Component 2: Daily Optimization of Medical Billing Processes
Components of Our Complete Oncology Billing Solution:
We process your charges every day for the services rendered. In this step, we provide:
In this step, we provide:
- Data Entry
- Daily charges reviewed by the client are accessed and pulled via VPN access or exported via HL7 inbound interfaces directly from your EHR platform. Our data entry turnaround is two business days from the business day received.
- Electronic and Paper Claim Submissions:
- We ensure required EDI enrollments are completed during the go-live process to allow for daily electronic claim submission, which expedites claim adjudication and minimizes paper claims.
- Line-Item Payment Posting
- Each CPT®/HCPS code is one line item and payments are posted per line item. Since your top payer fee schedules are loaded into the billing system, we can identify and investigate inaccurate payments. This process can quickly identify contracted payers’ inaccurate payments.
- Claim Scrubber
- All claims go through the claims scrubber to identify coding and front-end edits for quick resolution. Our A/R staff reviews these edits daily.
- Accounts Receivable Management
- We serve as your full-service A/R department. To keep your A/R at or below industry standards, we involve our top-level medical and radiation oncology billing experts, including the company owners. We’ll also schedule standing monthly conference calls with you and your team to discuss outstanding A/R, payer issues encountered, charges, and receipts so that you have a mastery of your financial health and can be informed and involved in any necessary root cause resolution actions. Set up monthly calls with you and your team to discuss A/R, charges, and receipts so that you have a mastery of your financial health. At this time, you will be informed of payer issues and trends for your involvement in any necessary root cause corrections.
- Appeal and Follow up on Accounts Receivable
- Payer denials can occur for both accurate and inaccurate reasons. Our billing experts tackle the payer appeals process without hesitation. No matter where your practice is located, we’re abreast of payer policies, guidelines, and behaviors. We obtain all applicable medical record documentation from your EHR to support patient-specific medical necessity for the payer appeal submission in an effort for the initial payer denial to be overturned. In the event that the payer does not overturn the initial denial, our billing experts will exhaust all levels of appeal that are available in an attempt to overturn the payer denial.
- Patient Services
- Our patient services team is available Monday-Friday, 7:30am – 6pm CT to assist patients with billing questions, obtain credit card payments from patients, and/or establishing an agreeable monthly payment plan.
- Patient statements are processed daily on a 30-day cycle and include a toll-free number for patients to contact our patient service team.
We Serve as YOUR Full-Service A/R Department in partnership with you.
Let us partner with your Oncology practice!