Our financial processes are designed to improve billing workflow, account for all anesthesia service's revenue, benchmark against financial projections, reduce AR and avoid compliance risks. The results for practices are higher revenues and a greater opportunity to focus on quality and patient care. Our billing professionals segment their operations into the following categories:

  • Clinical Records Management: Development of standardized forms management, Hospital systems data integration, document scanning and report reconciliation to ensure services rendered can be billed timely. 
  • Accurate Coding: All coders are CPC certified and many have anesthesia specialty certification as well. 
  • Charge Capture: Charge verification occurs by comparing the daily facility schedule to the patient charts. Case reports are reconciled to ensure every charge is captured through an exception reporting system. Any identified deficiencies are resolved with the onsite staff. 
  • Eligibility Verification: Through the use of automated eligibility databases of all of the major payors, we are able to validate insurance demographics from our partner institutions, manage exceptions and appropriately update patient insurance plan information to proactively minimize denials. We also use 3rd party proprietary systems to identify uninsured patients that could have coverage. 
  • Claims Management: Our claims management processes give feedback on claims status within minutes instead of hours or days. Our practice management solution is designed to ensure billing accuracy and minimization of denials through a series of controls integrated with clearinghouse functions. 
  • Payment Posting: Our goal is to maximize the volume of ERAs and EFTs to improve cash flow and posting accuracy with greater speed. Our team members are trained to identify paper EOB variances and electronic exceptions so that they can be reviewed and directly addressed by specialized professionals. 
  • Payor Contract Negotiations: We take responsibility for payor contract negotiations to maximize collections. Our regional footprint, coupled with our skilled negotiators provides our customers with optimal reimbursement rates. 
  • Reimbursement Tracking: We employ the use of a contract / payments reconciliation system to ensure we receive correct insurance payments & can appeal claims electronically. This is an industry-leading solution which is not only integrated with our clearinghouse for claims reconciliation but also has embedded over 20,000 nationwide payor rules. 
  • Denial Management: By using a combination of our reimbursement management system, clearinghouse tools and customized posting reports, payor denials and zero payments are placed into electronic work-flow queues. Trained insurance representatives take aggressive and appropriate follow-up actions to recover denied claim revenue thus minimizing AR. 
  • Audit Compliance: Internal compliance leaders perform quarterly audits on our demographics, coding and charge entry teams to ensure that we meet the highest level of program integrity. We use these audits for both internal and external efforts to align clinical documentation processes with revenue cycle best practices for continual improvements. 
  • Reporting: We strive to offer our customers a comprehensive customizable reporting and information toolset, providing them detailed insight into their practice's financial data. Additionally, we offer monthly reporting in a customized format based upon each customer's particular requirements.

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