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Roles and Responsibilities are keep changes but commitment
and attitude for work remain constant for Progress.

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Our Process

Our Process for RCM

We are Providing end to end RCM Solution from Clearing house set up to Patient Collection. We analyse your Practice by using SWOT analysis tool based on Historical Data and make sure that Medical Provider or Medical Billing Company get maximum reimbursement.

Patient demographics and charges are collected from the practice or the practice can utilize our full practice management and EHR system.  Our Coding and Billing team reviews all bills and utilize our practice management claim scrubbing prior to submission. Claims are then submitted to insurance companies via electronic submission. For workers Comp and Auto Insurance claims, we prefer to send Paper claim via their mailing address or direct Fax. We Prepare Billing Log which called CICO (Patients Check in and Check Out) report. With help of these report we can easily send Billing related queries on weekly basis so there is a no back log in billing which help the maximum revenue to Provider. We send CICO report every week to Provider office to review because sometime Providers may have forgot to send billing for few Patient or for forgot to lock Patients billing for claim submission so Provider office review this report and enter Pending claims or send Pending bill to billing company to send which help in Increasing revenue per month and avoid such TFL Issue.

We also keep our eyes on Clearing house rejection on daily basis. We work on those rejected claims and resolve on daily basis which help us in our CCR.

We received Payments via ERA or EOB from Provider office and we post the payment on outstanding claims and Prepare log sheet Payment received and Payment Posted. Also we Prepare sheet for denial claims which help A/R team to resolve Pending claims on high priority.

Accounts receivable unpaid claim reports are run and followed up upon daily basis. We work on all the Pending claims which cross 30 days from the billing date. We run a report by first bill date so there is no chance to miss any claims which require attention. We followed strictly Standard CCR Process while working on Account Receivables. All the claims followed up for the final resolution.

We send Pending from Provider report to Provider office or Medical Billing Companies. on regular basis. These are pending claims where we need help from Provider office for further steps. We send Patient Statement on regular cycle based on Providers Instruction. We followed up with Patients as well for their outstanding with Provider office and help Patient and Provider office to resolve and get resolution faster for both the parties.