Revenue Cycle Management

Healthcare Providers, understandably, can hardly afford to juggle their relationships with Insurance Carriers along with all of the important day-to-day responsibilities. We offer a few ways to assist in this process. Enrollments are the first steps to building the relationship with payers and start submitting claims.

 

There are a few types of enrollments that we would manage or assist your team in managing: There are ERA Enrollments - these are enrollments that ensure you receive EFT payments and Electronic Remittance instead of Paper Checks and Paper EOBs. Next, we have Claim Submission Enrollments - these ensure that the insurance carriers will receive your claim. Another process in this vein would be attempting to enroll or negotiate to become in-network with insurance carriers that require a provider to be in-network in order to adjudicate their claim. Lastly, there are eligibility enrollments, some insurance payers require enrollment prior to verifying eligibility and benefits.

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Payer Specific Auditing is a service that we offer to zero in on any denial trends you may be experiencing with a specific insurance payer by analyzing every payer response in the past 90 days.

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Advanced Eligibility is another service that we offer that takes any claim that doesn't show a clear benefit on the Date of Service and vets that sample against thousands of Insurances to make sure we identify any active coverage.

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If we have successfully piqued your interest and you are curious about pricing for any services shown above, that can be found here.

 

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