Frequently AskedFrequently AskedQuestionsQuestionsFrequently Asked Questions

We verify Patient Eligibility and Benefits two days prior to DOS.

We update your Patients Eligibility, Benefits verification and past balance directly into your EMR/EHR/PM and set an alert, so that no one in your office misses the vital information needed to inform and educate the patients at the time of visit.

Your staff can communicate with our staff via the HIPAA compliant messaging system that every EMR/EHR/PM has. Your staff can also call our staff through the dedicated phone number.

Yes, we have AAPC/AHIMA Certified Specialty Specific Coders to assist you with CPTs, ICD-10s and Modifiers based on LCD and NCD.

No, we will not make any changes to the CPT levels. We may query the provider for clarification, if we need to. We will have our Certified Clinical Documentation Specialists to educate the doctors on Clinical Documentation guidelines set by CMS and we can also help with setting up documentation template for the procedures.

Yes, we do audit 100% of charts to ensure accuracy and proper DX mapping.

Yes. We charge per chart basis or per Certified resource basis.

Our experienced billers have expertise with rules and guidelines specific to each state we work with, for both CMS and Medicaid. We use encoders, that are approved by the AAPC/AHIMA/CMS. Our billers have a minimum level of 7 years experience, working with several EMRs like, eClinicalWorks, AllScripts, eMDs, NextGen, Kareo, AdvancedMD, CollaborateMD, etc.

Our billers transfer claims within 3 business days and address any rejected claims within 2 business days.

Our billers post EOBs/ERAs into your EMR/EHR within 3 business days, this way we can address denials quicker.

We read and understand your insurance contractual fee schedule to keep track on Reimbursement vs Fee Schedule. We will work with the insurances to address lesser reimbursements.

Bliss is our proprietary Denial Management System. We have programmed Bliss in such a way that it can track every denial. This helps us to come up with 5 different reports to help us fix certain denials once for all.

Yes, we do send Patient Statements every 15/30 days depending upon your patient visit count. Also, we do a soft follow up after sending statements to ensure if the patients have received statements and answer any questions they may have.

We have a dedicated Toll-free number to answer your patients' questions. Our Patient Support staff are bilingual (English and Spanish).

The Bliss tool, has 15 different KPI reports and allows us to keep transparency with our clients extremely high. You can view/download 15 different KPI reports, which helps you measure and benchmark your revenue cycle and productivity based on MGMA ROI/RCM facts.