Charge Entry and Audit Services | Streamlined Billing

PROCESS
Our Charge Entry Process
Collecting documents – Encounter forms, superbills, charge sheets, scanned documents, etc. through fax or other document management systems.
Gathering patient information – Gather patient demographic information, insurance details, and the information regarding services rendered.
Verifying insurance coverage – Verify insurance coverage to ensure the patient is eligible for the services provided.

Reviewing medical records – Review medical / health records to ensure that the services provided are accurately captured and billed.

Assigning codes – Ensure procedural and diagnosis codes, with specialty-appropriate modifiers are applied to the services rendered.

Entering charges – Once the codes have been assigned, charges are entered into the medical billing system. This includes the charges for the services provided, any co-payments, and deductibles.

Double-checking entries – Before submitting the charges to the insurance company, entries are double-checked to ensure that all information is accurate.

Submitting claims – The final step in the charge entry process involves submitting the claims to the insurance company for payment.

Reporting – Providing daily reports to the customer and resolving pending issues for improved process turn-around time.

PROCESS
Our Charge Audit Process
Reviewing charges – The charges are reviewed to ensure they are accurate and compliant with the coding guidelines and policies of the payer.
Identifying coding errors – Coding errors, such as incorrect modifiers, upcoding, and undercoding, are identified to prevent denials or audits from payers.

Checking documentation – The documentation is checked to ensure that it supports the medical necessity of the services provided and meets the requirements of the payer.

Verifying reimbursement – The reimbursement is verified to ensure that it is consistent with the contracted rates and the fee schedules of the payer.