Is your urgency to claim bills proving difficult due to medical staff handling both patient care and backend processing? Are you in a fix about ways to improve your pain management claim remuneration? Are various types of pain such as chronic, acute, breakthrough, neuropathic causing complications the claims processing? We know how cumbersome dealing with chronic pain is and the attention required for the treatment of the patient. Filing pain management claims, which is a part of anesthesia billing, shouldn't be an additional cause for concern.
Our clientele grew from small clinics to large pain rehabilitation institutes that face a bottleneck in the backend. We ethically and effortlessly provide billing for pain managing treatments assuring you maximum remittances for your acquired claim. We steer you through the guidelines of government as well as private insurance as per compliance with the latest norms.
We proceed with the filing of the pain management claim based on the list of prerequisite documents provided. This includes checking the validity of policy particulars such as effective policy date, co-insurance details, payable benefits, information of deductibles, all-round information of coverage, details regarding co-payment options, etc. We check your claim's eligibility and examine all details ensuring that no payments are due by you towards the insurance company before starting the claim process.
All documentation about your claims, such as bills, case files, and invoices are verified. We extensively scrutinize and identify any instances that could lead to the potential delay or rejection of the claim process. Kindly note that any fraudulent and/ or lapsed claims are flagged off right from the start.
The data to be entered includes patient demographic and treatment details, consulting physician particulars, hospital/ dental clinic information, and all corresponding code sets. Every bit of information entered into the billing software is double-checked. We ascertain that all filings comply with the rules of the insurance provider. Before submission of claim forms, we send them across to you for approval. Claims that pass the editing process are then translated to HIPAA-compliant ANSI format and submitted electronically to the insurance company. We provide you with an e-copy and a hard copy as per your request.
Prior permission helps us determine the maximum reimbursements that will be compensated for a procedure performed or undertaken. All final pay-outs can be tentatively gauged from pre-authorizations. Pre-authorization provides a clear understanding, beforehand, on the reimbursed amount a treatment institute is entitled to as well as the sum the patient is responsible for. This gives you time to apply for remittances from second insurances. We inform you of how to proceed in such cases. We help send across X-rays and/ or your medical charting for the same if required. Without pre-authorization, there is a possibility that an insurance company can decline payments. Hence it is strongly recommended.
All applications with incomplete details, mismatched codes, and invalid documentation are electronically (and sometimes manually) weeded out once entered into the billing software. Approved documents are cross-checked for compliance as per the insurance payer's payment policies. All approved claims that pass this stringent step are then issued a remittance advice statement.
All claims that are down-coded are thoroughly assessed and deliberated on to certify that you receive the benefits you are entitled to. All grouped (bundled) claims are individually checked to make sure that the payout is inclusive of all settlements.
We inform you of the pain management treatment expense covered by the health care/insurance provider as well as the payments that you could be responsible for. We provide complete details on deductibles, co-payments options as well as insurance plan exclusions.
All reports are perfectly developed and include all details such as claim amount due, charges, number of services billed, adjustments, payments (co-payments and deductibles), previously paid and unpaid amount, etc. A report is customized based on the type of treatment undertaken to make for easy read and comprehension.
We immediately rectify and resubmit any claims at instances where they are not following the terms and conditions of the insurance company. We are equipped with a complete understanding of the Centers for Medicare and Medicaid Services (CMS) Medicare reimbursement schedule and ascertain that tall submissions comply with the submission policies. Any denials are thoroughly verified, and subsequently, an appeal is made for reconsideration. Once approved, we file the denied claim as a new application.
All disputes are assertively deliberated on with the insurance provider. Our team is persuasive in granting settlements in previously denied claims caused by misspelling errors, any invalid or missing data, incorrect diagnosis/ service code, etc. any misunderstandings that could get in the way late are tackled earlier itself.
Our team provides total assistance and guides you on the steps that need to be undertaken in case of any misplaced documentation, bills, invoices, or any crucial data that could reject your claim. We instantly set to fix any complications that are unforeseen or rise out of the blue.
We maintain a database that includes complete information of the coverage details, patient and treatment center details, doctor particulars as well as treatments underwent. Any information can be easily sought out in the future. The data repository is completely confidential. We can be approached at any stage to obtain a duplicate copy from the management.
With persuasive verbal and written communication skills, we provide complete assistance for successful claim approval. We offer help concerning any lost data or misplaced documentation. We contact the concerned authorities to obtain duplicate copies of any bills or prescriptions in case of any mandatory missing information.
Our staff meticulously checks for errors in calculations to ensure that you do not lose out on any payments. Any inconsistencies are immediately notified and brought to the attention of the insurance agency.
Our coders have extensive knowledge of CPT, ICD-9 certified code for pain management. We also have an in-depth understanding of all codes required to code each pain management billing for insurance plan submission.
We make certain that you are reimbursed at the earliest. We speed- up any old remittance payment processing thus overcoming any more delay with your dues. Any wrongly calculated amounts, payments to be recovered from secondary insurers, etc. are dealt with at the earliest.
We take care of posting of insurance payments by carefully calculating payments in the billing software. Insurance payers sometimes club together several payments in one check or deposit. This is reflected in the ERA. We then sort out the payments and using these recovery amounts we thereby help you draw benefits from secondary claims. Once all insurance payments are acquired and after accounting for individual claims is done with the balance patient payment can then be billed. The above procedure makes it easy for obtaining full remunerations.
You can check the progress of your application via the tracking link provided to you. We take prompt action against any hurdles detected during the tracking process and strive to rectify it at that instant.
Our streamlined process is designed to empower healthcare institutes and practitioners, enhancing accuracy and efficiency in medical coding while ensuring compliance with regulations.
