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Our professionals are specialized coders and billers certified by the American Medical Association (AMA) and the American Academy of Professional Coders (AAPC). They bank on well-defined processes and latest personal injury-specific billing software to streamline billing processes. As a specialized personal injury billing service provider, we offer end-to-end billing services from insurance verification to billing; electronic claims submission to payment posting and follow-up. Here is how we streamline your billing process:
- Use personal injury-specific billing software integrated with EDI, EHR, and EMR to streamline billing with real-time patient data and comply with fee schedules, billing guidelines, and submission requirements of payers.
- Collate patient information (demographics, medical history, accident reports) and insurance provider information (name, address, pre-authorization requirements, effective dates, expiration dates, coverage details) and validate them to ensure accurate billing for claims submission.
- Determine any pre-authorization needs for services. Submit the documentation stating the medical necessity of procedures to get approval from insurance payers.
- Assign the correct ICD-10-CM codes, HCPCS Level II codes, and CPT ranges such as E/M codes (99201–99499), Diagnostic Services (70010–79999, Treatment Services (20000–29999), modifiers and revenue codes.
- Expertise in several billing models for personal injury procedures, such as fee-for-service, value-based payment, capitation, global billing, and more.
- Submit clean claims to insurance providers such as government programs (Medicare, Medicaid), private health insurance companies (Aetna, Anthem, Humana), Workers' Compensation Insurance, Veterans Affairs (VA) Insurance, and Health Maintenance Organizations (HMOs), among others.
- Reconcile claims against Explanation of Benefits (EOB) from payers and identify reasons for claims denials or rejections. Resolve the claims disputes and initiate the appeal process for maximum reimbursement.
- Analyze EOBs to clarify patients’ out-of-pocket expenses (copayments, deductibles, and coinsurance).
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