Services

Managed Care Revenue Recovery

  • Strategic Pricing
    Maximizing payments from managed care companies
  • Underpay Recoveries
    Managed care payment compliance
  • Billed Claim Follow Up

Denial Management

  • Appeals of Managed Care, Medicare and Medicaid denied claims
  • RAC audits
  • Clinical staff explore the medical record and work with the treating physician
  • Sophisticated appeals written to pinpoint the facts in support of the claim
  • Team meetings with provider staff and payor to review details and expedite payments
  • Custom reports to identify and track denial trends, used to prevent future denials

Additional Services

  • Return Mail Processing
  • Credit Balance Management
  • Paid Claim Review

Interim Business Office Management

  • Manage all aspects of the Business Office and Revenue Cycle, reducing cost to collect and AR
  • Examine and retool Access, Denials Management and Claims Management processes
  • Establish Key Performance Indicators

Extended Business Office Services

  • Outsourcing Receivables after System Conversion
  • Third Party A/R
  • Early Out
  • EBO Customer Service with reports on monthly call volume, category of call, and success rate

Revenue Cycle Assessment

  • AR analysis, including self pay and third party
  • CDM charge capture
  • Unbilled accounts
  • Cash posting processes
  • Revenue Integrity Analysis
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