Submitting application to the Insurance to verify and evaluate a healthcare provider's qualifications, licenses, and credentials to ensure they meet the standards required by insurance companies and government health programs.
Coordinating appointments, managing patient calendars, and optimizing healthcare provider schedules to facilitate efficient and timely delivery of medical services.
Obtaining approval from insurance providers before certain medical services or procedures are performed to ensure coverage and reimbursement.
Assigning standardized codes to diagnoses, procedures, and services to facilitate accurate billing and insurance reimbursement.
Confirming a patient's insurance coverage and determining their financial responsibility before providing healthcare services.
Recording accurate service charges and submitting comprehensive claims to insurance companies for reimbursement.
Electronically submitted claims are flagged for errors or inconsistencies, requiring correction before resubmission to ensure successful processing by insurance providers.
Recording and reconciling received payments from insurance companies, as well as documenting and addressing any denied claims to facilitate accurate financial tracking and follow-up.
Reviewing and resolving overpayments or excess funds on patient accounts, ensuring accurate financial transactions and reimbursements.
The systematic process of identifying, analyzing, and resolving claim denials to maximize reimbursement and minimize financial losses for healthcare providers.
Contacting payers to follow up on outstanding claims, resolve issues, and expedite payment for services rendered by healthcare providers.
Generating and sending clear and detailed statements to patients, outlining their financial responsibility for healthcare services provided.
Communicating with patients to address inquiries, provide explanations of charges, and ensure clarity regarding billing matters.
Handling patient inquiries, clarifying billing information, and proactively reaching out to address payment-related issues for effective communication and resolution.
Accurately recording and matching received patient payments with outstanding balances to maintain precise financial records and ensure proper account reconciliation.