Medical Billing/ Coding/ Receivable: Entering of ALL patient demographics, Charge Entry, Claims submissions filed electronically to insurance companies, Submittal of
secondary and tertiary insurance claims, Submittal of some commercial claims filed on CMS FORM 1500 (02-12), Claims rejection follow up, Accounts Receivable follow up, Payment posting,
Remittance Auditing.
Patient Statement Billing & Collections: Monthly statements mailed to patients with outstanding balances.
A/R Clean Up: Actively work aging reports to determine collectable outstanding revenue. Advise practice ways to correct common errors. Communicate with insurance companies to
track denials and create appeals to get claims paid in a reasonable amount of time.
Financial Reports: End of Month reports provided to physician or as requested showing account receivables.
Contract Allowables: Insurance allowables provided to front office for proper collections of deductibles and co-insurance.
Credentialing: Establish contracts with insurance companies to add providers to their network or update provider demographic data as well as maintaining current
information.
Surgery: Prior Authorizations, Pre-Determinations, Verification and patient collections prior to Outpatient surgery.