Full Cycle Revenue Management

Insurance verification and real-time data including accumulation on deductibles and stop-loss of primary, secondary, and tertiary patient policies are possible through our physician revenue cycle management services. Our claims billing services use AAPC (The American Academy of Professional Coders) certified coding which is done by professionals. Charge entry for any volume of charges and coding analysis, including all modifiers, is used as well to ensure that all claims maximize the allowable payer reimbursement.

Our revenue cycle management services use claim scrubbing to ensure there are no coding or claim information errors with immediate electronic transmission of claims. All claims are filed with the payers within 48 hours, thus allowing consistent cash flow for your practice. Our services allow you to receive claim status verification within 24 to 48 hours after submitting the claim, allowing our claims-acceptance rates to be above 96% with more than 98% of claims being processed by the payers in fewer than 19 days.

All required insurance claim forms are generated from the Ambit office and receive immediate insurance follow up. This allows a timely follow up on electronic remittance advice from the insurance companies.

Payment posting is accurately completed through our revenue cycle management services utilizing dedicated staff that is experienced in analyzing EOBs / ERAs, and payer rejection codes. Our EOB / ERA follow up process then analyzes the processed claims detail and then takes the necessary actions to recover the amounts due. We utilize denial management to allow minimal days in accounts receivable, in which highly effective specialists perform claim-by-claim denial review, pursue payment, and execute appeals on your behalf.

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