Revenue Cycle Services We Offer
Health departments and private practices are under pressure to improve the quality of care while facing declining reimbursement. Hence, it is critical to maximize revenue cycle efficiency and improve efficiency in the areas of medical billing, coding and accounts receivable, while keeping pace with the ongoing changes in the healthcare industry.
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If your health department or private practice is struggling to maintain its revenue cycle operations, our revenue cycle management and medical billing services can help. We have extensive domain expertise in physician billing, health department services and mental health billing models. Using our resources and in-depth experience, we will work as an extension of your team, to help strengthen the financial health and profitability of your organization.
Health Departments
Do you experience similar issues listed below within your health department?
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Billing for Immunization, HIV/STD, Child & Maternal Services, Flu season and TB – Are we getting paid correctly?
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Are the staff keeping up with all the Medicaid changes?
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My staff are not certified coders. What do I do?
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How do I bill non-WIC services?
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Have we been credentialed with MCOs correctly?
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I don’t want to turn away patients because we are not credentialed.
If all these sound only too familiar, call us. We can help.
Private Practice
Several questions arise related to diminishing reimbursements. Do you face the same questions and have no qualified answers?
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In spite of seeing more patients, why is my revenue going down?
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My claims are not getting paid on time. Are my encounters being coded correctly? Are there any red-flags?
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How can I access my AR real-time?
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My AR backlog has grown beyond 120 days. What do I do?
If all these sound only too familiar, call us. We can help.
Behavioral Health
Several questions arise related to revenue loss due to compliance. Do you face the same issues in your facility?
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How can I be sure that all the documentation for ITPs and Assessments are complete? Are you a victim of multiple audit red flags?
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We have staff such as RSAs, MHPs, QMHPs, LPHAs, MCPs, LCPs, LPNs, RNs, APNs. Are we billing correctly?
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Is my EHR and PM designed for Mental Health rules? Does the system ensure compliance?
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Are the claims being paid on time? Who is following through?
If all these sound only too familiar, call us. We can help.
Our
Services
Credentialing Services
Contract management is key to eligibility and reimbursement models. Our credentialing team reviews your third-party payer contracts, addresses future contracts and performs contract negotiations. We also track managed care contractual agreements, including contract terms, to help maximize your reimbursement.
Monthly Reporting
Our Revenue Cycle Management model is based on transparency. You can track our progress and performance in real time. You have real time access to detailed monthly reporting of net revenue calculations and cash flow projections based on payer mixes. The ezEMRx solution also gives you real time access to detailed medical billing and accounts receivable data, insights into your revenue cycle with financial dashboards and standard reports.
Dedicated Account Managers
In order to establish collaboration between your staff and ours to resolve account issues, you will be assigned a dedicated account manager – your primary point of contact. Account managers can help in reviewing patient account records, assist in patient queries, clarify claims, facilitate requests for additional information from our coders and collaborate on analyzing denials.
Claims Management
Our team scrubs the billing codes against payer-specific edits to ensure a clean claim submission. We audit charge capture to ensure that charges and receipts are not missed by reconciling patient charges during the clinic or health department intake process. Our technology platform is designed to ensure such pit-falls are avoided.
AR Management Services
It is not easy to take on revenue cycle responsibilities for practices or health departments. We can provide support to help with billing, denials and backlog, and we can even provide the technology platform. Denials resolution procedures are performed using focused audits and experienced staff.
Medical Coding Compliance
Our revenue cycle management includes coding services, performed by skilled, certified coders, to identify missed opportunities as well as potential compliance issues caused by inaccurate coding.
Payments, Posting and Management
From insurance billing and patient statements, to payment posting and validation, we help manage the receivables that directly impact financial summaries and cash flows.
Patient Collections
Our AR teams compliment your staff with both insurance and patient accounts receivable follow-up services. We contact payers to determine the claim status and root causes for denied claims, and then work the details to resubmit claims or initiate appeals. Patient balance follow-up and collection are handled efficiently according to your policies and procedures.
ezEMRx’s combination of processes and technology are designed to optimize collections and shorten collection cycles on patient balances.