leverage a streamlined process that focuses on areas that are associated with high-risk MS-DRGs, RAC initiatives, high cost procedures, among others. Our entire medical coding services cover functions such as retrieving patient information, pre-coding, assigning medical codes, quality audits, customer feedback, and implement changes.

MEDICAL
BILLING

Our holistic medical billing process includes patient registration, insurance eligibility verification, medical coding, charge entry, auditing, claims transmission, clearing house rejections, payment posting, denial management, AR recovery, patient statement, and collections. Our services are compliant to regulations that are robust and customized to your requirements for faster and better reimbursement. We leverage the most advanced medical billing technologies such as Nextgen, MediTouch eClinical works to promote an improved cash flow.

PAYMENT
POSTING

We conduct payment reviews on a periodic basis, track payment patterns to determine any discrepancies in payments. Our responsibilities include writing off the difference between the claim received and the actual claim submitted. We identify instances of denials for medical emergency, denial of authorization of services, non-covered service, among others and initiate measures to prevent their re-occurrence.

Insurance
verification

We verify the insurance E&B prior to the day of a scheduled appointment. This includes capturing details and update in the patient notes – copay, deductible, co-insurance, in-network and out of network benefits, PCP name matching. We follow up with patients in case of any missing information and assist them in addressing the same. We also conduct service procedure check and need of authorization.

Patient
Liaison

Our team of experts with a clinical background with nurse degree reviews the prescription drug request coming through online portal, through incoming faxes, from patient or from the pharmacy on behalf of patient. They determine the necessity of drugs for the patient and sent the request to doctor approve it. We call pharmacies for any clarification and communicate to patient for further action on dosage or directions.

PRE-INSURANCE
VERIFICATION

Before the patient’s visit to the provider, we perform pre-insurance verification to check eligibility regarding the particular insurance, requirement for any pre-authorization or referral, whether any copayment has to be collected, if the patient has met the deductible, the amount of co-insurance the patient shares, and whether the patient’s insurance covers the service sought from the provider. This step is important because many insurance providers do not provide retro-authorization.

Patient
Care coordinator

Our staff coordinate with multiple departments for functions such as appointment reminders for patients, booking or cancellation of appointments. We process both global and procedure referrals by submitting requests through insurance portal or calling the insurance to process the request. Upon approval, the specialist office is duly notified. We also submit the medical records or lab results if it is required from the insurance to approve the authorization number. Our team reviews patient charts to identify quality gaps and proactively address the same. We set up reminders for patients for their yearly pathological tests and also provide follow-up services for patients to clear their dues, medication refill request, DME request, and patent billing clarification.

    How can we help?

    Please feel welcome to contact our friendly reception staff with any general or medical enquiry. Our doctors will receive or return any urgent calls.

    Helping Doctors from all over USA

    Our staff strives to make each interaction with patients clear, concise, and inviting. Support the important work of Medicsh Hospital by making a much-needed donation today.

    We believe in our services and we would invite you to experience the difference we can make in your net revenue.