For example, if a fourth or fifth digit level of specificity is required on a diagnosis code (such as with ICD-9 code 250.13 -- diabetes with ketoacidosis type I insulin dependent, uncontrolled), and the physician has provided only three digits, then our staff will notify the physician of the need for a more specific code before the claim is submitted for reimbursement. Additionally, we will review your fee schedule to minimize your risk of underpayment (e.g. Medicare or Medicaid paying the lower of cost or charges).
Our registration database has capability for a virtually limitless history of insurance carriers as well as different primary insurers for members of the same family. Our attention to detail and persistent follow up effort during the registration process insures timely, accurate claim adjudication. This translates to quick cash turnaround for our clients. We also verify authorization for outpatient treatment and maintain this information in our unique referral authorization tracking checklist. We share this tracking information with our clients to insure that all services rendered are paid. Our electronic communication capabilities minimize client effort and claims adjudication time.
My staff is experienced in their specific client’s attributes of procedural and diagnosis coding as well as Medicare’s correct coding initiative with respect to ICD-9/CPT agreement. Our software and procedures can be customized to identify specific instances of compliance or denial risk.
Our fees range from an approximate of 6% to 11% of cash receipts, depending on volume and complexity and are in compliance with the inspector general’s guidance for medical billing companies.
Cash Flow Management, Compliance, and Collection Services are also provided on both per engagement and contingency bases.