For more than a decade, Pert has been offering a complete ‘peace of mind’ service in Revenue Cycle Management in usa for numerous valued medical practices. We ensure efficient Revenue cycle management & medical billing and coding services in usa, to save your time and overhead costs in a well-organized manner.
PERT Revenue Cycle Management has been associated with US Healthcare from 1997 and since 2007, we have been successfully offering comprehensive medical billing and coding-Revenue cycle management services in usa to various medical facilities spread across several states. We have been successfully functioning in services revolving around EMR and Medical Transcription, medical billing and coding-Revenue cycle management in usa. In medical billing and coding-Revenue cycle management services, the primary value proposition for our esteemed clients has been reducing payroll costs and optimizing resources which we have helped realize by assuring impeccable accuracy and swift turn-around-times. As a competitive service provider, we always strive to offer highly competitive rates to our clients for our medical billing and coding-Revenue cycle management services in usa utilizing the best contemporary processes and tools in the business.
Our endeavor for highly accurate services is driven largely by diligent work that is done in the field of data analysis and management by defining, measuring, monitoring, analyzing, correcting and controlling.
Revenue Cycle Management Services
Our Revenue Cycle Management services assist physician practices in demographic entry, insurance verification, coding, charge entry, payment posting, accounts receivables and management activities. By outsourcing these, our valued clients realize increased profitability by decreasing the administrative time and expense vested in the billing process.
Continue to Bill In-House or Engage Pert's Revenue Cycle Management & Coding Services
In times when most of the physician revenues flow through the insurance channels, a significant effort has to be vested in keeping up with the dynamic regulations and stipulations from various government bodies governing such payouts. The best practices of Revenue Cycle Management along with efficient and effective decisions also are an important factor in differentiating a successful practice from the inefficient ones.
We help our clients to:
- Identify unbilled claims or missed out charges.
- Append right modifiers to ensure optimum reimbursements.
- Optimally maximize reimbursements while insuring proper coding to avoid any audit errors caused by over or under coding.
- Boost your claim-submission efficiency: become more efficient while getting the claims submitted and by extension achieving timely processing of the claims preventing any backlogs and cash flow inefficiencies.
- Data entry and claim submission on a daily basis.
- Payments posted to patients’ accounts in real time and manually
- Efficiently processing secondary claims and balances to patients, avoiding delays.
- Freeing in-house employees from billing and data entry tasks to generate better operational efficiencies for the practice.
Best Practices @ Pert Revenue Cycle Management & Medical Billing and Coding Services
- Quality First policy
- Ensure filing of complete and accurate claims
- 100% secondary insurance claims filed
- 100% accurate patient statements and balance processing
- Smooth real-time communication with insurance carriers ensuring swift resolution of queries/clarifications for on-time processing
- Active follow-ups in relation to claim amount, payer, and claim status
In effect, we have been successfully creating value by helping our clients decrease losses due to inefficiencies related to underpricing, coding errors, missed charges, non-reimbursed claims, etc. We work actively to eliminate such losses. We have also successfully hand-held many new clients switch to e-filing of claims with insurance providers. Our team is trained and oriented to be highly sensitive while interacting with patients to explain the charges and ensure appropriate resolution of queries to satisfaction of all patients.
Our team is highly self-motivated to benefit from all the opportunities afforded by our dynamic operations to stay ahead of the curve on all important aspects like:
- Medical terminology
- Medical Coverage Plans
- Types of Insurance Policies
- Medical Coding
- Changes/Updates in Claim Forms
- Medical and Surgical Procedures, etc.
Our team also has got added skills of Word Processing, Spreadsheets, and Presentation Skills that helps in creating reports and documentation for management.
Medical Coding services
As the first step of the charge entry process, medical coding requires spot-on accuracy. We train our medical coders in quick, accurate and reliable processing of records and periodically ensure review, retraining and orientation towards the latest best practices. We also believe that it is of utmost importance for us to ensure that we work with updated resources and tools at all times including but not limited to latest books or softwares for the procedure and diagnosis coding based on AMA guidelines
We ensure timely feedbacks on coding changes, documentation updates, and periodic reporting in line with every client’s dynamic requirements.
This helps our team to match steps with the best in the industry in so far as impeccable service delivery is concerned. We also keep a close eye on the government regulations to ensure dynamic real-time alignment with the segment’s best practices.
We have a proficient and skilled workforce that is well versed with various medical coding formats inclusive of ICD-9 coding, CPT coding, and HCPCS coding. They are medical reimbursement experts aiding in quick and hassle free reimbursements up to the complete satisfaction of the medical staff as well as the patients as per the laid out standard operating procedures.
Charge Entry
Our team practices strict adherence with HIPAA regulations and AHIMA rules with utmost attention to details to ensure correct and timely reimbursement from the providers for the valuable services rendered through great hard work of our physician clients.
Our team makes sure to have the charges entered within 48 hours of receiving the work. All the claims are entered adhering to the respective insurance’s billing guidelines. This ensures clean claims are sent to the insurance companies at the first go and the reimbursement is faster. We have done this since 2007 ensuring clean claims, minimal denials, 99.9% accuracy, full compliance with prevailing regulations, and consistent track record with negligible risk of errors.
Payment Posting
Our Payment positing team is aware of multiple insurances and how they process their claims. They are knowledgeable and understand the various terms used by insurance companies to indicate the payment details on an Explanation of Benefits (EOB)
Demographic Entry
Patient Registration form or the intake form has the details of the patient’s demographic information. All that information is entered the same day the data is received to ensure speedier charge posting.
Accounts Receivable Services
Cash flow management holds a high degree of importance in the professional, efficient, and economically viable operations of any modern medical practice, small or large. Towards that end Pert Promises of managing the cash and revenue flows most efficiently decisively gets our valued clients ahead of the competition. We do this by helping practices effectively manage their cash and revenue flow, by reducing the accounts receivable days and helping increase profitability through increase in the collection ratio.
Pert benefits from one of the best teams of AR followup professionals who can quickly identify patient accounts requiring follow up and take appropriate measures to collect unpaid and/or underpaid claims.
Our Services in Account Receivable include:
- AR analyses
- Insurance followup
- Patient payment followup
We also provide timely information on:
- Payer punctuality
- Aging analysis, procedure code analysis, insurance analysis, cash collection analysis, under payment analysis, and expected collection report
- Charges, payments and adjustments
---- The bottom-line for us is to help improve operational cash flow
by reducing bad debt and write-offs ----
Insurance Verification
Industry-wide experience shows that close to 75% of all healthcare claim denials are because of ineligibility of the patients for services billed to the insurer by the providers often because his or her policy stands terminated or modified on the day of service provided.
Our role is to help dramatically reduce the accounts receivable cycle and increase revenue by significantly reducing the impact of ineligibilities and increasing the number of "clean" claims - claims that are complete and are for patients who are eligible for the benefits being claimed.
This helps remedy numerous downstream issues, i.e., delayed payments, repeat work, decreased patient satisfaction, increased errors, and loss-inducing nonpayment.
Eligibility Verification, in effect, helps achieve the following benefits:
- Improved AR Cycles (reduced AR Days)
- Higher number of clean claims
- Greater cash collections and reduced write-offs and denials
Insurance Eligibility and Benefits Verification Services include:
- Receive Schedules from the Hospital via EDI, email or fax
- Coverage verification on all Primary and Secondary Payers (as applicable)
- Responses and phone calls to Payers.
- Contact with patient for information, as required
- Provide the client with the results which include eligibility and benefits information such as member ID, group ID, start dates and coverage end, co-pay information, benefits ( as per doctors specialization and procedures done) etc.
Related Services (optional)
- Obtain Pre-Authorization Number
- Obtain referral from PCP
- Enter/update Patient demographics
- Inform client if there is an issue with coverage or Authorization
Eligibility verification defines who can render what care and under what circumstances. As such, ensuring that patients are eligible for services before care is rendered reduces rework of claims and alerts providers and patients to their options.
Medical Biller: Skills & Responsibilities
- Navigate through various insurance rules and regulations to reduce A/R days.
- Understand the nuances of various types of insurance carriers along with their claim requirements.
- Provide successful follow-up efforts for A/R including the appeals process for denied claims.
- Practice best practices for insurance and patient collections while maintaining excellent public relations.
- Reduce risks by understanding Fair Debt collection practices, professional courtesy regulations, clean claims and timely filing guidelines, Refund requirements, and other regulations.
- Use data and reports as indicators for potential improvement areas.
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