We take care of all the billing and collections allowing you to increase revenue as we optimize efficiency and improve your cash flow which allows the provider to focus on patient care. Our highly experienced team can pre-empt claims rejections and identify underpayments for a more timely reimbursement.
The advanced functionality of EHS complete technology enabled Billing and Revenue Cycle Management (RCM) Solutions delivers total control across patient flow, account management, claims processing and performance analysis.
The first step in a clean claim is to make certain that the demographic information has been entered into the system correctly. This process involves collecting patient demographics from clinics and hospitals. Our team is trained to process, verify, and validate demographic information into the billing system.
Charge entry is one of the key areas in medical billing. In the medical billing charge entry process, created patient accounts are assigned with the appropriate $ value as per the coding and appropriate fee schedule. The charges entered will determine the reimbursements for physician’s service. Therefore, care should be taken to avoid any charge entry errors which may lead to denial of the claims. Moreover, good co-ordination between the coding and the charge entry team will produce enhanced results.
Charge entry process at EHS:
We ensure every medical claim is submitted properly. Our system metrics was created with a unique series of checks and balances, which allows for a quick turnaround time. At EHS, we have a strict “no error, no delay” policy. This process reduces the number of days your medical claim is outstanding. We understand our clients’ cash flow requirements.
Patient statements help you reduce your costs and save time by billing your patients quickly and efficiently. With patient statements, you can create a fully electronic billing and payment experience for your patients and leverage traditional print and mail statement workflow. By automating your patient billing process you can accelerate cash flow, lower your costs, and save precious time, while providing greater convenience to your patients.
At EHS, payment posting in medical billing is one of the key processes that get the utmost attention from our Operations management. The payments in lieu of claims, which are received from the Payer and Patients, are posted in the medical billing system of the client to reconcile the claim. EHS also does electronic payment posting in to the medical billing software and handles the exceptions (fallouts) manually to make sure no payment is missed. The posted ERAs are stored either in the billing system or a Document Management system (DMS) for future reference.
All payers either send an EOB (explanation of benefits) or ERA (electronic remittance advice) towards the payment of a claim. The medical billing staff posts these payments immediately into the respective patient accounts, against that particular claim to reconcile them. The payment posting is handled according to client-specific rules that would indicate the cut-off levels to take adjustments, write-offs, refund rules etc.
When the client’s office delays in either depositing the Payer checks or sending the ERAs and EOBs for posting, then a negative balance prevails for that claim, which is a false representation of the actual scenario. This false representation would show an inflated AR, resulting in the Physicians not knowing exactly how much revenue is due to them.
There could be several reasons why the patient needs to pay a part of the expenses including co-pays, deductible and non-covered services. If the amount due from the patients is very minimal, the Provider can set a mandate for taking write-offs. If the amount is quite large, then it should be collected from the patients either prior to or after rendering the services. Patients typically pay through checks or credit cards (via patient portals) and these need to be correctly accounted against the claim to avoid any inflated AR and proper closing of the claim.
EHS India is dedicated to minimize lost reimbursements and denials with highly efficient systems and services designed to meet our clients’ needs. One of the major problems faced by healthcare providers and medical billing companies is that a large proportion of rejected claims goes unattended and is never resubmitted. EHS Denial Management processes uncover and resolve the problem leading to denials and shorten the accounts receivables cycle. The denial management team establishes a trend between individual payer codes and common denial reason codes. This trend tracking helps to reveal billing, registration and medical coding process weaknesses that are then corrected to reduce future denials, thus ensuring first submission acceptance of claims. Also, the payment patterns from various payers are analyzed for setting up a mechanism to alert when a deviation from the normal trend is seen.
For claims that are denied and need to be appealed, appeal letters are prepared and sent along with supporting documents including Medical Records for processing. If the insurance permits telephonic or fax appeals, the same is also handled through those channels.