Erendiz can handle virtually every aspect of the revenue cycle process. We can work on your software platforms and can effectively handle the end-to-end revenue cycle management of your billing company.
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 in collecting patient demographics details from clinics and hospitals. Our team is well trained to process, verify, and validate demographic information into the billing system.
We have a well qualified staff that performs eligibility verification of benefits to avoid delays or issues in insurance coverage. The team then verifies coverage on any primary payers or any secondary payers, by payer websites AVRS(automated voice response systems), or by dialing phone calls to relevant payers. We also offer real-time pre-authorization services for walk-in patients.
Our team of expert medical coders then starts to abstract and assign the appropriate coding on your claims. They give appropriate CPT, ICD-10, and HCPCS codes in order to facilitate accurate claim submission downstream in the process.
Once all charges are posted to system, we submit your electronic claims to relevant payers (including HCFA 1500 claims). We work on all clearinghouse denials and give best suitable feedback with relevant suggestions, to reduce the number of claims that will not pass clearinghouse. A detailed report will be sent to you periodically. (on a daily, weekly, monthly, and yearly basis.)
Insurance payments are posted to patient accounts from Explanation Of Benefits (EOB's) into the client’s systems, with a turn-around-time between 24 hours to 48 hours. We also generate secondary claims and mail them to the right insurance companies. Daily payments are posted into the system which are reconciled with the bank’s deposit sheet on a daily basis.
Most insurance carriers are required to pay the claim or provide a denial in writing within 30 days of receipt. With our practical approach to handling denials, we can improve your “days in Accounts Receivables” substantially. All the denials are segregated and forwarded to our denial management team for prompt resolution. The team then measures, monitors, analyzes, and resolve all the denials received from each payer.
One of the most complicated areas to staff in a revenue cycle management company is PIF. (Patient Interaction Function.) By tradition, this function has been kept in-house and not outsourced. We can smoothly and effectively handle in-bound patient statement calls and outbound patient balance calls. There is nothing to worry about accents that are difficult to understand or knowledge of the American culture. Your end clients deserve the collection of every single penny in a dollar.
