RCM FAQ

What services do you offer?

Some practices prefer to keep some of their functions in-house, such as patient registration and charge entry. This allow us to reduce our labor and offer a lower percentage rate to our clients. Depending upon the specific needs of your practice, our services include but are not limited to the following:

  • CPT Coding review and fee schedule analysis
  • Input of patient demographics, referral information and authorization numbers
  • Posting and balancing of daily charges and co-payments
  • Charge & appointment reconciliation to ensure all charges are captured
  • Submission and verification of electronic claims
  • Editing of electronic claim denials for resubmission
  • Posting and balancing of all payments received
  • Handling appeals for denial resolution
  • Generating electronic patient statements and collection letters
  • Working the aged accounts receivable reports to follow-up on past due claims
  • Production of monthly financial reports for managerial review
  • Quarterly consulting to discuss practice financials and software updates with an Account Service Manager

What are the benefits of outsourcing my billing?

  • Eliminate postage and forms purchasing expenses
  • Reduce billing related staffing expenses
  • Consistent cash flow due to timely and accurate claim submissions
  • Faster reimbursements due to electronic claims filing
  • Complete confidentiality and security of your patient data
  • Personalized and comprehensive support for your staff and patients
  • Billing inquiries are handled by a dedicated Patient Accounts Manager
  • Eliminate costly software maintenance fees and patient portal fees
  • Free up valuable staff time to focus on patient care
  • We serve as an experienced advisor regarding all billing concerns and act as a liaison to the insurance companies on your behalf

How do I maintain control over my receivables?

  • We provide you with transaction reports on a schedule basis or upon request. Additionally, we schedule regular monthly, quarterly meetings with a dedicated Account Services Manager to personally go over your reports and assess your accounts receivables.

What items are needed for the billing center to process my daily charges?

  • For clients not using our EMR, we need a superbill indicating CPT and ICD-10 codes
  • For clients not entering their own patient information, we need a copy of their registration form
  • For clients not scanning the insurance card into the software, we need a copy of the card
  • Referral / Authorization information (if applicable)

How are the insurance and patient checks processed?

  • Normally, the checks continue to be mailed to your office. The following items are needed for payment posting and insurance appeals:
    • Most Insurance EOBs will come to us electronically for processing
    • Paper Insurance EOB’s (We provide a scanner for sending paper EOBs)
    • Copies of patient checks unless these are being posted in-house
    • Any other billing related correspondence (denial EOB’s, etc.)